Scope of templates
The SPS national 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.
New or recently updated templates
PGD templates published or updated within the last 3 months (in date order, most recent at the top).
- Doxycycline post exposure prophylaxis (doxyPEP)
- Medroxyprogesterone acetate (SC-DMPA) injection for contraception
- Medroxyprogesterone acetate (DMPA) IM injection for contraception
- Intravenous hyoscine butylbromide
- Gadobutrol contrast agent
- Gadoteric acid contrast agent
- Gadobenate dimeglumine contrast agent
- Gadoteridol contrast agent
- Gadoxetate disodium contrast agent
- Gadopiclenol contrast agent
- Iomeprol contrast agent
- Iopamidol contrast agent
- Iohexol contrast agent
- Iodixanol contrast agent
- Ioversol contrast agent
- Folic acid 5mg tablets for use during pregnancy
- Combined oral hormonal contraceptive (COC) in reproductive health
- Progestogen only pill (POP) for contraception
- Tranexamic acid injection for treatment of severe haemorrhage
- Flumazenil injection for reversal of midazolam
- Valaciclovir for shingles
- Aciclovir for shingles
- Lidocaine injection for subdermal etonogestrel in contraception
- Ulipristal acetate 30mg tablets for emergency contraception
- Cytisinicline for smoking cessation
Ambulance
Created by SPS with the support of NASMeD and JRCALC.
- Diazepam rectal tubes for managing seizures
- Tranexamic acid injection for treatment of severe haemorrhage
- Buccal midazolam for the management of seizures
- Flumazenil injection for reversal of midazolam
- Diazepam solution injection for managing seizures
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 NICE, RCGP, ARPHAI, UKHSA and 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
- Clarithromycin for sinusitis
- Clarithromycin for otitis media
- Fluticasone furoate nasal spray for sinusitis
- Otigo (phenazone with lidocaine) ear drops for otitis media
- Penicillin V (phenoxymethylpenicillin) for sinusitis
- Amoxicillin for otitis media
- Erythromycin for sore throat
- Erythromycin for otitis media
- Doxycycline for sinusitis
- Mometasone furoate monohydrate nasal spray for sinusitis
- Erythromycin for sinusitis
- Clarithromycin for sore throat
- Penicillin V (phenoxymethylpenicillin) for sore throat
Skin infections
- Aciclovir for shingles
- Clarithromycin for infected insect bites or stings
- Fusidic acid 2% cream for impetigo
- Erythromycin for infected insect bites or stings
- Clarithromycin for impetigo
- Flucloxacillin for infected insect bites or stings
- Flucloxacillin for impetigo
- Hydrogen peroxide 1% cream for impetigo
- Valaciclovir for shingles
- Erythromycin for impetigo
Urinary tract infections
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.
- Omeprazole for use within antenatal and maternity services
- Terbutaline injection for use in labour within maternity services
- Benzylpenicillin for Group B Streptococcus for use in neonates
- Folic acid 5mg tablets for use during pregnancy
- Aspirin tablets for use within antenatal and 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
- Gadopiclenol contrast agent
- Sodium chloride 0.9% in multi injector devices
- Ioversol contrast agent
- Gadoxetate disodium contrast agent
- Gadoteridol contrast agent
- Gadobenate dimeglumine contrast agent
- Gadoteric acid contrast agent
- Gadobutrol contrast agent
- Iodixanol contrast agent
- Iohexol contrast agent
- Iopamidol contrast agent
- Iomeprol contrast agent
Reproductive health and contraception
For use within reproductive health and contraception services across all healthcare sectors.
Created by SPS and the Faculty of Sexual and Reproductive Health (FSRH), with the support of specialist stakeholders working within clinical practice.
- Copper Intrauterine Device (Cu-IUD)
- Lidocaine 10mg/ml spray for IUC insertion or removal
- Lidocaine plus prilocaine cream for IUC insertion or removal
- Progestogen-Only Intra-Uterine Device (LNG-IUD) for contraception
- Medroxyprogesterone acetate (SC-DMPA) injection for contraception
- Medroxyprogesterone acetate (DMPA) IM injection for contraception
- Progestogen only pill (POP) for contraception
- Combined hormonal contraceptive transdermal patch
- Combined oral hormonal contraceptive (COC) in reproductive health
- Combined hormonal contraceptive vaginal ring
- Ulipristal acetate 30mg tablets for emergency contraception
- Levonorgestrel 1500 microgram tablets for emergency contraception
- Etonogestrel (e.g. Nexplanon®) implant for contraception
- Lidocaine injection for subdermal etonogestrel in 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.
- Doxycycline post exposure prophylaxis (doxyPEP)
- Podophyllotoxin (topical) for external anogenital warts
- Imiquimod 5% w/w cream for anogenital warts
- Aciclovir (oral) for genital HSV infection
- Fluconazole 150mg capsules for candidiasis
- Clotrimazole pessaries for candidiasis
- Clotrimazole cream for candidiasis and candidal balanoposthitis
- Ceftriaxone intramuscular injection for Neisseria gonorrhoeae
- Metronidazole (oral) for use within sexual health services
- Doxycycline for use within sexual health services
- Azithromycin (oral) for use within sexual health services
- Emtricitabine/tenofovir and raltegravir tablets for HIV PEP
- Emtricitabine and tenofovir disoproxil tablets as PrEP
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
Treatment and prophylaxis of human and animal bites
Expected publication end of 2025:
- Treatment and prophylaxis of human and animal bites: oral co-amoxiclav
- Treatment and prophylaxis of human and animal bites: oral co-trimoxazole (penicillin allergy under 12 years of age)
- Treatment and prophylaxis of human and animal bites: oral doxycycline and oral metronidazole (penicillin allergy 12 years of age and over)
Treatment of scabies
Expected publication end of 2025:
- Topical permethrin for the treatment of scabies
- Topical malathion for the treatment of scabies