Scope of templates
The SPS national Patient Group Direction (PGD), protocol and written-instruction templates are written in alignment with relevant national guidance to be applicable to a wide range of services, clinical environments and patient cohorts.
The templates are intended to support, not substitute, relevant national guidance and as such should always be used in practice alongside supporting guidance.
As the templates are intended to be used in a variety of different services and clinical environments, organisations may need to locally adapt the content to meet the needs of their local populations or service model, and other aspects such as laboratory reporting systems. For more information see Implementing the SPS Patient Group Direction, Written Instruction and protocol templates (SPS Page).
Transfer of templates to an accessible format
- All SPS PGD and protocol templates are being transferred to an accessible format as part of wider work within SPS to improve accessibility and user experience.
- All new and updated templates published from autumn 2025 will be in the accessible format.
- Current published templates will be gradually transferred to the new format and republished. As there will be no change to the clinical or pharmaceutical content the version number and expiry dates will remain unchanged. This work will be completed by autumn 2026.
- There is no requirement for organisations using previous non-accessible formats of the templates to transfer to the new accessible templates upon publication unless they wish to do so.
New or recently updated templates
Our most recently updated or new templates, listed in date order.
December 2025
November 2025
- Co-amoxiclav for human and animal bites
- Doxycycline and metronidazole for human and animal bites
- Combined hormonal contraceptive vaginal ring
- Levonorgestrel 1500 microgram tablets for emergency contraception
- Progestogen only pill (POP) for contraception
- Ulipristal acetate 30mg tablets for emergency contraception
- Combined oral hormonal contraceptive (COC) in reproductive health
- Combined hormonal contraceptive transdermal patch
- Malathion for scabies
- Permethrin for scabies
- Emtricitabine and tenofovir disoproxil (TD) tablets as PrEP
- Folic acid 5mg tablets for use during pregnancy
- Ceftriaxone intramuscular injection for Neisseria gonorrhoeae
October 2025
- Azithromycin (oral) for use within sexual health services
- Doxycycline for use within sexual health services
- Omeprazole for use within antenatal and maternity services
- Diazepam injection for seizures or symptomatic cocaine toxicity management
- Rectal diazepam for managing seizures
- Buccal midazolam for seizures or symptomatic cocaine toxicity management
- Lidocaine 10mg/ml spray for IUD insertion or removal
- Lidocaine plus prilocaine cream for IUD insertion or removal
- Nitrofurantoin for Urinary Tract Infection (UTI)
- Trimethoprim for Urinary Tract Infection (UTI)
Ambulance
Created by SPS with the support of National Ambulance Service Medical Directors (NASMeD) and Joint Royal Colleges Ambulance Liaison Committee (JRCALC).
- Diazepam injection for seizures or symptomatic cocaine toxicity management
- Rectal diazepam for managing seizures
- Buccal midazolam for seizures or symptomatic cocaine toxicity management
- Flumazenil injection for reversal of midazolam
- Tranexamic acid injection for treatment of severe haemorrhage
Community Pharmacy
The NHS Pharmacy First Service PGDs/protocols can be found at:
Community Pharmacy advanced service specification: NHS Pharmacy First Service
Any queries regarding the NHS Pharmacy First Service PGDs/protocols should be directed to: ENGLAND.CommunityPharmacy@nhs.net
Infection and infectious diseases
Created by SPS with the support of specialist stakeholders including National Institute for Health and Care Excellence (NICE), Royal College of General Practitioners (RCGP), British Association for Sexual Health and HIV (BASHH), UK Health Security Agency (UKHSA) and NHS England (NHSE).
Central nervous system infections
Hepatitis C
Created by SPS with the support of specialist stakeholders working within clinical practice.
The hepatitis C PGDs have now been shared with the Operational Delivery Networks (ODNs) by the hepatitis C elimination team at NHS England.
Any queries regarding access to the hepatitis C PGDs should be directed to: ENGLAND.hepc-enquiries@nhs.net
Respiratory tract infections
- Doxycycline for sinusitis
- Fluticasone furoate nasal spray for sinusitis
- Clarithromycin for sore throat
- Clarithromycin for otitis media
- Mometasone furoate monohydrate nasal spray for sinusitis
- Penicillin V (phenoxymethylpenicillin) for sinusitis
- Penicillin V (phenoxymethylpenicillin) for sore throat
- Erythromycin for sinusitis
- Erythromycin for sore throat
- Erythromycin for otitis media
- Clarithromycin for sinusitis
- Otigo (phenazone with lidocaine) ear drops for otitis media
- Amoxicillin for otitis media
Skin infections
- Co-amoxiclav for human and animal bites
- Doxycycline and metronidazole for human and animal bites
- Valaciclovir for shingles
- Aciclovir for shingles
- Flucloxacillin for infected insect bites or stings
- Hydrogen peroxide 1% cream for impetigo
- Flucloxacillin for impetigo
- Clarithromycin for impetigo
- Clarithromycin for infected insect bites or stings
- Erythromycin for infected insect bites or stings
- Erythromycin for impetigo
- Fusidic acid 2% cream for impetigo
Skin infestations
Urinary tract infections
Occupational health services
Written instruction templates for use in occupational health services, created by SPS and published annually.
Pregnancy and supportive medicines
For use in antenatal and maternity services across all healthcare sectors.
Created by SPS and NHSE, with the support of specialist stakeholders working within clinical practice and the Royal College of Obstetrics and Gynaecology (RCOG), as part of the wider Preventative Medicines in Pregnancy programme.
- Aspirin tablets for use within antenatal and maternity services
- Folic acid 5mg tablets for use during pregnancy
- Omeprazole for use within antenatal and maternity services
- Intrapartum administration of benzylpenicillin sodium
- Terbutaline injection for use in labour within maternity services
Public Health
PGD templates are developed by UKHSA for a variety of clinical scenarios.
Note these PGDs are not developed by SPS; any queries regarding these templates should be directed to the UKHSA immunisation team at immunisation@ukhsa.gov.uk
Radiology
Created by SPS, NHS England, the Royal College of Radiologists (RCR) and the Society and College of Radiographers (SCoR), with the support of specialists working within NHS clinical practice. For use in radiology service in NHS England commissioned services.
- Intravenous hyoscine butylbromide
- Gadoxetate disodium contrast agent
- Gadoteridol contrast agent
- Ioversol contrast agent
- Iomeprol contrast agent
- Gadoteric acid contrast agent
- Gadobutrol contrast agent
- Gadobenate dimeglumine contrast agent
- Iopamidol contrast agent
- Iohexol contrast agent
- Iodixanol contrast agent
- Sodium chloride 0.9% in multi injector devices
- Gadopiclenol contrast agent
Reproductive health and contraception
For use within reproductive health and contraception services across all healthcare sectors.
Created by SPS and the College of Sexual and Reproductive Health (CoSRH), with the support of specialist stakeholders working within clinical practice.
- Etonogestrel (e.g. Nexplanon®) implant for contraception
- Ulipristal acetate 30mg tablets for emergency contraception
- Lidocaine injection for subdermal etonogestrel in contraception
- Progestogen only pill (POP) for contraception
- Lidocaine plus prilocaine cream for IUD insertion or removal
- Copper Intrauterine Device (Cu-IUD)
- Progestogen-Only Intra-Uterine Device (LNG-IUD) for contraception
- Levonorgestrel 1500 microgram tablets for emergency contraception
- Lidocaine 10mg/ml spray for IUD insertion or removal
- Medroxyprogesterone acetate (SC-DMPA) injection for contraception
- Combined hormonal contraceptive transdermal patch
- Combined hormonal contraceptive vaginal ring
- Combined oral hormonal contraceptive (COC) in reproductive health
- Medroxyprogesterone acetate (DMPA) IM injection for contraception
Sexual health
For use within sexual health services across all healthcare sectors.
Created by SPS and the British Association of Sexual Health and HIV (BASHH)/British Association of HIV (BHIVA), with the support of specialist stakeholders working within clinical practice.
- Podophyllotoxin (topical) for external anogenital warts
- Imiquimod 5% w/w cream for anogenital warts
- Emtricitabine and tenofovir alafenamide (TAF) tablets as PrEP
- Emtricitabine and tenofovir disoproxil (TD) tablets as PrEP
- Ceftriaxone intramuscular injection for Neisseria gonorrhoeae
- Doxycycline for use within sexual health services
- Azithromycin (oral) for use within sexual health services
- Aciclovir (oral) for genital HSV infection
- Clotrimazole pessaries for candidiasis
- Fluconazole 150mg capsules for candidiasis
- Clotrimazole cream for candidiasis and candidal balanoposthitis
- Emtricitabine/tenofovir and raltegravir tablets for HIV PEP
- Metronidazole (oral) for use within sexual health services
- Doxycycline post exposure prophylaxis (doxyPEP)
Smoking cessation
Created by SPS with the support of specialist stakeholders including the National Centre for Smoking Cessation and Training (NCSCT), College of Mental Health Pharmacy (CMHP) and NHSE.
Templates in development
No new templates currently in development.