NHSE Pharmacy First PGDs
Characteristics of staff
Qualifications and professional registration
-
Registered healthcare professional listed in the legislation as able to practice under Patient Group Directions.
Initial training
- The registered healthcare professional authorised to operate under this PGD must have undertaken appropriate education and training and be competent to undertake clinical assessment of patients ensuring safe provision of the medicines listed in accordance with the specification.
- To deliver this service, the registered healthcare professional should have evidence of competence in the clinical skills and knowledge covered in the Centre for Pharmacy Postgraduate Education (CPPE) Pharmacy First Service self-assessment framework.
- Before commencement of the service, the pharmacy contractor must ensure that pharmacists and pharmacy staff providing the service are competent to do so and be familiar with the clinical pathways, clinical protocol and PGDs. This may involve completion of training
Competency assessment
Ongoing training and competency
- Individuals operating under this PGD are personally responsible for ensuring they remain up to date with the use of all medicines and guidance included in the PGD - if any training needs are identified these should be discussed with the senior individual responsible for authorising individuals to act under the PGD and further training provided as required.
The decision to supply any medication rests with the individual registered health professional who must abide by the PGD and any associated organisational policies.
Fluticasone | Mometasone
Clinical condition or situation to which this PGD applies
Acute sinusitis (rhinosinusitis) in children aged 12 years and over and adults.
Criteria for inclusion
- Informed consent
- Individuals aged 12 years and over
- Signs and symptoms of acute sinusitis using the appropriate NICE guidance
- Diagnosis of acute sinusitis using the appropriate NICE CKS guidance.
- Presence of ONE of the following signs/symptoms (which suggests acute sinusitis is more likely):
- Nasal blockage (obstruction/congestion) OR
- Nasal discharge (anterior/posterior nasal drip)
AND ONE or more of the following:
- Facial pain/pressure (or headache) OR
- Reduction (or loss) of the sense of smell (in adults) OR
- Cough during the day or at night (in children)
- Symptom duration of 10 days of more with little improvement
- Presence of TWO or more of the following signs/symptoms (which suggests acute bacterial sinusitis is more likely):
- Marked deterioration after an initial milder phase
- Fever (>38°C)
- Unremitting purulent nasal discharge
- Severe localised unilateral pain, particularly pain over the teeth (toothache) and jaw
Exclusions & Additional Prescribing Details Links
Description of treatment Fluticasone
Description of treatment Mometasone
Phenoxymethylpenicillin (Penicillin V)
Clinical condition or situation to which this PGD applies
Acute bacterial sinusitis (rhinosinusitis) in children aged 12 years and over and adults.
Criteria for inclusion
- Informed consent
- Individuals aged 12 years and over
- Signs and symptoms of acute sinusitis using the appropriate NICE guidance
- Diagnosis of acute sinusitis using the appropriate NICE CKS guidance.
- Presence of ONE of the following signs/symptoms (which suggests acute sinusitis is more likely):
- Nasal blockage (obstruction/congestion) OR
- Nasal discharge (anterior/posterior nasal drip)
AND ONE or more of the following:
- Facial pain/pressure (or headache) OR
- Reduction (or loss) of the sense of smell (in adults) OR
- Cough during the day or at night (in children)
- Symptom duration of 10 days of more with little improvement
- Presence of TWO or more of the following signs/symptoms (which suggests acute bacterial sinusitis is more likely):
- Marked deterioration after an initial milder phase
- Fever (>38°C)
- Unremitting purulent nasal discharge
- Severe localised unilateral pain, particularly pain over the teeth (toothache) and jaw
- Persistent symptoms despite use of high-dose nasal corticosteroid (off-label) for 14 days
OR
- High-dose nasal corticosteroid (off-label) unsuitable
Exclusions & Additional Prescribing Details Links
Description of treatment
Clarithromycin
Clinical condition or situation to which this PGD applies
Acute bacterial sinusitis (sinusitis) in children aged 12 years and over and adults where phenoxymethylpenicillin is not appropriate due to hypersensitivity.
Criteria for inclusion
- Informed consent
- Individuals aged 12 years and over
- Signs and symptoms of acute sinusitis using the appropriate NICE guidance
- Diagnosis of acute sinusitis using the appropriate NICE CKS guidance.
- Presence of ONE of the following signs/symptoms (which suggests acute sinusitis is more likely):
- Nasal blockage (obstruction/congestion) OR
- Nasal discharge (anterior/posterior nasal drip)
AND ONE or more of the following:
- Facial pain/pressure (or headache) OR
- Reduction (or loss) of the sense of smell (in adults) OR
- Cough during the day or at night (in children)
- Symptom duration of 10 days of more with little improvement
- Presence of TWO or more of the following signs/symptoms (which suggests acute bacterial sinusitis is more likely):
- Marked deterioration after an initial milder phase
- Fever (>38°C)
- Unremitting purulent nasal discharge
- Severe localised unilateral pain, particularly pain over the teeth (toothache) and jaw
- Persistent symptoms despite use of high-dose nasal corticosteroid (off-label) for 14 days
OR
- High-dose nasal corticosteroid (off-label) unsuitable
- Known hypersensitivity to phenoxymethylpenicillin (penicillin V), any penicillin or any of the components within the formulation of phenoxymethylpenicillin formulations - see Summary of Product Characteristics. Acceptable sources of allergy information include individual/carer/parent/guardian or National Care Record
OR
- History of severe immediate hypersensitivity reaction (e.g. anaphylaxis) to another beta-lactam antibiotic (e.g. cephalosporin, carbapenem or monobactam). Acceptable sources of allergy information include individual/carer/parent/guardian or National Care Record
Exclusions & Additional Prescribing Details Links
Description of treatment
Erythromycin
Clinical condition or situation to which this PGD applies
Acute bacterial sinusitis (sinusitis) in adults 16 years and over who are pregnant or where pregnancy is suspected and where phenoxymethylpenicillin is not appropriate due to hypersensitivity.
Criteria for inclusion
- Informed consent
- Individuals aged 16 years and over
- Signs and symptoms of acute sinusitis using the appropriate NICE guidance
- Diagnosis of acute sinusitis using the appropriate NICE CKS guidance.
- Presence of ONE of the following signs/symptoms (which suggests acute sinusitis is more likely):
- Nasal blockage (obstruction/congestion) OR
- Nasal discharge (anterior/posterior nasal drip)
AND ONE or more of the following:
- Facial pain/pressure (or headache) OR
- Reduction (or loss) of the sense of smell (in adults) OR
- Cough during the day or at night (in children)
- Symptom duration of 10 days of more with little improvement
- Presence of TWO or more of the following signs/symptoms (which suggests acute bacterial sinusitis is more likely):
- Marked deterioration after an initial milder phase
- Fever (>38°C)
- Unremitting purulent nasal discharge
- Severe localised unilateral pain, particularly pain over the teeth (toothache) and jaw
- Persistent symptoms despite use of high-dose nasal corticosteroid (off-label) for 14 days
OR
- High-dose nasal corticosteroid (off-label) unsuitable
- Pregnancy or suspected pregnancy
- Known hypersensitivity to phenoxymethylpenicillin (penicillin V), any penicillin or any of the components within the formulation of phenoxymethylpenicillin formulations - see Summary of Product Characteristics. Acceptable sources of allergy information include individual/carer/parent/guardian or National Care Record
OR
- History of severe immediate hypersensitivity reaction (e.g. anaphylaxis) to another beta-lactam antibiotic (e.g. cephalosporin, carbapenem or monobactam). Acceptable sources of allergy information include individual/carer/parent/guardian or National Care Record
Exclusions & Additional Prescribing Details Links
Description of treatment
Doxycycline
Clinical condition or situation to which this PGD applies
Acute bacterial sinusitis (rhinosinusitis) in children 12 years and over and adults where phenoxymethylpenicillin is not appropriate due to hypersensitivity.
Criteria for inclusion
- Informed consent
- Individuals aged 12 years and over
- Signs and symptoms of acute sinusitis using the appropriate NICE guidance
- Diagnosis of acute sinusitis using the appropriate NICE CKS guidance.
- Presence of ONE of the following signs/symptoms (which suggests acute sinusitis is more likely):
- Nasal blockage (obstruction/congestion) OR
- Nasal discharge (anterior/posterior nasal drip)
AND ONE or more of the following:
- Facial pain/pressure (or headache) OR
- Reduction (or loss) of the sense of smell (in adults) OR
- Cough during the day or at night (in children)
- Symptom duration of 10 days of more with little improvement
- Presence of TWO or more of the following signs/symptoms (which suggests acute bacterial sinusitis is more likely):
- Marked deterioration after an initial milder phase
- Fever (>38°C)
- Unremitting purulent nasal discharge
- Severe localised unilateral pain, particularly pain over the teeth (toothache) and jaw
- Persistent symptoms despite use of high-dose nasal corticosteroid (off-label) for 14 days
OR
- High-dose nasal corticosteroid (off-label) unsuitable
- Known hypersensitivity to phenoxymethylpenicillin (penicillin V), any penicillin or any of the components within the formulation of phenoxymethylpenicillin formulations - see Summary of Product Characteristics. Acceptable sources of allergy information include individual/carer/parent/guardian or National Care Record
OR
- History of severe immediate hypersensitivity reaction (e.g. anaphylaxis) to another beta-lactam antibiotic (e.g. cephalosporin, carbapenem or monobactam). Acceptable sources of allergy information include individual/carer/parent/guardian or National Care Record
Exclusions & Additional Prescribing Details Links
Doxycycline 100mg capsules
Doxycycline 100mg dispersible tablets
Description of treatment
Key references
Key references