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.
Phenoxymethylpenicillin (Penicillin V)
Clinical condition or situation to which this PGD applies
Acute sore throat due to suspected streptococcal infection in children aged 5 years and over and adults.
Criteria for inclusion
Diagnostic tool (children and adults)
FeverPAIN score for Strep pharyngitis (one point for each):
- Fever (high temperature) in previous 24 hours
- Purulent tonsils
- Attend rapidly (symptom onset ≤3 days)
- Severe tonsillar Inflammation
- No cough/coryza
FeverPAIN score of 4 or 5 with severe symptoms required for antimicrobial to be considered (see [Action to be taken if the individual is excluded] section).
Exclusions & Additional Prescribing Details Links
Description of treatment
Clarithromycin
Clinical condition or situation to which this PGD applies
Acute sore throat due to suspected streptococcal infection in children aged 5 years and over and adults, where phenoxymethylpenicillin is not appropriate due to hypersensitivity.
Criteria for inclusion
- Informed consent
- Individuals aged 5 years and over
- Diagnosis of sore throat using the appropriate NICE guidance.
- Known hypersensitivity to phenoxymethylpenicillin (penicillin V), any penicillin or any of the components within the formulation of phenoxymethylpenicillin - 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
Diagnostic tool (children and adults)
FeverPAIN score for Strep pharyngitis (one point for each):
- Fever (high temperature) in previous 24 hours
- Purulent tonsils
- Attend rapidly (symptom onset ≤3 days)
- Severe tonsillar Inflammation
- No cough/coryza
FeverPAIN score of 4 or 5 with severe symptoms required for antimicrobial to be considered (see Action to be taken if the individual is excluded section).
Exclusions & Additional Prescribing Details Links
Description of treatment
Erythromycin
Clinical condition or situation to which this PGD applies
Acute sore throat due to [suspected] streptococcal infection in young people and adults aged 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
- Diagnosis of sore throat using the appropriate NICE guidance.
- Pregnancy or suspected pregnancy
- Known hypersensitivity to phenoxymethylpenicillin (penicillin V), any penicillin or any of the components within the formulation of phenoxymethylpenicillin - 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
Diagnostic tool (children and adults)
FeverPAIN score for Strep pharyngitis (one point for each):
- Fever (high temperature) in previous 24 hours
- Purulent tonsils
- Attend rapidly (symptom onset ≤3 days)
- Severe tonsillar Inflammation
- No cough/coryza
FeverPAIN score of 4 or 5 with severe symptoms required for antimicrobial to be considered (see Action to be taken if the individual is excluded section).
Exclusions & Additional Prescribing Details Links
Description of treatment
Key references
Key references