The preferred way for patients to receive medicines is for trained health professionals to prescribe for individual patients on a one-to-one basis.
Patient Group Directions NICE MPG2 (2017) states that the supply or administration of medicines under PGDs should be reserved for those limited situations where this offers advantage for patient care without compromising patient safety.
It is for the individual organisation to decide which mechanism(s) to use, taking account of patients’ needs (including safety) and how the particular service is being structured and delivered.
Prescribing (including non-medical prescribing) should be considered if this offers an appropriate and safer alternative for patients to access the services they need in a timely manner (although this will of course be dependent on the how and where the individual service is being delivered).
As the NICE MPG2 2017 acknowledges, local interpretation has allowed PGDs to be used in a wide range of circumstances, provided that this can be done safely.
PGDs are not intended for the long-term and open ended supply of medicines to patients, but there is nothing to prevent them being used for the supply of repeat contraception or other medicines where there is a clearly defined episode of care such as the administration of a second dose of a vaccine, 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’ should not be interpreted as indicating that the patient cannot be known to the service in advance of a medicine being supplied or administered.
The intent of this statement is to help ensure that medicines are only ever supplied in circumstances using a PGD when it is appropriate and legal.
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 patient against the PGD for each discrete episode of care and ensure that records are kept up to date. Robust referral and information transfer processes should be in place as well as the relevant clinical governance and audit arrangements to ensure patient safety.