Patient Specific Directions (PSDs) and Patient Group Directions (PGDs)
The advice on the use of Patient Group Directions (PGDs) and Patient Specific Directions (PSDs) in general practice has been updated, January 2016. This guidance is for England only. Download the full guidance here
Overview
The Human Medicines Regulations 2012 do not permit non-qualified prescribers to administer or supply prescription only medicines (POMs) unless one of three types of instruction is in place:
- a signed prescription
- a Patient Specific Direction (PSD)
- a Patient Group Direction (PGD)
There are some specific exemptions from medicines legislation which may apply in limited circumstances e.g. administration of certain parenteral medicines such as adrenaline that can be administered in an emergency without the directions of a prescriber.
If non-prescribing health care professionals administer a medicine on the instruction of a GP, the GP must be able to show that the health care professional has authority for that administration via one of the above methods.
Use this quick checklist
- PGDs should be used only where appropriate, suitable and legal. Use the flow chart listed below "to PGD or not to PGD" to check
- PGDs can be written by anyone involved with their use but the group should include a doctor or dentist and a pharmacist who will sign it off
- PGDs can only be approved by certain bodies, in the cases relevant to general practice these are Clinical Commissioning Groups (CCGs), Local Authorities or NHS England
- PGDs can only be used by certain registered health professionals listed in legislation - this excludes health care assistants
- there are certain categories of medicines for which a PGD should only be used with caution for example antibiotics, off license drugs, controlled drugs, or those subject to black triangles
Make sure you also review these helpful resources:
NICE Medicines Practice Guideline 2 (MPG2)
Exemption from restrictions on sale and supply of prescription only medicines - The Human Medicines Regulations 2012
To PGD or not to PGD - A guide to choosing the best option for individual situations
List of certain registered health professionals authorised in legislation to use PGDs
The full guidance from GPC contains helpful resources for your reference, including:
- definitions of Patient Specific and Patient Group Directions
- a checklist of what should be included in a PGD
- common questions and answers
- examples of when to use PSD or PGD
- useful links for further information
- detailed MHRA guidance
