Use of Patient Group Directions by registered healthcare professionals undertaking training or competency assessment

Jo Jenkins, Specialist Pharmacist (Patient Group Directions) SPS Medicines Use and Safety Division Source NHS PGD WebsitePublished Last updated See all updates

This Q&A outlines the advice on the use of PGDs by registered healthcare professionals who are undertaking training and/or competency assessment.

Questions have been asked as to whether or not registered health professionals who are trainee injectors can administer injections under PGD whilst being supervised.

It is not specified in legislation that only trained and competent professionals should be authorised to practice under PGDs.  However, members of the PGD Service Advisory Board who include representatives from the Department of Health and Social Care (DHSC), Care Quality Commission (CQC), Medicines and Healthcare products Regulatory Agency (MHRA), National Institute of Health and Care Excellence (NICE) have produced this advice to support organisations.

The MHRA have advised that the original Department of Health guidance envisaged PGDs would only be used by fully trained health professionals and it is doubtful there was any expectation that they would be used for training purposes.

NICE Medicines Practice Guideline for PGDs (2017) provides good practice recommendations for individual people and organisations involved with PGDs, with the aim of ensuring patients receive safe and appropriate care and timely access to medicines, in line with legislation. Both organisations and individual practitioners have legal and governance responsibilities which are specified in the guidelines under a number of recommendations.

NICE Medicines Practice Guideline for PGDs (2017) states:

 1.7 Training and competency:

1.7.1 Identify the senior person in each profession who is responsible for ensuring that only fully competent, qualified and trained health professionals use PGDs.

If an organisation decides to disregard NICE recommendations, in full or in part, it would be advised to formally note and record any justification for this non-compliance with NICE guidelines.  It is also suggested that the organisation carries out a local risk assessment, documents any decisions and records any justification for non-compliance (with evidence to support the decision) at Trust Board level, in line with good governance procedures.

The Health and Care Professions Council (HCPC) have advised the PGD Service Advisory Board that:

Registrants are required to practice in accordance with HCPC standards having regard to other guidance for best practice, such as that produced by NICE. Registrants are expected to practice within the legal and ethical boundaries of their profession, ensuring that they only act within the limits of their knowledge, understanding and skills at all times. HCPC acknowledges the intent behind the legislation on PGDs and the position taken in the NICE guidance. Whilst the use of PGDs for training purposes is a matter for organisations, HCPC expects registrants to always make decisions which can be justified in the best interests of patients.

REVIEW 2019: This Q&A was reviewed by the HCPC in 2019 and their position remains unchanged.

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