Wednesday, 27 January 2016

PGD and Independent Prescribing

Can independent prescriber nurses/pharmacists use PGDs in their daily practice?

In short no. PGDs should only be used in the absence of a prescriber, if the prescriber can write a prescription there should be no need for a PGD. However, as with most things in life, this issue is not so black and white. PGDs are generally used in primary care for those high volume, generally safe medicines which can be given to a well defined group of patients which is usually established via the Specific Product Characteristic (SPC) of the medicine. Whereas healthcare professionals who can prescribe, do not need a well defined group but base their decision on an individual basis i.e. writing a prescription is a type of Patient Specific Direction.

The only possible reason why a prescriber would use a PGD is that although they can prescribe any medicine, they can only prescribe within their own specialty. For instance, if a nurse prescribers specialty was diabetes you would assume that they could prescribe things like:

  • Insulin  
  • Oral hypoglycemics
  • Needles
  • Syringes
  • etc
You would not expect them for instance to be trained to prescribe Emergency Hormonal Contraceptives (EHC) or Hair Loss medication as this would be outside of their scope of practice. In this case the prescriber is in limbo land on one hand they are excluded from using PGDs because they are a prescriber but they cannot prescribe the medicine as this is not in their scope of practice. The easiest answer to this is to undergo some sort of training as per best practice whether this is a course endorsed by the GPhC or NMC.

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