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When PGDs can be used

Last updated See all updates
Topics: Patient Group Directions

Understanding when PGDs are a suitable mechanism for the supply and/or administration of medicines ensures an appropriate legal framework for service provision.

This article forms part of a series
  1. Introduction to PGDs
    1. When PGDs can be used
    2. When not to use a PGD
    3. P and GSL medicines with PGDs

Contents

  1. Using a PGD
    1. Scenarios when a PGD can be used
  3. Special considerations
    1. Antimicrobials
    2. Black triangle medicines
    3. Off label use of licenced medicines
    4. End of life care
    5. Controlled drugs
  5. Update history

Using a PGD

PGDs must only be used where there is no other suitable mechanism for the administration or supply of the medicine within the legislation. Careful consideration should be given to opportunities within the care pathway to use a prescription or a Patient Specific Direction (SPS page) and also consider the use of relevant HMR 2012 Schedule 17 or 223  exemptions.

Patient Group Directions NICE Guideline MPG2 (2017) states that organisations should consider investing in the training of additional non-medical prescribers to enable the redesign of services if necessary.

PGDs must not be used to manage inefficiencies within services.

Scenarios when a PGD can be used

Examples include:

  • vaccinations
  • minor injury units and other, non-prescriber led, first contact services including community pharmacy services
  • services where assessment and treatment follows a clearly predictable pattern such as NHS immunisation clinics, contraception clinics and sexual health services.

Special considerations

Specific guidance is provided on including the following medicines in a PGD.

Antimicrobials

Advice is provided in NICE Guideline MPG2 (2017), recommendation 1.1.10:

‘Do not jeopardise local and national strategies to combat antimicrobial resistance and healthcare-associated infections. Ensure that an antimicrobial is included in a PGD only when:

  • clinically essential and clearly justified by best practice guidance
  • a local specialist in microbiology has agreed that a PGD is needed and this is clearly documented
  • use of the PGD is monitored and reviewed regularly’

Video explainer

This PGD explainer discusses the appropriate use of PGDs for the supply and/or administration of antimicrobials.

Black triangle medicines

Advice is provided in NICE Guideline MPG2 (2017), recommendation 1.1.8:

‘Ensure that a black triangle medicine is included in a PGD only when clearly justified by best clinical practice. Clearly indicate the black triangle status on the PGD.’

Video explainer

This short video discusses the appropriate use of PGDs for the supply and/or administration of medicines with black triangle status.

Off label use of licenced medicines

Advice on off label use of medicines within PGDs can be found in:

Video explainer

This video outlines the appropriate inclusion of off label medicine use within PGDs.

End of life care

Advice on the use of PGDs in End of Life Care (EoLC) can be found in the SPS resource Patient Group Direction use in End of Life Care (SPS page).

Video explainer

This PGD explainer discusses why the use of PGDs for the supply and/or administration of medicines in end of life care is often not appropriate.

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Controlled drugs

Not all controlled drugs can be supplied or administered under a PGD. Further information can be found in Supply and/or administration of Controlled Drugs under a PGD (SPS page).

Video explainer

This PGD explainer discusses the appropriate use of PGDs for the supply and/or administration of controlled drugs.

Update history

  1. Republished
  2. Page contents reviewed; no amendments required.
  1. Video format updated
  1. Links to relevant exemptions added
  1. Reformatting, video explainers added and further information section removed
  1. Published