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The NHS has a focus on delivering services around the needs of the patient 'ensuring better, local and faster access to health care'. (Ref: Scottish Government 2007, 'Better Health, Better Care')

The best known and understood way for patients to receive their medicines is through a prescription written by a qualified prescriber. Traditionally the prescriber would be a Doctor or Dentist. Prescribers may now also be a Nurse, Pharmacist, Podiatrist, Physiotherapist, Radiographer or Optometrist, if the individual has the appropriate additional recorded qualification as a prescriber. This extension of prescribing rights has meant that healthcare practitioners can now deliver patient care in new ways that offer easier access and greater convenience. Another consequence is that better use is made of the skills and training of health care professionals.

There are also groups of healthcare professionals who can administer and supply medicines under exemptions from the Medicines Act 1968 for certain situations and conditions. These situations and conditions are explained in the section on exemptions. There are situations, however, not covered by these exemptions where patients would benefit, without compromising their safety, from the supply or administration of medicines by healthcare professionals following an assessment of their condition under a Patient Group Direction (PGD).

Legislation was introduced throughout the UK in 2000, which provided the framework for the supply and administration of medicines without the need for an individual prescription (Ref: Human Use Amendment Order 2000). This framework was Patient Group Directions (PGDs) and was described in HDL (2001)7,to support the use of PGDs in Scotland.

The definition of a PGD is:

'"Written instructions for the supply or administration of medicines to groups of patients who may no be individually identified before presentation for treatment." (Ref:

There are still instances when the development of a PGD is still the best way to meet the needs of patients. This need is likely to remain although diminished even with the further development of extended prescribing for individual patients.

PGDs should only be considered where development would benefit patient care without compromising safety. The healthcare practitioners using the PGDs are individually named and are required to ensure that they follow appropriate professional standards and codes of conduct.

Advice for GP practices on the use of PGDs and their requirements to support the supply and administration of medicines can be found in the following document 'Patient Group Directions and Patient Specific Directions in general practice
BMA response to enquiries'. (PDF) August 2010

Patient Group Directions NICE Guidance 2013

Supporting guidance has been updated by NICE for use within England and Wales, but has relevance and good governance guidance for Scottish NHS organisations. it can be found at the following link: