Shared-care planning across primary, secondary and tertiary care

Overview & Definition

Picture a school-age child with epilepsy who sees a tertiary neurologist twice a year, a local paediatrician for intercurrent illness, and a GP for scripts. The neurologist changes the medicine. The letter arrives late. The GP issues the old dose. Mother carries both plans in her handbag. That is multi-level care without shared-care planning. [1] [3]

Shared care is deliberate co-management of a child’s problems across care levels. Primary care holds whole-child continuity. Secondary care provides local paediatric and ambulatory specialty capacity. Tertiary care concentrates rare expertise, complex procedures and high-intensity programmes. Shared care does not mean every child needs every tier. It means that when more than one team is involved, roles, information and decisions stay coherent. [5] [17] [18]

Haggerty’s continuity framework still applies. Relational continuity is being known. Informational continuity is usable past information. Management continuity is one coherent plan when several clinicians act. Shared-care planning is how you build management continuity across levels. [16]

[17] [18] [19]

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