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Prescribing and Patient Group Direction

Roles and responsibilities of those involved in PGD

Responsibilities related to PGDs lie not only with practitioners who use them but also with the Local Health Board and the practitioners' Managers.

All those involved in the development of a PGD must sign it. The development groups must include a doctor (or when appropriate, a dentist), a pharmacist, and a professional from the group to whom the PGD will apply (e.g. nurse if PGD applies to nurses). Additionally the PGD must be authorised by the relevant appropriate body as set out in the legislation. In Scotland NHS Health Boards have usually assigned this process to the local Area Drug and Therapeutics Committee or one of its subcommittees.  It is recommended that the process within your own Health Board Area is reviewed before proceeding with any PGD development. It is advisable to follow the local process as defined
by each Health Board.

What responsibilities do the Local Health Board have?

The local health board will:

  • Ensure that Patient Group Directions (PGDs) be drawn up by a multi-disciplinary group involving a doctor, a pharmacist and a representative of any professional group expected to supply or administer medicines under the PGD. It is also good practice to involve local Drug and Therapeutics Committees, Area Prescribing Committees and similar advisory bodies. It is a legal requirement for the NHS Board to approve PGDs before they can used in an operational setting.
  • Overall responsiblity for ensuring PGDs are audited on an agreed basis across the Health Board as per local Health Board policy.
  • Ensure senior managers responsible for practitioners using PGDs prepare their staff appropriately particularly regarding the assessment of the patient and the condition to which the PGDs apply

What responsibilities do Managers have?

Local managers:

  • will be aware of the requirements for a valid PGD
  • will require to ensure that local agreed processes are followed in respect to the development and approval of PGDs
  • ensure that only fully competent, qualified and trained professionals operate within PGDs.
  • ensure staff carry out audits on an agreed basis

What responsibilities do Practitioners have?

Practitioners will:

  • act within their appropriate Professional Code of Conduct
  • be aware of the essential components that require to be included within a PGD
  • have the requisite assessment skills related to the condition for which medication will be administered using the PGD
  • act in accordance with the information within the PGD
  • be aware of the process of administering medication via PGDs
  • be familiar with the marketing authorisation holder's summary of product characteristics for all medicines supplied or administered
  • maintain the necessary records to all audit to take place as required.

Practioners' responsibilities before using PGDs:

  • ensure that they have undertaken the necessary training in the use of PGDs
  • ensure that their competence following this training is assessed and deemed competent
  • ensure that the PGD to be used is the most up to date copy available
  • ensure that they read and fully understand the PGD they intend to use

Practitioners' responsibilities while practicing within a PGD

  • ensure that you have enough information about the patient regarding any inclusion or exclusions
  • understand the need to seek further information if required e.g. NICE PGD pathways
  • fully cognizant of the mode of administration of the medication
  • be aware of any potential side effects of the medication and its management
  • understand the storage requirements for the medication
  • be aware of any follow up requirements following administration of the medication
  • know how to report any Adverse Drug Reactions
    (ADRs)
  • ensure that all documentation is completed timeously and accurately as per professional standards