A Patient Group Direction (PGD) is a written direction, signed by a doctor or dentist, and by a pharmacist, relating to supply and administration only, of a prescription-only medicine (PoM) or pharmacy medicine (P) to persons generally (subject to specific exclusions set out in the legislation). PGDs can be authorised by Health Boards in Scotland and other NHS bodies.

A PGD must not be confused with a Written Direction which must be patient specific.

In most cases, the most appropriate clinical care will be provided on an individual basis by a specific prescriber to a specific individual patient. PGDs for the supply and/or administation of medicines should only be considered where it would offer a benefit to patient care without compromising safety in any way. This is best achieved by engaging representatives of all the health care professionals involved, including a representative from the professional group expected to supply or administer medicines under the direction. A senior representative of each profession should be reponsible for ensuring the suitability and competence of the professionals operating within the scheme.

Patient Group Direction Policy
GPs who do not wish to develop their own PGDs can authorise nurses and appropriate healthcare professionals to administer/supply medicines under an approved NHS Grampian PGD by "adopting" the PGD using the appropriate documentation. Development of any new PGD should be in accordance with the NHS QIS Best Practice Statement ~ March 2006 - Patient Group Directions.

[0751] Guidance For The Development And Implementation Of Patient Group Directions (PGDs) For Staff Working Within NHS Grampian, (Amended March 2016) Review Date: July 2018 - PDF 203KB 

Blank PGD template [intranet only] - please use when developing/updating a PGD.

[0864] Guidance for the use of Patient Group Directions (PGD's), Review Date: April 2020 - PDF 97KB

A


[0827] Adrenaline (Epinephrine) in cases of suspected Anaphylactic reactions by Qualified Health Professionals Working Within NHS Grampian, Review Date: September 2018 - PDF 189KB
[0847] Adrenaline (Epinephrine) By Trained Nurses In The Management Of Cardiac Arrest In The Coronary Care Unit (CCU) Working Within NHS Grampian, Review Date:November 2018 - PDF 167KB
[0806] Atovaquone/Proguanil For The Prophylaxis Of Malaria By Nurses Working In Occupational Health And Pharmacists Working Within NHS Grampian, Review Date: July 2018 - PDF 110KB
[0848] Atropine In The Event Of Life Threatening Bradycardias By Trained Nurses In The Coronary Care Unit (CCU) Working Within NHS Grampian, Review Date: November 2018 - PDF 143KB
 
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B


[0736] Patient Group Direction For The Administration Of Statens Serum Institut (SSI) Bacillus Calmette-Guerin (BCG) Vaccine By Nurses And Midwives Working Within NHS Grampian, (Amended May 2016) Review Date: October 2017 - 254KB (This PGD contains information that is specific to Danish Statens Serum Institute (SSI) BCG Vaccine and should be used only when using SSI vaccine).  See Policies section for protocol for administration of SSI Tuberculin PPD for Mantoux testing.
Benoxinate eye drops for ocular anaesthesia - see 'O'
Buscopan in GI endoscopy and barium enema - see 'E' - Endoscopy PGDs above
Buccastem by nurses in day surgery and short stay units - see 'P
 
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C



Combined Oral Contraceptives and Cerazette (desogestrel pill) - See Sexual Health PGDs  
[0773] Carbomer 0.2% Eye Drops By Registered Nurses Working Within Eye Out Patient Clinics and Ophthalmology Wards in ARI and Dr Grays, Review Date: November 2017 - PDF 147KB
[0774] Chloramphenicol 1% Eye Ointment Following Cyst Excision By Registered Nurses Working Within NHS Grampian, Review Date: November 2017 - PDF 146KB
[0768] Chloramphenicol eye drops 0.5% under the Minor Ailment Service by Community Pharmacists Working Within NHS Grampian, Review Date: November 2017 - PDF 144KB
[0845] Cholera VaccineBy Nurses And Pharmacists Working Within NHS Grampian, Review Date: October 2018 - PDF 107KB
[0785] Local Corticosteroid Injections And/Or Lidocaine By Physiotherapists and Radiographers, Review Date: March 2018 - PDF 166KB
[0849] Cyclopentolate by Orthoptists working within the Children's Eye Clinic, RACH, Review Date: November 2018 - PDF 95KB

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D


[0840] Administration/Supply Of Medicines As Included In The Dental Therapists And Dental Hygienists Formulary, Review Date: October 2018 - PDF 227KB 
Depo-Provera contraceptive injection and Desogestrel Pill (Cerazette®) - see Sexual Health PGDs
[0822] Booster Dose Of DTaP/IPV (Infanrix-IPV®) or dTaP/IPV (Repevax®) By Nurses Working Within NHS Grampian, (Version 6.1 amended March 2017) Review Date: September 2018 - PDF 115KB
[0846] DTaP/IPV/Hib by Nurses, midwives and health visitors working within NHS Grampian, Review Date: October 2018 - PDF 217KB
[0739] Administration of Diphtheria, Tetanus, Pertussis And Poliomyelitis Vaccine dTaP/IPV (Boostrix IPV) In Pregnant And Newly Delivered Women By Nurses and Midwives Working Within NHS Grampian(extended until June 2018) Review Date: June 2017 - PDF 143KB
[0860] Low dose diphtheria, tetanus and inactivated poliomyelitis vaccine dT/IPV (Revaxis)by nurses, midwives, health visitors and pharmacists working within NHS Grampian, Review Date: April 2019 - PDF 119KB
[0808] Administration Of Domperidone To Prevent Vomiting Following Emergency Hormonal Contraception By Nurses And Midwives Working Within NHS Grampian, Review Date: July 2018 - PDF 98KB
[0798] Doxycycline by nurses working in Occupational Health and pharmacists working within NHS Grampian for the prophylaxis of malaria, Review Date: June 2018 - PDF 95KB
 
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E


ellaOne® - see Sexual Health PGDs
[0795] Emla® Cream prior to IV cannulation or venepuncture, Review Date; June 2018 - PDF 98KB
Etonorgestrel Contraceptive Implant (Nexplanon®) and Evra® combined contraceptive transdermal patch - see Sexual Health PGDs
[0809] ENT Nurse Practitioner Formulary By ENT Nurse Practitioners Working Within NHS Grampian, Review Date: October 2018 - PDF 149KB

Endoscopy PGDs - These PGDs must not be used by staff unless specific training has been undertaken
[0758] Patient Group Direction For The Administration Of Hyoscine Butylbromide Injection (Buscopan®) 20mg/mL For The Treatment Of Acute Spasm During Upper/Lower GI Endoscopy And As A Prophylactic Anti-Peristaltic Agent In Radiological Procedures By Endoscopy Nurse Practitioners/GI and MR Radiographers Working Within NHS Grampian, Review Date: September 2017 - PDF 156KB
[0743] ED-PGD ~ Midazolam And Flumazenil Injection By Nurse Practitioners Working Within NHS Grampian To Patients Undergoing Upper/Lower GI Endoscopy And Insertion Of Central Venous Catheters, Review Date: July 2017 - PDF 173KB

 
 

F


Flumazenil injection used prior to upper/lower GI endoscopy - see 'E' - Endoscopy PGDs above
 
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G


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H


[0861] Hepatitis A Vaccine By Nurses and Pharmacists Working Within NHS Grampian, Review Date: April 2019 - PDF 156KB
[0796] Combined Inactivated Hepatitis A and Hepatitis B Vaccine, Review Date: June 2018 - PDF 163KB
[0797] Combined Hepatitis A and Typhoid Vaccine by nurses and pharmacists working within NHS Grampian, Review Date: June 2018 - PDF 106KB
new1-blue-25[1].gif[0872] Hepatitis B Vaccine By Registered Nurses And Pharmacists Working Within NHS Grampian, Review Date: May 2019 - PDF 125KB
Hyoscine Butylbromide Injection (Buscopan®) for acute spasm during upper/lower GI Endoscopy and Radiological Procedures - see 'E' - Endoscopy PGDs above

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I


Ibuprofen to children in hospitals for minor injury or pyrexia - see 'P' - 'Paracetamol or Ibuprofen'
[0831] Influenza Vaccine (Inactivated) Nurse and Midwives administration, (Version 3.2 amended September 2016) Review Date: September 2017 - PDF 244KB
new1-blue-25[1].gif[0884] Influenza vaccine Nurses And Pharmacists Working In Community Pharmacies, Or By Nurses Working In Occupational Health Services, Review Date: June 2018 - PDF 207KB
[0832] Influenza Vaccine Live Attenuated Intranasal Influenza Vaccine (LAIV) By Nurses, Midwives and Health Visitors, (Version 3.1 amended September 2016) Review Date: September 2017 - PDF 232KB
Infanrix-IPV for booster dose see DTaP/IPV
 
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J


[0745] Patient Group Direction For The Administration Of Japanese Encephalitis Vaccine (Ixiaro®) By Nurses And Pharmacists Working Within NHS Grampian, (Amended August 2016) Review Date: July 2017 - PDF 200KB
 
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L


Lidocaine spray for upper GI endoscopy - see 'E' - Endoscopy PGDs above
new1-blue-25[1].gif[0871] Lidocaine HCI1% Injection as infiltration anaesthesia for insertion/removal of tunnelled central venous catheters by nurses/radiographers working within the Radiology Departments, Review Date: May 2019 - PDF 108KB
[0734] Lidocaine/Cetrimide (Xylonor®) Spray For Oropharyngeal And Nasopharyngeal Surface Anaesthesia To Patients Undergoing Upper GI Investigations/Bronchoscopy By Registered Nurses Working Within NHS Grampian, Review Date: July 2017 - PDF 165KB
 
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M


[0728] Measles, Mumps and Rubella (MMR) Vaccine By Midwives, Nurses And Pharmacists Working Within NHS Grampian, (Amended May 2016) Review Date: July 2017 - PDF 160KB
[0810] Mefloquine By Nurses Working in Occupational Health And Pharmacists Working Within NHS Grampian For The Prophylaxis Of Malaria, Review Date: July 2018 - PDF 114KB
[0799] Meningococcal Group B Conjugate Vaccine (Bexsero) By Nurses, Midwives and Health Visitors Working Within NHS Grampian, (Version 2.2 amended January 2017)  Review Date: July 2018 - PDF 183KB
[0750]  Meningococcal ACWY Conjugate Vaccine (Childhood Programme) By Nurses, Midwives and Health Visitors Working Within NHS Grampian, (Version 1.3 amended September 2016) Review Date: July 2017 - PDF 248KB
[0862] Meningococcal ACW135Y Vaccine By Nurses And Pharmacists Working Within NHS Grampian, Review Date: April 2019 - PDF 184KB
For Men C with Hib see 'H' above
For Midazolam prior to and during upper/lower GI endoscopy - see 'E' - Endoscopy PGDs above
[0821] PGD For The Supply Of Metoclopramide Hydrochloride 5mg/5mL Oral Solution By GI Advanced Practice Radiographers Working Within NHS Grampian, Review Date: September 2018 - PDF 106KB
[0779]  PGD for the administration or supply of medicines for the treatment of minor injuries in NHS Grampian - Review Date: January 2018 - PDF 269KB
[0438] PGD For The Administration Of Medicines By Midwives Working Within NHS Grampian As Included In The Midwives PGD Formulary, Review Date: November 2013 (Extended until July 2016) - PDF 378KB
[0521] PGD For The Administration And Supply Of Medicines By Midwives Working Within NHS Grampian As Included In The National Midwives PGD Formulary, Review Date: August 2014 (Extended until July 2016) - PDF 686KB
 
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N


[0828] Naloxone Injection In Suspected Or Known Opioid Overdose For Patients Aged 12 Years And Over By Nurses And Midwives Working Within NHS Grampian, Review Date: October 2018 - PDF 117KB
[0763] Patient Group Direction For The Supply Of Naloxone By Registered Nurses And Pharmacists In NHS Grampian To Individuals At Risk Of Opioid Overdose And Services In Contact With Those At Risk, Review Date: October 2017 - PDF 154KB
Nexplanon® (etonorgestrel contraceptive implant) - see Sexual Health PGDs
NuvaRing® - see Sexual Health PGDs
 
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O


[0843] Oxybuprocaine 0.4% w/v Single Use Eye Drops For Ocular Anaesthesia By Nurses Working Within NHS Grampian, Review Date: October 2018 - PDF 106KB
 
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P


For Pediacel® see 'D' above DTaP/IPV/Hib
 
For the temporary programme of pertussis (whooping cough) vaccination of pregnant women see 'D' above dTaP/IPV
 
[0811] Oral Paracetamol For Analgesia In Patients Over 16 Years By Nurses In Day Surgery And Short Stay Units Working Within NHS Grampian, Review Date: July 2018 - PDF 125KB
[0784] Paracetamol or Ibuprofen to children in hospitals for minor injury or pyrexia, Review Date: March 2018 - PDF 246KB
[0853] Phosphate Enema adminstration by nurses working within NHS Grampian to patients prior to undergoing bowel investigations,  Review Date: November 2018 - PDF 98KB
[0824] Pneumococcal Conjugate Vaccine (PCV) (Prevenar 13®) by Nurses, Midwives and Health Visitors, Review Date: September 2018 - PDF 158KB
[0823] Pneumococcal Polysaccharide Vaccine (PPV) by nurses and pharmacists working within NHS Grampian, Review Date: September 2018 - PDF 116KB
[0807] Buccal prochlorperazine tablets in patients over 16 years by nurses in day surgery and short stay units working within NHS Grampian, Review Date: July 2018 - PDF 100KB
[0753] Paracetamol 120mg/5mL Oral Suspension, At The Time Of The appointment For Administration Of Meningococcal Group B Conjugate (Bexsero) Vaccine, By Nurses, (Amended November 2015) Review Date: August 2017 - PDF 203KB
[0761] Paracetamol Oral Suspension 120mg/5mL For Prevention Of Post Immunisation Fever Following Administration Of Meningococcal Group B Vaccine (Bexsero®) Black Triangle symbol indicating that the CHM and MHRA are intensively monitoring this product By Community Pharmacists, Review Date: October 2017 - PDF 263KB
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R


[0854] Rabies vaccine pre-exposure prophylactic administration by nurses and pharmacists working within NHS Grampian, (Amended April 2017) Review Date: November 2018 - PDF 158KB
[0841] Radiotherapy - Supply of supportive drugs to Radiotherapy Patients by Radiographers, Review Date: October 2018 - PDF 202KB
For Repevax (including temporary programme of pertussis (whooping cough) vaccination of pregnant women) see 'D' above dTaP/IPV
For Revaxis see 'D' above dT/IPV
[0740] Rotavirus Vaccine Rotarix By Nurses Working Within NHS Grampian, (extended until August 2018) Review Date: June 2017 - PDF 212KB
 
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S



Sexual Health - These PGDs must not be used by staff unless specific training in contraception has been undertaken.
 
[0787] AzithromycinFor the treatment of chlamydia by nurse specialists, midwives or registered nurses working within NHS Grampian, Review Date: April 2018 - PDF 93KB
[0788] Ceftriaxone 500mg Injection (Reconstituted With Lidocaine 1%) By Nurses Working Within NHS Grampian, Review Date: April 2018 - PDF 97KB
[0462] FP-PGD ~ Combined Hormonal Contraception - Pill or Transdermal Patch, Review Date: January 2015 (extended until January 2017) - PDF 117KB
[0612] FP-PGD ~ Depo-Provera® contraceptive injection, Review Date: October 2015 (extended until January 2017) - PDF 182KB
[0555] Insertion of Etonorgestrel Contraceptive Implant (Nexplanon®), Review Date: January 2015 (extended until January 2017) - PDF 352KB
(also see PGD below for s/c lidocaine for insertion/removal of implant)
[0554] FP-PGD ~ Supply of NuvaRing®, Review Date: January 2015 (extended until January 2017) - PDF 349KB
[0789] FP-PGD ~ Lidocaine 1% For Insertion/Removal Of The 68mg Etonogestrel Contraceptive Implant By Nurses And Midwives Working Within NHS Grampian, Review Date: April 2018 - PDF 102KB
[0725] Supply Of Levonorgestrel For Emergency Hormonal Contraception By Pharmacists, Review Date: September 2017 - PDF 174KB
[0842] Administration Of Levonorgestrel Emergency Contraception By Registered Nurses and Midwives, Review Date: October 2018 - PDF 158KB
[0833] Levonorgestrel Releasing Intrauterine System (IUS) By Nurses With A Letter Of Competence In Intrauterine Techniques (LoCIUT), Review Date: September 2018 - PDF 196KB
[0604] FP-PGD ~ Ulipristal (ellaOne®), Review Date: August 2015 (extended until January 2017) - PDF 215 KB
(a PGD for single dose domperidone anti-emetic is also available see D above)
[0613] FP-PGD ~ Progestogen Only Pill , Review Date: October 2015 (extended until January 2017) - PDF 176KB
[0706] Podophyllotoxin by nurses working within the NHS Grampian sexual health service, Review Date: March 2018 - PDF 101KB

[0759] Salbutamol Unit Dose Vials Via Nebuliser By Nurses, Review Date: September 2017 - PDF 202 KB
new1-blue-25[1].gif[0873] Salbutamol via a large volume spacer by nurses and midwives working within NHS Grampian, Review Date:May 2019 - PDF 255KB
new1-blue-25[1].gif[0865] Link opens in new windowSalbutamol Via A Spacer By Nurses or Pharmacists Working Within NHS Grampian For Post Bronchodilator Lung Function Assessment Or Reversibility Testing, Review Date: May  2019 - PDF 345KB
[0839] Sepsis Formulary - Administration Of Medicines Included In The Sepsis Formulary To Adults With Suspected Sepsis in Community Hospitals, NHS Grampian, Review Date: October 2018 - PDF 111KB
[0748] Shingles (Herpes Zoster) Vaccine (Live) Zostavax By Nurses Working Within NHS Grampian, (Version 3.5 amended March 2017) - Review Date: July 2017 - PDF 277KB
[0744] Sodium Chloride (0.9%) Via Nebulisation By Physiotherapists, Review date: July 2017 - PDF 149 KB
[0698] Sodium Chloride 0.9% w/v Solution For Injection For Flushing Intravenous Catheters/Cannulae By Certified Healthcare Professionals Working Within NHS Grampian, Review Date: July 2017 - PDF 168KB
[0790] Sodium Chloride 0.9% Intravenous Infusion during haemodialysis treatment, Review Date: March 2018 - PDF 136KB
[0792] PGD for the administration of medicines included in the Symptomatic Relief Formulary, Review Date: April 2018 - PDF 186KB
 
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T


[0791] Human Tetanus Immunoglobulin, Review Date: April 2018 - PDF 105KB
new1-blue-25[1].gif[0875] Tick-Borne Encephalitis vaccine, Review Date: June 2019 - PDF 153KB
for Japanese Encephalitis Vaccine (Ixiaro®) see 'J'
[0783] Typhoid vaccine for administration by nurses and pharmacists working within NHS Grampian, Review Date: January 2018 - PDF 97KB
For combined Hepatitis A and Typhoid vaccine see H above
[0760] Trimethoprim For The Treatment Of Women With Uncomplicated Urinary Tract Infections By Nurses And Pharmacists, (Updated November 2015) Review Date: October 2017 - PDF 188KB
[0679] 1% Tropicamide Eye Drops And 2.5% Phenylephrine Eye Drops For Dilatation In Preparation For Eye Examination And Cycloplegia Pre-Operatively By Nurses

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U


Ulipristal - see Sexual Health PGDs
 
 

V


[0762] PGD For The Administration Of Varicella Vaccine To Non-Immune Adult Healthcare Workers By Nurses Working Within NHS Grampian Occupational Health, Review Date: October 2017 - PDF 145KB
[0829] NHS Scotland Patient Group Direction for the Supply of Varenicline by Authorised Community Pharmacists Working Within NHS Grampian, Review Date: September 2018 - PDF 206KB
 

Z


Zostavax® see 'S' shingles (Herpes Zoster) vaccine
 

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