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  • Print publication year: 2008
  • Online publication date: August 2009

1 - Methods available for the delivery of medicines to patients


A number of different methods are available to healthcare professionals for the delivery of medicines to patients. These methods include patient specific directions (PSDs), patient group directions (PGDs), independent prescribing and supplementary prescribing. This chapter describes each of these different methods of delivery.

Patient group directions

Legislative changes

Prior to 2000, group protocols were used by nurses and other groups of healthcare professionals to administer or supply medicines to patients. However, the legal basis for these protocols was uncertain and changes in legislation were required to legalise their use. These changes took place in 2000, and group protocols became known as PGDs. The PGDs apply only for use in the National Health Service (NHS), including those services funded by the NHS but provided by the private, voluntary or charitable sectors. They also apply for use by independent hospitals, agencies and clinics registered under the Care Standards Act 2000, the prison health care services, police services, and the defence medical services.

Prescription Only Medicines, Pharmacy or General Sales List items

A PGD, signed by a doctor and agreed by a pharmacist, acts as a direction to a healthcare professional (i.e. midwife, nurse, pharmacist, optometrist, podiatrist/chiropodist, radiographer, orthoptist, physiotherapist and ambulance paramedics) to supply and/or administer a Prescription Only Medicine (POM) to a patient (using their own assessment of a patients need), without necessarily referring back to a doctor for an individual Prescription.

Related content

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,DoH (2002) Extending Independent Nurse Prescribing within the NHS in England: A Guide for Implementation. London: Department of Health.
,DoH (2003) Supplementary Prescribing for Nurses and Pharmacists within the NHS in England. London: Department of Health.
,DHSS (1986). Neighbourhood Nursing: A Focus for Care (Cumberlege Report). London: HMSO.
,Home Office (2007). Public Consultation: IndependentPrescribing or Controlled Drugs by Nurse and PharmacistIndependent Prescribers. London: Home Office.
,MHRA (2007). Patient Group Directions (MLX 336). London: Medicines and Healthcare Products Regulatory Agency.
Nurse Prescribers' Formulary. London: BMJ Publishing and RPS Publishing.