Patient Group Directions in Complex Commissioning Scenarios

Commissioning of NHS and publically funded health services has become increasingly complex with many services provided by a number of providers with sub-contracting or sub-commissioning arrangements; in addition to complex provider arrangements sometimes more than one commissioner may be involved. When Patient Group Directions (PGDs) are used to provide commissioned services it can potentially become complicated when determining which organisation is responsible for developing, implementing, authorising, adopting and managing PGDs. There is no ‘one size fits all’ model and varying systems have developed.

The PGD Board has frequently been asked for support in determining lines of responsibility for PGD governance in such complex arrangements. As structures differ widely it is difficult to give specific advice but we recognise that commissioners and providers require support and guidance in determining the best process for their own local system. The PGD Board has produced the attached guidance document which poses a number of questions and considerations to support and guide both commissioners and providers (commissioned organisations) on the principles to consider when developing PGDs for NHS or publicly funded services which are being provided in such structures. Not all questions posed will be relevant to all organisations and structures but readers are advised to consider the document as a whole to support and guide any decision making process and be mindful of their own organisation’s governance processes.

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