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Patient Specific Directions (PSDs) and Patient Group Directions (PGDs)

A Patient Specific Direction (PSD) is the traditional written instruction, signed by a doctor, dentist, or non-medical prescriber for medicines to be supplied and/or administered to a named patient after the prescriber has assessed the patient on an individual basis. In practice, a PSD is may be referred to as a “prescription” by those who write and follow them because this indicates that it is written by a prescriber.  But this should not be confused with an FP10 or other written prescription given to the patient for supply from a pharmacy or dispensary.  

Patient Group Directions (PGDs) are written instructions for the supply or administration of medicines to groups of patients who may not be individually identified before presentation for treatment.'

PGDs provide a legal framework that allows the supply and/or administration of a specified medicine(s), by named, authorised, registered health professionals, to a pre-defined group of patients needing prophylaxis or treatment for a condition described in the PGD, without the need for a prescription or an instruction from a prescriber. Using a PGD is not a form of prescribing.

The supply and/or administering of medicines under PGDs should be reserved for situations in which this offers an advantage for patient care, without compromising patient safety. Organisations should have policies and processes in place to consider all options before a service is designed or commissioned using PGDs. Before a PGD is developed, the organisation must ensure that PGDs are appropriate, legal and that relevant governance arrangements are in place. 

Occupational health setting 'written instructions'

In occupational health settings, the legislation allows for the supply and/or administration of medicines specified in a written instruction signed by a medical practitioner. The scope of this is much broader and simpler than the use of a PGD. The NHS PGD web site has further information. The BMA guidance for occupational physicians also has some useful information on prescribing in occupational health settings, including an example template for a ‘Specimen operating policy/written instruction’ in the appendix 6.

Useful resources

You may find the following RCN advice sheets useful:

See the RCN information on the role of health care support workers and administration of specific vaccines: