This guideline provides good practice recommendations for individual people and organisations involved with PGDs, with the aim of ensuring patients receive safe and appropriate care and timely access to medicines, in line with legislation.
The preferred way for patients to receive the medicines they need is for a prescriber to provide care for an individual patient on a one-to-one basis. Historically, a doctor (or dentist) would prescribe a medicine(s) for an individual patient. A pharmacist (or dispensing doctor) would then dispense the medicine against the prescription and supply the medicine(s) to the patient.
This traditional ‘medical model' changed in the years after publication of the final Crown report Review of prescribing, supply and administration of medicines in 1999. Legal frameworks were developed that have allowed services to be redesigned and health professionals to work more flexibly for the benefit of patients. As a result of these changes, there are now several legal options for supplying and/or administering medicines, including Patient Group Directions (PGDs).
PGDs provide a legal framework that allows some registered health professionals to supply and/or administer a specified medicine(s) to a pre defined group of patients, without them having to see a doctor (or dentist). However, supplying and/or administering medicines under PGDs should be reserved for situations in which this offers an advantage for patient care, without compromising patient safety.
Legislation establishing PGDs was introduced in 2000 and the Health Service Circular (HSC 2000/026) provided additional guidance. The current legislation for PGDs is included in The Human Medicines Regulations 2012.
This guideline is written in the context of the NHS in England, including independent organisations or contractors who are commissioned to provide NHS services. It may also be applicable to individual people and organisations delivering non-NHS healthcare services, and to some of the devolved administrations.
Changes to this guideline
From February 2014, good practice guidance became known as medicines practice guidelines. This is to bring the guideline naming in line with other NICE products. This is purely a name change - the guideline recommendations and everything else remains the same.