PGDs Flashcards
What is supply?
Supply is the provision of a medicine to an individual to be taken or administered according to the specified directions.
An example would be the supply of progesterone only contraceptive tablets by a nurse working in a contraception clinic to an individual for them to take daily.
Note: Supplying a medicine against a PGD is not dispensing.
What is Administration?
Administration refers to the giving of a medicine (by any route) to an individual at the time of a consultation or at a later time, according to the specified directions.
An example would be the injection of a long acting contraceptive injection into an individual’s arm, by a registered nurse, in a contraception clinic under a PGD.
What are the 3 legal categories of medicines?
POM
pharmacy only
general sale list
What do POM medicines require?
a prescription or PSD from a prescriber
a PGD
an exemption for their legal supply or administration
What does a pharmacy-only medicine require?
P medicines can be sold under the supervision of a pharmacist from a registered pharmacy. They do not require a PSD or PGD to be purchased from a pharmacy.
P medicines may also be supplied under a PGD, under an exemption or be prescribed in certain circumstances.
What do general sales lists mean?
GSL medicines may be bought in limited quantities from general retail premises and do not require pharmacist supervision or a PSD/PGD for their supply.
Which organisation includes PGDs?
Human Medicines Regulations 2012 (HMR 2012)
What kind of medicines can PGDS include?
PGDs must only include medicines with a UK marketing authorisation but can include:
+ off label use (use of a medicine with a UK marketing authorisation but being used outside the terms of its Summary of Product Characteristics)
+ black triangle medicines (new)
+ Regulation 174 authorised medicines (herbal)
Who can supply and/or administer under PGD?
Only a qualified and registered health professional listed in PGD legislation
which types of drugs are subject to restrictions?
Controlled drugs are subject to certain restrictions.
What other legal requirements also apply to PGDs
labelling of medicines [4]
provision of a manufacturer’s patient information leaflet for supply
prescription charges and exemptions
When is PGD use not permitted?
+ where there is a delegation of responsibility to supply or administer the medicine
+ when 2 or more licensed medicines are mixed together if this results in an unlicensed medicine
+ unlicensed medications
+ supply or administration of radiopharmaceuticals (Administration of Radioactive Substances Regulations 1978)
+ supply or administration of dressings and medical devices
+ supply or administration of abortifacients (Abortion Act 1967)
+ as part of training [9]
When should PGDs not be used?
- for managing long-term conditions, such as hypertension or diabetes, or when uncertainty remains about the differential diagnosis
- for the supply of medicines needing frequent dosage adjustments or frequent or complex monitoring
- to make dose adjustments when the medicine is already in the individual’s possession
Which professionals cant supply or administer any controlled drugs under a PGD?
Dietitians
speech and language therapists
dental hygienists or dental therapists
pharmacy technicians
Which CDs can be included in a PGD?
Schedule 2: morphine and diamorphine: only registered nurses and pharmacists for the immediate necessary treatment of a sick or injured person (except for treating addiction).
Schedule 2: ketamine.
Schedule 3: midazolam.
Schedule 4: all listed medicines except anabolic steroids and injectable formulations used for treating addiction.
Schedule 5: all listed medicines.
What 3 topics must a PGD cover?
Governance, clinical and record-keeping/audit
Which organisations can authorise a PGD?
integrated care boards (ICBs)
local authorities
NHS trusts or NHS foundation trusts
special health authorities
NHS England
UK Health Security Agency (UKHSA)
You have been approached by a GP surgery who ask you if healthcare assistants are able to use a PGD to administer intramuscular influenza vaccines.
Is this legal?
NO
A community contraception clinic uses a PGD to administer Depo-Provera® injections. A new nurse is recruited.
Can the new nurse be supervised administering an injection under a PGD as part of their training and assessment of competency?
NO
Would the new nurse be allowed to work under the PGD if she had undertaken the same role under a PGD in another Trust and thought herself to be fully competent?
No
A community mental health team has a specialist mental health nurse working within a GP practice. They would like to have PGD to initiate sertraline, citalopram and mirtazapine.
Would this be an appropriate use of PGDs?
No - cant be used to manage long-term conditions
A clinical pilot study is being undertaken by a trust studying the benefit of the administration of meningitis B vaccines to individuals aged 16 to 19.
It has been proposed that a PGD is used to allow school nurses to supply and administer the vaccine. The vaccine has a black triangle and is being used within its licence.
Would this be appropriate for administration under a PGD?’
yes
A paramedic in an urgent care centre supplies a 41-year-old individual with a course of antibiotics under a PGD. They advise the individual that they will need to pay the standard prescription charge for the medicine as they are not exempt from charges.
The individual states that they do not need to pay as they are not being given the medicine from a pharmacy.
Who is correct?
paramedic
A PGD for use in patients being seen at home with heart failure has been developed by a community cardiology team.
The intention is that the patient would have their medication prescribed by their GP and the PGD is then used to amend doses based on symptoms.
Is this acceptable under a PGD?
no
An independent healthcare provider (IHP) is commissioned by an integrated care board ICB to provide an urgent care service and PGDs are used to supply medicines.
Who must authorise the PGDs?
ICB
A Trust has several PGDs due to expire shortly and they are considering extending the expiry date of these due to other pressures.
Is this acceptable?
yes
