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.
Flucloxacillin
Clinical condition or situation to which this PGD applies
Infected insect bite(s) and sting(s) in children aged 1 year and over and adults.
Criteria for inclusion
- Informed consent
- Individuals aged 1 year and over
- Diagnosis of infected insect bite or sting using the appropriate diagnostic (NICE CKS) guidance.
- Clear evidence of infection that is present or worsening at least 48 hours after the initial bite(s) or sting(s) with 3 or more of the following symptoms:
- Redness of the skin (erythema may be more difficult to distinguish on darker skin tones)
- Pain or tenderness to the area
- Swelling of the skin
- Skin surrounding the bite(s) or sting(s) feels hot to touch
AND any of the following:
- Redness or swelling of the skin surrounding the bite(s) or sting(s) is spreading
- Evidence of pustular discharge at site of bite(s) or sting(s)
Exclusions & Additional Prescribing Details Links
Description of treatment
Clarithromycin
Clinical condition or situation to which this PGD applies
Infected insect bite(s) and sting(s) in children aged 1 year and over and adults, where flucloxacillin is not appropriate due to hypersensitivity.
Criteria for inclusion
- Informed consent
- Individuals aged 1 year and over
- Diagnosis of infected insect bite or sting using the appropriate diagnostic (NICE CKS) guidance.
- Clear evidence of infection that is present or worsening at least 48 hours after the initial bite(s) or sting(s) with 3 or more of the following symptoms:
- Redness of the skin (erythema may be more difficult to distinguish on darker skin tones)
- Pain or tenderness to the area
- Swelling of the skin
- Skin surrounding the bite(s) or sting(s) feels hot to touch
AND any of the following:
- Redness or swelling of the skin surrounding the bite(s) or sting(s) is spreading
- Evidence of pustular discharge at site of bite(s) or sting(s)
- Known hypersensitivity to flucloxacillin, any penicillin or any of the components within the formulation of flucloxacillin – 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
Infected insect bite(s) and sting(s) in young people and adults aged 16 years and over who are pregnant, or where pregnancy is suspected and where flucloxacillin is not appropriate due to hypersensitivity.
Criteria for inclusion
- Informed consent
- Individuals aged 1 year and over
- Diagnosis of infected insect bite or sting using the appropriate diagnostic (NICE CKS) guidance.
- Clear evidence of infection that is present or worsening at least 48 hours after the initial bite(s) or sting(s) with 3 or more of the following symptoms:
- Redness of the skin (erythema may be more difficult to distinguish on darker skin tones)
- Pain or tenderness to the area
- Swelling of the skin
- Skin surrounding the bite(s) or sting(s) feels hot to touch
AND any of the following:
- Redness or swelling of the skin surrounding the bite(s) or sting(s) is spreading
- Evidence of pustular discharge at site of bite(s) or sting(s)
- Pregnancy or suspected pregnancy
- Known hypersensitivity to flucloxacillin, any penicillin or any of the components within the formulation of flucloxacillin – 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
Key references
Key references