Questions are frequently asked around the use of Patient Group Direction (PGDs) use in End of Life Care (EoLC).
As with any other patient pathway clinicians should be mindful that NICE guidance on PGDs states ‘Provide the majority of clinical care involving supplying and/or administering medicines on an individual, patient-specific basis. Reserve patient group directions (PGDs) for limited situations in which this offers an advantage for patient care, without compromising patient safety, and where there are clear governance arrangements and accountability.’
EoLC specialist clinicians and GPs will be involved in an individual’s EoLC and so able to prescribe on an individual, patient specific basis (see Questions about Patient Specific Directions (PSD)). As a result the potential need for PGDs in EoLC is likely to be very limited, if at all, and there are several legislative restrictions which organisations must be mindful of if considering PGD use. These are summarised in the table below.
Organisations are responsible for ensuring that any PGD they develop is not only legal and clinically appropriate in the care pathway but not used to overcome inefficiencies within systems.