PGDs

Question 1

What are Patient Group Directions (PGDs)?

Answer 1

• A written instruction for the sale, supply and/or administration of named medicines in an identified clinical situation. It applies to groups of patients who may not be individually identified before presenting for treatment.
• Only certain qualified professionals may supply or administer under a PGD.
• PGDs may be used by NHS organisations and services contracted to the NHS, private hospitals and clinics, prison healthcare etc.

Question 2

What medicines can be included on a PGD?

Answer 2

• All POMs, Ps, GSLs
• In a pharmacy, supply of P and GSL medicines should not be on a PGD unless the PGD authorises a supply outside of a medicinal product’s marketing authorisation.
• Some controlled drugs
• May, exceptionally, include unlicensed (‘off-label’) use if justified by current best clinical practice and if PGD clearly records the status of medicine
• PGDs cannot include unlicensed medicines.

Question 3

What details should a PGD contain?

Answer 3

• The name of the business who owns the direction.
• The start and end date of the PGD.
• A description of the medicine(s).
• The class of the health professional who can supply or administer the medicine.
• A signature of a doctor or dentist (as appropriate) and a pharmacist.
• A signature by an appropriate organisation (e.g. clinical commissioning groups, local authorities, NHS trusts or NHS foundation trusts, special health authorities, the NHS Commissioning Board).
• The clinical condition or situation to which the direction applies (e.g. the specified condition/conditions that can be treated).
• A description of patients excluded from treatment under the direction.
• A description of when you should get more advice from a doctor (or dentist, as appropriate) and arrangements for referral.
• Details of appropriate dosage, maximum total dosage, quantity, pharmaceutical form and strength, route and frequency of administration, and minimum or maximum period to administer the medicine.
• Relevant warnings, including potential adverse reactions.
• Details of any necessary follow-up actions.
• A statement of the records to be kept for audit purposes.

Question 4

When is best to use a PGD?

Answer 4

• Emergency hormonal contraception.
• Antimicrobials for impetigo, conjunctivitis, urine infections etc.
• Analgesia (acute).
• Immunisation (e.g. flu, COVID, travel).
• Antiviral medicines for treatment or prophylaxis of influenza.