Patient specific directions (PSDs) and patient group directions (PGDs) explained
The law allows local arrangements to be developed for professionals without prescribing rights to supply or administer medicines to patients, in certain circumstances.
The methods or “mechanisms” by which this is possible are patient specific directions (PSDs) and patient group directions (PGDs).
Legal exemptions are another way that some health professionals can supply or administer medicines without being prescribers. We address legal exemptions on a separate page.
Patient Specific Directions
What is a PSD?
A patient specific direction (PSD) is a written and signed instruction, given by an independent prescriber to another professional to supply and/or administer medicine(s) to a named patient. The patient must have been individually assessed by the prescriber.
"A PSD is an instruction to administer/supply a medicine written in the patient’s notes […]. In acute care, this might be an instruction written on an inpatient’s medicine chart.
A PSD can also be an instruction to administer a medicine to a list of named patients where each patient on the list has been individually assessed by that prescriber."
A PSD for supply of medicines to a patient is a prescription form. A prescription form is a legal document and so must comply with the Human Medicines Regulations 2012.
Read the NHS Specialist Pharmacy Service Questions and Answers about PSDs for more information, such as what a PSD must include.
Can I supply or administer medicines under a PSD?
There are no legal restrictions around who can supply or administer medicines following a PSD.
However, remember that you must have the proper skills, knowledge and experience before you supply or administer medicines.
If your employer has policies or procedures around who can supply or administer medicines under a PSD, we expect you to follow them.
Patient group directions (PGDs)
What is a PGD?
A patient group direction (PGD) is a written instruction for the supply and/or administration of medicines to certain groups of patients, by certain named health professionals. For example, as part of a routine immunisation programme.
How is a PGD set up?
A PGD must be authorised by a clinical commissioning group (CCG), local authority, NHS trust or foundation trust, NHS England or Public Health England.
It must include detailed information about the medicines and patient group involved and be signed by several parties, including a senior doctor (or dentist) and senior pharmacist.
These requirements are set out in the Human Medicines Regulations 2012.
The National Centre for Clinical Excellence (NICE) have developed guidance for developing, authorising, using and updating PGDs.
The Care Quality Commission (CQC) have published a ‘myth buster’ article about PGDs and PSDs, particularly addressing their use in GP surgeries.
Can I supply or administer medicines under a PGD?
Which professions can administer medicines under a PGD is set out in law. Check whether your profession can on our medicines and prescribing homepage.
Read Patient group directions: who can use them, guidance from the Medicines and Healthcare products Regulatory Agency (MHRA).
Remember that you must have the proper skills, knowledge and experience before you supply or administer medicines:
"Before practising under a PGD, health professionals should ensure that they:
- have undertaken the necessary initial training and continuing professional development
- have been assessed as competent and authorised to practise by the provider organisation (see recommendation 1.4.9)
- have signed the appropriate documentation (see recommendation 1.4.9)
- are using a copy of the most recent and in date final signed version of the PGD (see recommendation 1.4.10)
- have read and understand the context and content of the PGD."