Integrated Care Organisation
Incorporating the Community Services of
Brent, Ealing, and Harrow
Approval of PGDs (previously used within NWLHT), for use by Nurses, and by Emergency Care Practitioners (registered with the Healthcare Commission as Paramedics), employed by the NHS and working within the Ealing Hospital NHS Trust Urgent Care Centre (UCC) at Northwick Park Hospital.Purpose of this document:
To authorise, on behalf of Ealing Hospital NHS Trust, the use of the PGDs listed below, by NHS-employed staff working in the Ealing Hospital NHS Trust Urgent Care Centre, (at Northwick Park Hospital)
Background: The listedPGDs were previously approved in October 2011 by the NWLHT Drugs and Therapeutics Committee for use by NWLHT-employed Triage Nurses (T) and Emergency Nurse Practitioners (ENP) in the A&E Department at Northwick Park Hospital.
Ealing Hospital NHS Trust Urgent Care Centre employs some nurses who are not qualified as non-medical prescribers, for whom the use of the listed PGDs is appropriate. The UCC will also be employing Emergency Care Practitioners, registered with the Healthcare Professionals Council as paramedics, who may be trained and authorised to work under the listed PGDs. (MHRA website
The listed PGDs are due for review in October 2013.
The PGDs were written for NWLHT by a team comprising:
Lead nurse: Julie O’Donoghue, Matron, A&E Northwick Park Hospital.
Doctor: Dr Gillian Park, Consultant, A&E NPH.
Pharmacist: Debbie McGrath, Principal Pharmacist, Central Middlesex Hospital, NWLHT.
The PGDs were approved via the NWLHT Drugs and Therapeutics Committee and by:
NWLHT Chief Pharmacist: Christine Ward.
NWLHT Chair of Drugs and Therapeutics Committee: Dr David Sherman.
NWLHT Clinical Director:Dr Charles Cayley.
NWLHT Director of Nursing: Carole Flowers.
Each member of UCC staff will be authorised individually to work under each PGD.
A copy of this form, and a copy of the individual ‘Staff Authorisation Form’ must be attached to the copy of each PGD:
- held in the file in the Urgent Care Centre
- held by each member of staff who is trained and authorised to work under each PGD.
The Chair of the Drugs and Therapeutics Group, and the Chief Pharmacist, Director of Nursing and Medical Director of Ealing Hospital NHS Trust are requested to sign the form below.
A copy of this form will be attached as a front cover to each of the NPH A&E PGDs as an authorisation for the listed PGDs to be used within the Ealing Hospital NHS Trust and Greenbrook Healthcare Partnership Urgent Care Centre at Northwick Park Hospital.
Name / Job Title
(Within Ealing Hospital NHS Trust). / Signature / Date
Chair of Drugs and Therapeutics Group.
Chief Pharmacist.
Director of Nursing.
Medical Director.
Approval of PGDs (previously used within NWLHT), for use by Nurses, and by Emergency Care Practitioners (registered with the Healthcare Commission as Paramedics), employed by the NHS and working within the Ealing Hospital NHS Trust Urgent Care Centre (UCC) at Northwick Park Hospital.
The listed PGDs are due for review in October 2013.
Title / Age range. / NPH staff previously using PGD.
(T/ENP*)
Chloramphenicol eye ointment 1% and drops for the prophylaxis and treatment of presumed bacterial eye infections. / Adults and Children (over 1 year). / ENP
Chlorphenamine tabs/liquid for the treatment of allergy. / Adults and Children (over 1 year). / T/ENP
Co-amoxiclav tabs for the treatment of dental abscesses. / Adults and Children (over 12 years). / ENP
Co-amoxiclav tabs/liquid for the treatment of bites. / Adults and Children (over 1 year). / ENP
Co-amoxiclavtabs/liquid for the treatment of minor wound infections. / Adults and Children (over 1 year). / ENP
Co-dydramol tablets for the treatment of moderate pain. / Adults and Children (over 12 years). / T/ENP
Flucloxacillin caps/liquid for the treatment of minor wound infections. / Adults and Children (over 1 year). / ENP
Fluorescein sodium Ophthalmic strips to detect foreign bodies and lesions. / Adults and Children (over 1 year). / ENP
Ibuprofen tabs/liquid for the treatment of mild/moderate pain and pyrexia. / Adults and Children (over 1 year). / T/ENP
Lidocaine 1% injection as a local anaesthetic. / Adults and Children (over 5 years). / ENP
Lidocaine 2% injection as a local anaesthetic. / Adults and Children (over 5 years). / ENP
Paracetamol tabs/liquid for the treatment of mild to moderate pain. / Adults and Children (over 1 year). / T/ENP
Revaxis vaccine. / Adults and Children (over 10 years). / ENP
Tetracaine 1% Eye minims to anaesthetise the eye, prior to minor surgery/diagnostic procedures. / Adults and Children (over 1 year). / ENP
Sofradex Ear Drops for the treatment of Otitis Externa. / Adults and Children (over 1 year). / ENP
Salbutamol nebules for the relief of acute wheezing in adults. / Adults (over 18 years). / T/ENP
Salbutamol nebules for the relief of acute wheezing in paediatrics. / Children (under the age of 18 years). / T
*Triage=T. Emergency Nurse Practitioners=ENP.
In accordance with the requirements of the Ealing Hospital NHS Trust PGD Policy, all staff working under any of these PGDs must fulfil the training requirements of the PGD , and be authorised to work under each PGD, using the authorisation form below.
In accordance with the Ealing Hospital NHS Trust PGD policy, each member of staff working under the PGD will be assessed individually for their knowledge and understanding of the law relating to the use of PGDs, of the content of each PGD, their ability to make an appropriate diagnosis and thus of their competence to work under each PGD. Where necessary, staff may be required to undertake further formal training prior to working under the PGD. However experienced members of staff may not require any additional formal training.
17 June 2012 Philippa Lewis, Community Health Services Pharmacist, NWLHT
For: Title of Patient Group Direction………………………………………………………………………..
PGD Approval Date:………………… PGD Review date:………………………..
To be completed, signed and dated by the employer (Service manager) and employee.
PGDs DO NOT REMOVE INHERENT PROFESSIONAL OBLIGATIONS OR ACCOUNTABILITY.
IT IS THE RESPONSIBILITY OF EACH PROFESSIONAL TO PRACTICE ONLY WITHIN THE BOUNDS OF THEIR OWN COMPETENCE AND IN ACCORDANCE WITH THEIR OWN CODE OF PROFESSIONAL CONDUCT.
YOU CANNOT DELEGATE TASKS UNDER THIS PGD TO ANYONE ELSE.
Authorisation for the named health professional:______(print name) ______(place of work)
who has completed the required training, and assessment satisfactorily and is now deemed competent, to supply/ administer the medicine/s in accordance with the attached Patient Group Direction
To be completed, signed and dated by the employee.
I agree that I have received, read and fully understood the Patient Group Direction to supply/administer the named medicine(s). In addition I have read and fully understood the related guidance and policies relating to the Patient Group Direction.
I have read and understood the PGD Policy.
I have completed the training related to the PGD, have been assessed as competent, and would like to accept the responsibility to work under the PGD.
I agree to work within my competence and professional code of conduct.I also agree to inform the Service Manager of any changes in my circumstances that would affect my ability to act as a practitioner under the PGD.
Healthcare professional’s signature: ______
Date: ______
A record of training undertaken and a copy of competency assessments, if appropriate, should be attached to this form.
Authorised by: Signature, name and address of authorising clinician.I, ______/______/ date: ______(Print
name/signature) (Service Manager) give authorisation on behalf of Ealing Hospital NHS Trust Integrated Care Organisation Incorporating the Community Services of Brent, Ealing and Harrow for the above named Healthcare Professional who has signed this Patient Group Direction, and has been assessed as competent, to supply/administer the medicine in accordance with Patient Group Direction and current guidelines.
This PGD is to be read, agreed to and signed by all registered healthcare professionals it applies to.
One copy of this form, with the Patient Group Direction, should be given to each healthcare professional and the original signed copy kept by the Service Manager. It is the responsibility of the healthcare professional to ensure that their employer has a copy of the signed authorisation form.
L:\Mem Iron NPH\EICO PGDs\UCC PGDs EICO 2012\120617 PGDs UCC EICO approval forms DTG Final 17 Jun 2012 v4.doc