Shared care can work

EDITOR,—We welcome D A Fitzmaurice and colleagues' reference to quality assurance in their editorial on monitoring anticoagulation in primary care.1 In 1993 we have introduced a formal shared care policy for monitoring oral anticoagulant treatment in a district where few general practitioners are prepared to manage their own patients.2 This policy clearly defines areas of responsibility for the hospital, general practitioners, and community nurses.

A “yellow anticoagulant book” is used as the principal means of communication. Patients are initially seen in the clinic and are subsequently transferred to a community sampling system. …