Patient Group Directions (PGD)

Patient Group Directions (PGDs) templates and guidance

This page provides information about Patient Group Directions (PGDs) and their use in clinical practice. Guidance, advisory documents, templates and resources can be accessed via the subheadings below.

PGD templates are available to support immunisation programmes, the antivirals for respiratory viruses programmes and components of the Clinical Community Pharmacy Service.

This page is to support NHS Wales Health Board colleagues to develop and authorise PGDs locally.

Any queries regarding the clinical content of these PGDs or advisory documents should be addressed to: welshmedicines.information@wales.nhs.uk

See additional information on

Legal mechanisms for the supply and administration of vaccines in Wales ➜

On this page
1. About PGDs
2. PGD templates for:

– Immunisations
– Antivirals
– Chemical, Biological, Radiological and Nuclear (CBRN) hazards
– Common Ailments Service (CAS)
– Clinical Community Pharmacy Service

3. FAQs

Background

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

National PGD templates produced by the Welsh Medicines Advice Service (WMAS) for NHS Wales, with input from relevant experts, such as Public Health Wales (PHW), are provided for Health Boards or NHS organisations to review, authorise and sign off locally according to their policies and governance procedures.

For the COVID-19 vaccine programme, WMAS will provide NHS Wales with template PGDs for local review, authorisation and sign off procedures.

Some of the PGD templates are provided by UK Health Security Agency (UKHSA) which can be used as a reference resource. Health Boards or NHS Organisations may use these to develop, produce and authorise their own PGDs according to local policies and governance procedures. We gratefully acknowledge UKHSA for permission to use their PGDs as reference resource. UKHSA do not allow the addition of local logos or adaptation to their PGDs.

An advisory document will only be provided by WMAS to support the UKHSA reference resource when there are policy differences in Wales. Governance and sign off of any PGD is the responsibility of each authorising organisation. Practitioners using authorised PGDs must be familiar with the relevant Summary of Product Characteristics (SmPC), Welsh policy and guidance, and national guidance, such as the relevant chapters of the Green Book for all immunisation PGDs.

Any queries regarding the clinical content of these PGDs or advisory documents should be addressed to: welshmedicines.information@wales.nhs.uk

PGD templates

Immunisations

These national PGD templates are not legal for use until adapted and authorised by the relevant Local Health Board.

Primary to pre-school age immunisations

School age immunisations

Adult immunisations

Individuals at increased risk

Seasonal influenza

Important update regarding egg allergy and influenza vaccination

Please note that the Green Book: Influenza chapter was updated on 26 August 2026, after publication of the Autumn 2026 Influenza Vaccine Group Directions (VGDs) and Patient Group Direction (PGD).

In line with advice from the Joint Committee on Vaccination and Immunisation (JCVI), the updated Green Book chapter states that egg allergy is no longer considered a contraindication to any influenza vaccine produced for use in the UK.

The Autumn 2026 influenza VGDs and PGD will not be revised to reflect this change until Autumn 2027. Therefore, individuals who would otherwise be excluded from vaccination under the current VGD or PGD, solely because of egg allergy, may be considered for vaccination under a Patient Specific Direction (PSD), provided they have no other contraindications and no history of allergy to any other component of the vaccine.

Seasonal influenza VGD for Wales

COVID-19

COVID-19 vaccine VGD for Wales

Vaccine group directions (VGDs)

WMAS have developed guidance in collaboration with Public Health Wales on the legal mechanisms for the supply and administration of vaccines in Wales

Information on VGDs can be found on the Specialist Pharmacy Service (SPS) website – Understanding Vaccine Group Directions (VGDs)

Public Health Wales Vaccine Preventable Disease Programme held a webinar on the update to the Human Medicines Regulations on 04 March 2026 – the slides and recording are available can be accessed from an NHS Wales networked device from the VPDP Training SharePoint. A Questions and Answer document is also available to view. These resources can be accessed here – Immunisation training resources and events – Public Health Wales

COVID-19 vaccine VGD for Wales

Seasonal influenza vaccine VGD for Wales

Important update regarding egg allergy and influenza vaccination

Please note that the Green Book: Influenza chapter was updated on 26 August 2026, after publication of the Autumn 2026 Influenza Vaccine Group Directions (VGDs) and Patient Group Direction (PGD).

In line with advice from the Joint Committee on Vaccination and Immunisation (JCVI), the updated Green Book chapter states that egg allergy is no longer considered a contraindication to any influenza vaccine produced for use in the UK.

The Autumn 2026 influenza VGDs and PGD will not be revised to reflect this change until Autumn 2027. Therefore, individuals who would otherwise be excluded from vaccination under the current VGD or PGD, solely because of egg allergy, may be considered for vaccination under a Patient Specific Direction (PSD), provided they have no other contraindications and no history of allergy to any other component of the vaccine.

Respiratory Syncytial Virus (RSV) vaccine VGD for Wales

Outbreak and Incident Response PGDs

Some of the PGDs listed below also appear in the routine immunisation schedule sections of this page.
This is because their inclusion criteria cover both routine use and use during outbreaks or incidents.

Antivirals

These national PGD templates are not legal for use until adapted and authorised by the relevant Local Health Board.

Chemical, Biological, Radiological and Nuclear (CBRN) hazards

These national PGD templates are not legal for use until adapted and authorised by the relevant Local Health Board.

Common Ailments Service (CAS)

The Common Ailments Service (CAS) is an NHS Wales clinical community pharmacy service for adults and children living in Wales. Patients can access advice and treatment for 27 conditions.

More information on the service can be found on its webpage. Below are PGD templates for pharmacists delivering the Common Ailment Service component of the Clinical Community Pharmacy Service. These PGDs are not legal or valid without authorisation by the Local Health Board in which they are operating.

Clinical Community Pharmacy Service

The Welsh Medicines Advice Service (WMAS) has developed these PGDs for local authorisation. The 2022 PGD templates are editable pdfs – to adopt these PGDs locally, please make sure that you open them in Adobe Acrobat.

These national PGD templates are not legal for use until adapted and authorised by the relevant Local Health Board.

Not found what you are looking for? If there isn’t an NHS Wales PGD template available, check the Specialist Pharmacy Service (SPS) website for their PGD templates.

FAQs

What are PGDs, PSDs and VGDs and when should they be used?

Information about Patient Group Directions (PGDs), Patient Specific Directions (PSDs), and Vaccine Group Directions (VGDs) can be found on the Specialist Pharmacy Service (SPS) website:

In addition, the following questions and answers document was developed to support the Public Health Wales Q&A webinar on 04 March 2026 – Preparing for the update to Human Medicines Regulations

WMAS have developed guidance in collaboration with Public Health Wales on the legal mechanisms for the supply and administration of vaccines in Wales

[updated 28 Apr 26]

Can a Health Care Support Worker (HCSW) administer the nasal live attenuated influenza vaccine (LAIV) to a child once it has been supplied to the child by a registered nurse under a Patient Group Direction (PGD)?

Yes.  A registered healthcare professional can supply non-injectable medicines under a PGD and give these to the patient for self-administration or for administration by another person e.g. HCSW.

This means that a HCSW could administer a live intranasal flu vaccine (LAIV) to a child to whom the vaccine has been supplied by a registered healthcare professional under a PGD. The law requires that the administration of the supplied medicine is in accordance with the PGD, which needs to specify that the medicine is supplied for subsequent administration by another person (or for self-administration).

Injectable vaccines cannot be supplied in this way so a patient cannot be provided with inactivated flu, shingles and/or pneumococcal vaccine under a PGD or given to a HCSW for administration. All injectable vaccines administered by a HCSW must be under a Patient Specific Direction (PSD).

HCSWs must be appropriately trained and competent, work in compliance with legislation and have appropriate level of support from a registered healthcare professional.

[updated 25 Mar 26]

Can vaccines temporarily stored outside the recommended temperature range be administered under a Patient Group Direction (PGD)?

Vaccines should always be stored in accordance with the manufacturers licence. If the cold chain has been compromised and a vaccine is exposed to warmer or colder temperatures than recommended, the vaccine will fall outside the specifications of its product licence.

Depending on how long the vaccine has been outside the cold chain, the temperatures reached, and based on additional stability studies the product remains a licensed product but any subsequent use will be considered “off-label”.

Unlicensed medicines cannot be supplied or administered under a PGD, but off-label medicines can be included provided that there is documented evidence to support its inclusion. Risk assessments must be made on a case by case basis taking account of the time out of the cold chain, and temperatures reached, additionally reference to the manufacturer and/or via local Medicines Advice teams will be required to determine whether off-label use of a specific vaccine under these circumstances is appropriate.

At an organisational level, consider the stock levels to be wasted and impact on implementation of the national immunisation programme. Generally, these types of assessments are not consistent with the principles of inclusion in Patient Group Directions and are best managed on an incident case-by-case basis.

PHW have produced an advisory document on ordering, storage and handling of vaccines. The UKHSA vaccine incident guidance provides advice for healthcare professionals on responding to a cold chain breach or compromised storage event.

A leaflet describing the circumstances of off-label use of vaccines due to cold chain breaches has been produced as a brief guide for parents ‘The use of vaccines that have been temporarily stored outside the recommended temperature range’.

[updated 14 Aug 23]

Can a Patient Group Direction (PGD) be used by registered health professionals to administer vaccines as part of immunisation competency and assessment training?

The NICE Patient Group Directions Medicines Practice Guideline [MPG2] states that PGDs are not suitable for health professionals who are undergoing relevant training, for example, for administering intramuscular injections.

PGDs should only be used by fully trained and competent health professionals.

Further information is available from the NHS Specialist Pharmacy Service:

[updated 26 Mar 26]

Are UKHSA Patient Group Direction (PGD) templates suitable for use as a resource in Wales?

Yes, health boards are able to use UKHSA’s PGD templates as a reference resource when developing their own PGDs. The UKHSA clinical signatures do not apply in Wales.

Governance and sign off for any PGD is the responsibility of the authorising organisation in Wales.

Where policy differs from England, an advisory document for Wales will be provided jointly by the Welsh Medicines Advice Service (WMAS) and Public Health Wales.

[reviewed 26 Mar 26]

UK guidance

Human Medicines Regulations 2012

Medicines and Healthcare Regulatory Agency (MHRA)

UK Health Security Agency (UKHSA)

Immunisation against infectious disease – the Green Book

Vaccine incident guidance: responding to vaccine errors 2022. (UKHSA)

Using written instruction for seasonal ‘flu vaccination (NHS Specialist Pharmacy Service)

Patient Group Directions: Medicines practice guideline [MPG2] 2017. (NICE)

Retaining legal mechanism documentation (NHS Specialist Pharmacy Service)

Wales guidance

Some of these links are only accessible on an NHS Wales networked device:

Welsh Policy and Guidance as provided by Welsh Government, including Welsh Health Circulars (WHCs), Written Statements and Chief health professional letters

Public Health Wales A-Z Vaccination Information

Public Health Wales Vaccine resources for health and social care professionals

Advisory document on ordering, storage and handling of vaccines 7th Revision. Sep 2017. (NHS Wales)

Welsh Health Technical Memorandum 07-01: Safer management of healthcare waste 2013. (NHS Wales)

Change history

30 Sep 26

Hepatitis A vaccine v6.0 and hepatitis A/B vaccine v5.0 updated

23 Sep 26

Further details added of the recent Green Book: Influenza chapter update and egg allergy guidance to the ‘Seasonal Influenza’ and ‘Seasonal Influenza Vaccine VGD for Wales’ sections.

17 Sep 26

COVID-19 mRNA vaccine in children aged 6 months – 4 years v6.0 PGD and COVID-19 vaccine in adults and children aged 5 years and above v2.0 VGD updated .

01 Sep 26

Community Pharmacy inactivated influenza vaccine v5.0 PGD updated.

20 Aug 26

RSV vaccine in older adults VGD v1, advisory documents for PPV23 and PCV20 PGDs published.

06 Aug 26

Inactivated influenza vaccine VGD v1, live attenuated influenza vaccine VGD v1, inactivated influenza vaccine for 6 month – 2 years PGD v1 published. RSV vaccine in older adults PGD v4 updated.

26 Jun 26

New MenB vaccine PGD for one-off, time-limited offer Autumn 2026 programme.

18 May 26

New subsection of immunisation PGDs to cover incident and outbreak response.

28 Apr 26

Link to new page on the legal mechanisms for supply and administration of vaccines in Wales added.

07 Apr 26

Link to Q&A document on preparing for the update to the HMR added to VGD and FAQs section.

01 Apr 26

COVID-19 vaccine VGD published.

26 Mar 26

Published information on VGDs and updated FAQs section.

19 Mar 26

Updated COVID-19 vaccine PGD for 6 months to 4 years v5.0 and new COVID-19 vaccine PGD for adults and children aged 5 years and over v1.0 published.

12 Mar 26

Updated RSV PGD for older adults v3.0.

25 Feb 26

Addendum v1.0 to desogestrel PGD in Contraception Services PGD v2.1 published.

22 Jan 26

Updated MMRV PGD v2.0.

05 Jan 26

Updated PCV13/PCV15 PGD v7.0.

22 Dec 25

Updated MMR vaccine PGD to v7.0.

17 Dec 25

Added PCV20 PGD v1.0.

27 Nov 25

Updated MMR vaccine PGD v6.0 and added MMRV vaccine v1.0.

08 Nov 25

Addenda to Inactivated Influenza Vaccine PGD v3.0 and Inactivated Influenza Vaccine in community pharmacy PGD v4.0 published.

03 Nov 25

CAS PGDs for back pain, constipation, dyspepsia, threadworms updated. CCPS contraception service PGD booklet updated. CCPS contraception service memo retired.

06 Oct 25

Added copy of letter from Welsh Government to community pharmacies clarifying poultry workers flu vaccination offer.

01 Oct 25

dTaP/IPV vaccine v6.0 PGD updated.

26 Sep 25

Addendum to Community Pharmacy inactivated influenza vaccine v4.0 PGD added.

25 Sep 25

COVID-19 mRNA vaccine v2.0 national protocol updated.

16 Sep 25

COVID-19 mRNA vaccine v4.0 PGDs updated.

01 Sep 25

Community Pharmacy inactivated influenza vaccine v4.0 PGD updated.

21 Aug 25

Inactivated influenza vaccine v3.0 and live attenuated influenza vaccine v3.0 national protocols updated.

19 Aug 25

Shingles vaccine PGD published.

18 Aug 25

Inactivated influenza vaccine, live attenuated influenza vaccine, RSV vaccine in older adults, RSV vaccine in pregnancy PGDs published.

05 Aug 25

Oseltamivir and zanamivir treatment and prophylaxis PGDs updated.

28 Jul 25

HPV vaccine v7.0 and HPV vaccine for GBMSM v5.0 PGDs updated.

03 Jul 25

CCPS Contraception Service memo on GLP-1 agonists and oral contraception added.

19 Jun 25

Gonorrhoea risk groups – 4CMenB vaccine PGD v1.0 added.

09 Jun 25

Advisory document to accompany the Hexavalent vaccine DTaP/IPV/Hib/HepB PGD v6.0 added.

04 Jun 25

Hexavalent vaccine DTaP/IPV/Hib/HepB PGD v6.0, MenB vaccine PGD v8.0, PCV (13-valent or 15-valent, adsorbed) PGD v6.0, MenACWY vaccine PGD v6.0, MenACWY vaccine risk groups PGD v5.0, Hepatitis B vaccine PGD v6.0, CAS allergic rhinitis PGD v2.0 and CAS sore throat PGD v2.0 updated. Expired PCV advisory document and Hib/Men C vaccine PGD removed.

22 May 25

Paxlovid PGD v4.0 and molnupiravir PGD v4.0 updated.

07 May 25

New NHS Wales CBRN PGDs booklet v1.0 published.

10 Apr 25

COVID-19 mRNA vaccine PGD advisory document v1.1 updated.

08 Apr 25

COVID-19 mRNA vaccine PGD advisory document v1.0 added.

03 Mar 25

COVID-19 mRNA vaccine PGDs updated for Spring 2025 campaign.

01 Mar 25

Hepatitis B vaccine for renal patients PGD v5.0 updated.

01 Feb 25

Levonorgestrel, ulipristal and desogestrel PGDs v2.0 for the clinical community pharmacy contraception service updated.

22 Jan 25

MenB vaccine PGD v7.0 and MenB vaccine risk groups PGD v5.0 updated.

16 Jan 25

Oseltamivir pre and post exposure prophylaxis of avian flu advisory document v1.0 added.

18 Dec 24

Varicella vaccine PGD v2.0 updated, MVA-BN vaccine PGD v4.0 updated.

11 Dec 24

Oseltamivir pre and post exposure prophylaxis of avian flu PGD added.

28 Nov 24

New CBRN PGDs booklet added.

04 Nov 24

Doxycycline CBRN PGDs updated. Shingles vaccine (Zostavax) PGD and advisory document retired.

24 Sep 24

COVID-19 mRNA vaccine national protocol in adults and children aged 5 years and above updated for 24/25 season.

18 Sep 24

COVID-19 mRNA vaccine PGDs updated for Autumn-Winter 24/25 season

13 Sep 24

Link to Sore throat Test and Treat interim guidance updated.

26 Jul 24

RSV vaccine for older adults, RSV vaccine in pregnancy, inactivated influenza vaccine, live attenuated influenza vaccine, and community pharmacy inactivated influenza vaccine PGDs updated.

18 Jun 24

Paxlovid and sotrovimab PGDs updated.

17 Jun 24

Urinary Tract Infection (UTI) service PGDs for CAS added.

10 Jun 24

Mebendazole PGD for CAS updated.

04 Jun 24

Pertussis vaccination PGD and accompanying advisory document updated.

28 Mar 24

Molnupiravir PGD retired and mpox vaccine PGD updated.

29 Feb 24

Advisory document for pneumococcal conjugate vaccine (PCV) PGD added.

18 Dec 23

Shingles vaccine advisory documents for Shingrix and Zostavax updated.

08 Nov 23

Link to SPS PGD templates page added.

10 Oct 23

Hepatitis A vaccine, hepatitis B vaccine and hepatitis A/B vaccine PGDs updated.

06 Oct 23

COVID-19 mRNA vaccine PGDs for children aged 6 months to 4 years, and children aged 5 to 11 years added.

29 Sep 23

CBRN PGDs added. COVID-19 mRNA vaccine for adults and children over 12 years updated.

26 Sep 23

Antivirals PGD section added. COVID-19 vaccine national protocols updated.

18 Sep 23

CAS PGDs added.

15 Sep 23

COVID-19 mRNA vaccine for adults and children over 12 years PGD added.

06 Sep 23

Smallpox PGD template updated. Banner relating to transition of immunisation PGDs from PHW site removed as all content now on WMAS.

05 Sep 23

IIV and Comirnaty BA4.5 PGDs added. Links to influenza national protocols updated.

23 Aug 23

Zostavax advisory document added

17 Aug 23

Shingrix advisory document added

16 Aug 23

Background and FAQs added. Remaining immunisation PGDs added. CCPS template and guidance added.

14 Aug 23

Pertussis PGD and advisory document added.

28 Jul 23

LAIV PGD and advisory document added.

14 Jul 23

HPV school immunisations and GBMSM PGDs added.

10 Jul 23

Published.

Cymraeg