A patient group direction (PGD) is a written instruction that allows named, authorised and registered healthcare professionals to sell, supply or administer named medicines in an identified clinical situation legally, without needing a written, patient-specific prescription from an approved prescriber.
PGDs can be used by dental hygienists and dental therapists in:
- NHS practices in England, Wales and Scotland and their equivalent in Northern Ireland
- private dental practices in England registered with the Care Quality Commission
- private dental practices in Wales, providing the individual dentists are registered with the Health Inspectorate Wales
- private dental practices in Northern Ireland registered with the Regulation and Quality Improvement Authority
- private dental practices in Scotland registered with Health Improvement Scotland.
The Human Medicines Regulations 2012 require a PGD to be signed by a dentist and a pharmacist. As the requirements for an NHS PGD are slightly different to those for a private PGD, it's important to check that the PGD is valid for its purpose.
For example, for practices providing NHS primary dental services, it must also be signed on behalf of the authorising body. As regulations may vary in the different countries of the UK, it's sensible to check the PGD is signed by the appropriate persons in the area in which you're working.
PGDs need to contain the following:
- the period when the PGD will have effect
- the description or class of medicinal product it relates to
- the clinical situations when medicinal products of that description or class can be used
- whether there are any restrictions on the quantity of medicinal product that can be sold or supplied on any one occasion - and if so, what those restrictions are
- the clinical criteria under which a patient is eligible for treatment and whether anyone is excluded from treatment under the PGD
- the circumstances in which further advice should be sought from a doctor or dentist
- the pharmaceutical form or forms in which the medicinal products of that description or class are to be administered
- the strength or maximum strength at which the products can be administered, the applicable dosage or maximum dosage, the route and frequency of administration and the minimum or maximum period of administration
- relevant warnings
- the circumstances in which any follow-up action is needed
- referral arrangements for medical advice
- what records should be kept of the supply, or the administration, of products.
Before administering drugs under a PGD, dental hygienists and therapists should be sure it is valid. This means checking they are named on the PGD, that the patient meets the clinical criteria, and that it applies to the POM concerned. It's also important to be aware that the expiry date of a PGD should "not exceed 3 years from the date the PGD was authorised".
The dental hygienist and dental therapist should be fully trained and competent to perform the procedure, and are professionally accountable for their actions or omissions. They should also make sure they have adequate indemnity arrangements in place to cover their work.
If you're a DDU member and have specific queries about PGDs, contact our helpline for individual advice.
This page was correct at publication on 02/11/2022. Any guidance is intended as general guidance for members only. If you are a member and need specific advice relating to your own circumstances, please contact one of our advisers.