PGDs – general requirements

Patient group directions (PGDs) are written instructions to help health professionals supply or administer medicines to patients, usually in planned circumstances. 

Medicines can only be supplied and/or administered under PGDs if there is an advantage for the patient without compromising their safety. 

In line with legal requirements, each PGD for Pharmacy First includes: 

• The name of the business who owns the direction 
• The start and end date of the PGD 
• A description of the medicine(s) 
• The class of the health professional who can supply or administer the medicine 
• A signature of a doctor or dentist (as appropriate) and a pharmacist 
• Authorisation by an appropriate organisation 
• The clinical condition to which the direction applies (e.g. the specified condition/conditions that can be treated) 
• A description of patients excluded from treatment under the direction 
• A description of when more advice should be obtained from a doctor and arrangements for referral 
• Details of appropriate dosage, maximum total dosage, quantity, pharmaceutical form and strength, route and frequency of administration, and minimum or maximum period to administer the medicine 
• Relevant warnings, including potential adverse reactions 
• Details of any necessary follow-up actions 
• A statement of the records to be kept for audit purposes. 
• Pharmacists signing a PGD should have evidence of competence in the relevant clinical skills and knowledge (covered in CPPE’s Pharmacy First Service self-assessment framework) or complete a self-declaration of competence to operate under the PGD. 

Each PGD lists specific criteria for patient inclusion (and exclusion), depending on the clinical condition to which the PGD applies, along with: 

• Cautions 
• Specific information 
• Actions to be taken if the individual is excluded or declines treatment 
• A description of the treatment that can be provided, including route of administration, dose and frequency of administration, duration of treatment and quantity to be supplied 
• Drug interactions and management of adverse reactions 
• Individual advice and follow-up treatment. 

For each episode of service under the PGD, the following signed and dated contemporaneous records must be kept: 

• That valid informed consent has been given 
• Individual’s name, address and date of birth 
• Name of GP individual is registered with 
• Name and registration number of pharmacist operating under the PGD 
• Specify how the individual has/has not met the criteria of the PGD 
• Relevant past and present medical history and medication history 
• Any known allergies and nature of reaction(s) 
• Name/dose/form/quantity of medicine supplied 
• Date and time of supply 
• Documentation of cautions as appropriate 
• Advice given, including advice given if individual excluded or declines treatment 
• Details of any adverse drug reactions and actions taken 
• Advice given about the medication including side-effects, benefits, and when and what to do if there are any concerns. 
• Any follow-up and/or referral arrangements made 
• The supply must be entered in the patient medication record (PMR) and that it was made under a PGD.