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
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
These national PGD templates are not legal for use until adapted and authorised by the relevant Local Health Board.
| PGD | Link and date effective | Advisory document for NHS Wales (if required) |
|---|---|---|
| dTaP/IPV (Repevax® or Boostrix®-IPV) | 01 November 2023 Refer to UKHSA v5.0 | Find relevant Welsh Health Circular |
| Hexavalent vaccine DTaP/IPV/Hib/HepB (Infanrix®Hexa or Vaxelis®) | 25 July 2022 Refer to UKHSA v4.0 | Find relevant Welsh Health Circular |
| Hib/MenC (Menitorix®) | 31 July 2022 Refer to UKHSA v5.0 | Find relevant Welsh Health Circular |
| MenB vaccine (Bexsero®) | 28 February 2023 Refer to UKHSA v6.0 | Find relevant Welsh Health Circular |
| MMR vaccine (Priorix® or MMRVaxPRO®) | 01 March 2022 Refer to UKHSA v4.0 | Find relevant Welsh Health Circular |
| PCV (13-valent, adsorbed) (Prevenar®13) | 01 March 2022 Refer to UKHSA v4.0 | Find relevant Welsh Health Circular |
| Rotavirus vaccine (Rotarix®) | 30 June 2023 Refer to UKHSA v6.0 | Find relevant Welsh Health Circular |
| PGD | Link and date effective | Advisory document for NHS Wales (if required) |
|---|---|---|
| Diphtheria, tetanus and inactivated poliomyelitis vaccine (Td/IPV) (Revaxis®) | 05 August 2022 Refer to UKHSA v5.0 | Find relevant Welsh Health Circular |
| Human Papillomavirus (HPV) vaccine (Gardasil®) | 01 September 2023 Refer to UKHSA v6.0 | Find relevant Welsh Health Circular |
| MenACWY vaccine (Menveo®, Nimenrix® or MenQuadfi®) | 31 July 2023 Refer to UKHSA v5.0 | Find relevant Welsh Health Circular |
| PGD | Link and date effective | Advisory document for NHS Wales (if required) |
|---|---|---|
| Pertussis vaccination (dTaP/IPV) (Boostrix®-IPV or Repevax®) | 31 March 2023 Refer to UKHSA v6.0 | Advisory document Pertussis 2023 Find relevant Welsh Health Circular |
| Pneumococcal polysaccharide vaccine (PPV) (Pneumovax®) | 31 August 2022 Refer to UKHSA v4.0 | Find relevant Welsh Health Circular |
| Shingles vaccine (Shingrix®) | 01 September 2023 Refer to UKHSA v2.0 | Advisory document Shingrix 2023 Find relevant Welsh Health Circular |
| Shingles vaccine (Zostavax®) | 01 September 2023 Refer to UKHSA v1.0 | Advisory document Zostavax 2023 Find relevant Welsh Health Circular |
| PGD | Link and date effective | Advisory document for NHS Wales (if required) |
|---|---|---|
| BCG vaccine AJV | 31 August 2023 Refer to UKHSA v4.0 | Find relevant Welsh Health Circular |
| Hepatitis A vaccine (Havrix® Monodose®, Havrix® Junior Monodose, AVAXIM®, AVAXIM® Junior, VAQTA® Adult or VAQTA® Paediatric) | 31 October 2023 Refer to UKHSA v5.0 | Find relevant Welsh Health Circular |
| Hepatitis A/B vaccine (Twinrix® Adult, Twinrix® Paediatric, or Ambirix®) | 31 October 2023 Refer to UKHSA v4.0 | Find relevant Welsh Health Circular |
| Hepatitis A/Typhoid vaccine (ViATIM®) | 01 March 2022 Refer to UKHSA v3.0 | Find relevant Welsh Health Circular |
| Hepatitis B vaccine (Engerix B® 10 micrograms/0.5 mL, Engerix B® 20 micrograms/1 mL, HBvaxPRO® 5 micrograms/0.5 mL, HBvaxPRO® 10 micrograms/1 mL, PreHevbri® 10 micrograms/1 mL, or HEPLISAV B® 20 micrograms/0.5 mL) | 31 October 2023 Refer to UKHSA v5.0 | Find relevant Welsh Health Circular |
| Hepatitis B vaccine for renal patients | 30 April 2023 Refer to UKHSA v4.0 | Find relevant Welsh Health Circular |
| Human Papillomavirus (HPV) vaccine (Gardasil®) for GBMSM | 01 September 2023 Refer to UKHSA v4.0a | Find relevant Welsh Health Circular |
| MenACWY vaccine risk groups (Menveo®, Nimenrix® or MenQuadfi®) | 28 February 2023 Refer to UKHSA v4.0 | Find relevant Welsh Health Circular |
| MenB vaccine risk groups (Bexsero®) | 28 February 2023 Refer to UKHSA v4.0 | Find relevant Welsh Health Circular |
| PCV (13-valent, adsorbed) risk groups (Prevenar®) | 01 March 2022 Refer to UKHSA v5.0 | Find relevant Welsh Health Circular |
| Smallpox (MVA-BN) vaccine (Jynneos) | 15 September 2023 Refer to UKHSA v3.0 Coming soon - template for use in NHS Wales | Find relevant Welsh Health Circular |
| Typhoid Vi vaccine (TYPHIM Vi®) | 01 March 2022 Refer to UKHSA v3.0 | Find relevant Welsh Health Circular |
| Varicella vaccine (Varivax®, Varilrix®) | 05 January 2023 Refer to UKHSA v1.0 | Find relevant Welsh Health Circular |
| PGD | Link and date effective | Advisory document for NHS Wales (if required) |
|---|---|---|
| Inactivated influenza vaccine (QIVc, aQIV, QIVr, QIV-HD) | 01 September 2023 PGD Template v1.2 | Find relevant Welsh Health Circular |
| Live attenuated influenza vaccine (Fluenz Tetra®) | 01 September 2023 Refer to UKHSA v13.0 | Advisory document LAIV 2023-24 Find relevant Welsh Health Circular |
| PGD | Link and date effective | Advisory document for NHS Wales (if required) |
|---|---|---|
| COVID-19 mRNA vaccine to adults and children aged 12 years and above | 01 September 2023 PGD Template v1.3 | Find relevant Welsh Health Circular |
| COVID-19 mRNA vaccine to children aged 5 to 11 years | 01 September 2023 PGD Template v1.0 | Find relevant Welsh Health Circular |
| COVID-19 mRNA vaccine to children aged 6 months to 4 years | 01 September 2023 PGD Template v1.0 | Find relevant Welsh Health Circular |
| Comirnaty® Bivalent BA.4-5 (15/15 micrograms)/dose COVID-19 vaccine (Pfizer BioNTech) | 01 September 2023 PGD Template v2.1 | Find relevant Welsh Health Circular |
| VidPrevtyn Beta® COVID-19 vaccine (Sanofi) | 01 April 2023 PGD Template v1.0 | Find relevant Welsh Health Circular |
COVID-19 vaccine protocols for Wales
| Protocol name and link | Date effective |
|---|---|
| Comirnaty® Omicron XBB.1.5 30 micrograms/dose COVID-19 vaccine (Pfizer BioNTech) | 25 September 2023 |
| Comirnaty® Bivalent BA.4-5 COVID-19 vaccine (Pfizer BioNTech) | 01 March 2023 |
| Comirnaty® Omicron XBB.1.5 10 micrograms/dose (children 5-11 years) COVID-19 vaccine (Pfizer BioNTech) | 25 September 2023 |
| Spikevax® XBB.1.5 COVID-19 vaccine (Moderna) | 25 September 2023 |
| VidPrevtyn Beta® COVID-19 vaccine (Sanofi) | 01 March 2023 |
Seasonal influenza vaccine protocols for Wales
| Protocol name and link | Date effective |
|---|---|
| Inactivated influenza vaccine aQIV, QIVc, QIV-HD and QIVr (Supemtek▼) | 01 September 2023 |
| Live attenuated influenza vaccine (Fluenz Tetra®) | 01 September 2023 |
These national PGD templates are not legal for use until adapted and authorised by the relevant Local Health Board.
| PGD | Date effective | Additional Guidance |
|---|---|---|
| (Paxlovid▼®) nirmatrelvir 150 mg film-coated tablets and ritonavir 100 mg film-coated tablets for the treatment of mild to moderate coronavirus disease in high risk individuals for severe disease | 17 April 2023 PGD Template v2.6 | - |
| (Lagevrio▼®) molnupiravir 200 mg capsules for the treatment of mild to moderate coronavirus disease in high risk individuals for severe disease | 18 April 2023 PGD Template v2.3 | - |
| (Xevudy▼®) sotrovimab 500 mg in 8 mL (62.5 mg in 1 mL) concentrate for solution for infusion for the treatment of mild to moderate COVID‑19 infection in adults at high risk for severe disease | 12 July 2023 PGD Template v2.4 | - |
| Oseltamivir 75 mg and 30 mg capsules for post exposure prophylaxis of seasonal influenza | 08 August 2022 Refer to UKHSA v5.0 | - |
| Zanamivir inhalation powder (5 mg per dose) for post exposure prophylaxis of seasonal influenza | 08 August 2022 Refer to UKHSA v4.0 | - |
| Oseltamivir 75 mg and 30 mg capsules for the treatment of seasonal influenza | 08 August 2022 Refer to UKHSA v5.0 | - |
| Zanamivir inhalation powder (5 mg per dose) for the treatment of seasonal influenza | 08 August 2022 Refer to UKHSA v4.0 | - |
These national PGD templates are not legal for use until adapted and authorised by the relevant Local Health Board.
| PGD | Date effective | Additional Guidance |
|---|---|---|
| Initial supply | ||
| Ciprofloxacin 500 mg tablet for post-exposure to anthrax - initial supply | 17 January 2022 Refer to UKHSA v4.0 | PGD template for NHS Wales under development |
| Ciprofloxacin to children under 12 years for post-exposure to anthrax - initial supply | 31 January 2022 Refer to UKHSA v4.0 | PGD template for NHS Wales under development |
| Ciprofloxacin 500 mg tablet for post-exposure to plague - initial supply | 17 January 2022 Refer to UKHSA v5.0 | PGD template for NHS Wales under development |
| Ciprofloxacin to children under 12 years for post-exposure to plague - initial supply | 31 January 2022 Refer to UKHSA v4.0 | PGD template for NHS Wales under development |
| Ciprofloxacin 500 mg tablet for post-exposure to tularemia - initial supply | 17 January 2022 Refer to UKHSA v5.0 | PGD template for NHS Wales under development |
| Ciprofloxacin to children under 12 years for post-exposure to tularemia - initial supply | 31 January 2022 Refer to UKHSA v4.0 | PGD template for NHS Wales under development |
| Doxycycline for post-exposure to anthrax - initial supply | 01 November 2021 Refer to UKHSA v4.0 | PGD template for NHS Wales under development |
| Doxycycline for post-exposure to plague - initial supply | 01 November 2021 Refer to UKHSA v5.0 | PGD template for NHS Wales under development |
| Doxycycline for post-exposure to tularemia - initial supply | 01 November 2021 Refer to UKHSA v5.0 | PGD template for NHS Wales under development |
| Potassium iodide 65 mg tablets for adults and children exposed to, or at risk of exposure to, radioactive iodine | 14 December 2021 Refer to UKHSA v2.0b | PGD template for NHS Wales under development |
| Potassium iodide 85 mg tablets for adults and children exposed to, or at risk of exposure to, radioactive iodine | 14 December 2021 Refer to UKHSA v2.0b | PGD template for NHS Wales under development |
| Further supply | ||
| Ciprofloxacin 500 mg tablet for post-exposure to anthrax - further supply | 17 January 2022 Refer to UKHSA v4.0 | PGD template for NHS Wales under development |
| Ciprofloxacin to children under 12 years for post-exposure to anthrax - further supply | 31 January 2022 Refer to UKHSA v4.0 | PGD template for NHS Wales under development |
| Ciprofloxacin 500 mg tablet for post-exposure to tularemia - further supply | 17 January 2022 Refer to UKHSA v5.0 | PGD template for NHS Wales under development |
| Ciprofloxacin to children under 12 years for post-exposure to tularemia - further supply | 31 January 2022 Refer to UKHSA v4.0 | PGD template for NHS Wales under development |
| Doxycycline for post-exposure to anthrax - further supply | 01 November 2021 Refer to UKHSA v4.0 | PGD template for NHS Wales under development |
| Doxycycline for post-exposure to tularemia - further supply | 01 November 2021 Refer to UKHSA v5.0 | PGD template for NHS Wales under development |
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 26 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.
| PGD template | Formulation | Indication |
| Anusol® HC | Ointment and suppository | Haemorrhoids |
| Azelastine hydrochloride 0.1% | Nasal spray | Allergic rhinitis |
| Benzoyl preoxide 5% | Gel | Acne vulgaris |
| Chloramphenicol 0.5% | Eye drops | Bacterial conjunctivitis |
| Chloramphenicol 1% | Eye ointment | Bacterial conjunctivitis |
| Clobetasone 0.05% | Cream and ointment | Dry skin |
| Clotrimazole 1% and 2% | Cream | Athlete's foot, fungal skin infection, nappy rash and vulvo-vaginal candidiasis |
| Clotrimazole 10% | Vaginal cream | Vulvo-vaginal candidiasis |
| Clotrimazole 500 mg | Vaginal pessary | Vulvo-vaginal candidiasis |
| Docusate sodium 100 mg | Capsule | Constipation |
| Duac Once Daily® | Gel | Acne vulgaris |
| Fluconazole 150 mg | Capsule | Vulvo-vaginal candidiasis |
| Fluticasone furoate 27.5 micrograms per dose | Nasal spray | Allergic rhinitis |
| Fluticasone propoionate 50 micrograms per dose | Nasal spray | Allergic rhinitis |
| Hydrocortisone 1% | Cream and ointment | Athlete's foot, dry skin, intertrigo and nappy rash |
| Ibuprofen 10% | Gel | Acute lower back pain without radiculopathy |
| Lansoprazole 15 mg and 30 mg | Gastro-resistant capsule | Dyspepsia and gastroprotection from NSAID treatment in lower back pain |
| Macrogol 3350 | Oral powder sachets | Constipation |
| Mebendazole 100 mg and 100 mg per 5 mL | Chewable tablets and oral suspension | Threadworm |
| Miconazole 2% | Oral gel | Oral candidiasis |
| Mometasone 50 micrograms per dose | Nasal spray | Allergic rhinitis |
| Naproxen 250 mg | Gastro-resistant tablet | Acute lower back pain without radiculopathy |
| Nystatin 100,000 units per mL | Oral suspension | Oral candidiasis |
| Omeprazole 20 mg | Gastro-resistant capsule | Dyspepsia and gastroprotection from NSAID treatment in lower back pain |
| Scheriproct | Ointment and suppository | Haemorrhoids |
| Terbinafine 1% | Cream | Athlete's foot and fungal skin infection |
The Welsh Medicines Advice Service (WMAS) has developed these PGDs for local authorisation. 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.
| PGD | Date effective | Additional Clinical Guidance for Community Pharmacists |
|---|---|---|
| Administration of Inactivated Influenza Vaccine by pharmacists delivering the Community Pharmacy seasonal influenza vaccination component of the clinical community pharmacy service | 01 September 2023 (v2.0) | Find relevant Welsh Health Circular |
| Supply and / or administration of Levonorgestrel 1500 microgram tablet by pharmacists delivering the Community Pharmacy emergency contraception component of the clinical community pharmacy service | 01 October 2022 (v1.0) | - |
| Supply and / or administration of Ulipristal Acetate (ellaOne®) 30mg tablet by pharmacists delivering the Community Pharmacy emergency contraception component of the clinical community pharmacy service | 01 October 2022 (v1.0) | - |
| Supply of Desogestrel 75 microgram tablet by pharmacists delivering the clinical community pharmacy service for bridging and quickstart oral contraception | 21 November 2022 (v1.0) | Bridging and QuickStart Contraception Service Guidance 2022 * Young Persons Brief Screening Checklist * |
| Supply of antibiotics by pharmacists delivering the Sore Throat Test and Treat Service | 30 November 2022 (v1.3) | Sore Throat Test and Treat (STTT) Interim Guidance Monograph |
* Bridging and QuickStart oral contraception guidance has been produced by the NESB Community Pharmacy Services working group. Please direct any questions about these to your Local Health Board community pharmacy lead, or the service lead. |
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
Information about Patient Group Directions (PGDs) and Patient Specific Directions (PSDs) can be found on the Specialist Pharmacy Service (SPS) website:
[reviewed 07 Aug 23]
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.
- Can supply or administration be delegated to another practitioner under a PGD? (NHS Specialist Pharmacy Service)
- Further information can be found on the PHW training resources and events page
[updated 07 Aug 23]
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]
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 08 Aug 23]
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.
[updated 08 Aug 23]
Vaccine incident guidance: responding to vaccine errors 2022. (UKHSA)
Using written instruction for seasonal ‘flu vaccination (NHS Specialist Pharmacy Service)
Retaining legal mechanism documentation (NHS Specialist Pharmacy Service)
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)
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.
