Abstract
The Berkshire 4 Way Agreement (4WA) is a programme to deliver shared care by general practitioners (GPs), pharmacists and drug agency staff to drug misusers who are prescribed methadone. The programme integrates elements of treatment and harm minimisation. It is a practical response both to the health needs of patients and the need for support for a range of different professionals in primary and specialist care. Interviews were conducted with 37 professionals and patients within Berkshire, England and were analysed using a qualitative methodology. All participants stated that the scheme improved the care and quality of life for patients and improved patient-professional and inter-professional relationships. However, a need for additional specialist and generic services was identified; problems and practical issues and their solution were detailed. All in all, the professionals participating in the 4WA were enthusiastic about its merits. It demonstrates the benefits of shared care, particularly the participation of pharmacists, and fits well into the national modernisation agenda. The study is intended to inform policy and practice in other areas wishing to develop similar schemes.
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