Patient Group Directions are not an appropriate mechanism for regular repeated supplies or administration of a medicine. Prescribing is preferred.

Best practice

The preferred way for individuals to receive medicines is for trained health professionals to prescribe for individuals on a one-to-one basis.

Guidance

NICE PGD guidance states that the majority of clinical care involving supplying and/or administering medicines should be on an individual, patient-specific basis and the supply or administration of medicines under PGDs should be reserved for those limited situations where this offers advantage for care without compromising patient safety.

It is for individual organisations to decide which mechanism(s) to use, taking account of safety, the needs of individuals and how the particular service is being structured and delivered.

PGD use in long term conditions

PGDs are not intended for the management of long-term conditions or the long-term, repeat supply of medicines to individuals to manage a long term condition.

Management of medicines for long term conditions should be part of holistic care undertaken by a prescriber.

SPS have further advice in Using PGDs to manage long term conditions.

PGD use in discrete episodes of care

The legislation does not prevent PGDs being used for the supply of repeat contraception/PrEP or the administration of a second/subsequent dose of a vaccine where each supply/administration is a clearly defined, discrete episode of care rather than long term management of a medical condition.

The part of definition of a PGD that states that it ‘…applies to patients who may not be individually identified before presenting for treatment…’ does not mean that an individual cannot be known to the service in advance of a medicine being supplied or administered.

Therefore, if the PGD is used for a repeat supply or repeat administration of a medicine, each practitioner working under the PGD needs to assess the individual against the PGD for each discrete episode of care and ensure that records are maintained in line with the requirements of the PGD.

Where appropriate robust referral and information transfer processes should be in place.

Update history

  1. Link added to SPS article on using PGDs to manage long term conditions
  1. Reformatted page
  1. Content reviewed by SPS PGD Service Advisory Board as part of rolling content review and republished.
  2. Published