Patient Group Directions: Authorisation: Flu Immunisations

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A decision made on 05 October 2018

Decision Reference: MD-HSS-2018-0044
Decision Summary Title :	Authorisation of three Patient Group Directions (PGDs) to enable Primary Care Practice Nurses and Community Pharmacists to administer flu vaccinations.		Date of Decision Summary:	02 September 2018
Decision Summary Author:	Head of Preventive Programmes		Decision Summary: Public or Exempt?	Public
Type of Report:	Written		Person Giving Report:	Head of Preventive Programmes
Written Report Title :	Authorisation of Patient Group Directions for flu immunisations delivered by Healthcare Professionals in Primary Care		Date of Written Report:	02 September 2018
Written Report Author:	Head of Preventive Programmes		Written Report : Public or Exempt?	Public
Subject: Authorisation of Patient Group Directions to enable flu immunisations to be delivered by Healthcare Professionals in Primary Care.
Decision(s): The Minister for Health and Social Services authorised the use, by appropriately trained Practice Nurses and Community Pharmacists, of Patient Group Directions to enable the administration of flu vaccinations to specific groups of people without the need for a doctor’s prescription.
Reason(s) for Decision: Patient Group Directions (PGDs) are written instructions which provide a framework for qualified healthcare professionals (such as nurses and pharmacists) to administer medicines such as vaccinations, to people in designated groups without the need for a doctor to write an individualised prescription. PGDs are used frequently within the NHS and Health organisations and are used regularly within Health & Community Services to support efficient delivery of services to patients. Practice Nurses and Community Pharmacists in Jersey are not directly employed by the Health and Social Services Department and authorisation for their use of PGDs must be given by the Minister for Health and Social Services.
Resource Implications There are no financial or manpower implications.
Action required: Minister to sign authorisation of three PGDs for flu vaccinations. Head of Preventive Programmes to circulate copies of the authorised PGDs to Primary Care Practice Nurses and Pharmacists. Primary Care Practice Nurses and Pharmacists to sign the PGD ‘individual practitioner authorisation sheets’ and to obtain signature of their authorising manager and return scanned copies to the Head of Preventive Programmes. Head of Preventive Programmes to maintain a record of flu vaccinators working under the PGDs.
Signature:		Position: Minister for Health and Social Services
Date Signed:		Date of Decision (If different from Date Signed):

Patient Group Directions: Authorisation: Flu Immunisations

Report

Purpose

This report provides the background and rationale for seeking the Health Minister’s decision to authorise Patient Group Directions (PGDs) to enable Primary Care healthcare professionals to administer flu immunisations.

Background:

Patient Group Directions (PGDs) are written instructions that provide a framework for healthcare professionals (such as nurses and pharmacists) to administer medicines (such as flu vaccines) to people in designated groups without the need for an individualised prescription from a doctor. This supports the efficient delivery of patient care.

Patient Group Directions are used frequently within the National Health Service and within Health & Community Services (HCS). In HCS, the Chief Pharmacist, as Chair of the Medicines Governance Committee, has delegated authority from the Health Minister to authorise PGDs used by HCS employees. For healthcare professionals within Primary Care, who are not directly employed by HCS, the Health Minister’s authorisation is required. In 2017, a governance process was implemented to support the approval and authorisation of PGDs (summarised in appendix 1) for use by Jersey’s Primary Care Community Pharmacists and Practice Nurses.

Authorisation for three PGDs is now sought to support healthcare professionals within Primary Care to administer flu immunisations:

These are:

A PGD for intramuscular (via injection) flu immunisation by Community Pharmacists
A PGD for intramuscular (via injection) flu immunisation by Practice Nurses
A PGD for nasal flu immunisation by Practice Nurses

The above PGDs will enable appropriately trained Community Pharmacists and Practice Nurses to administer flu immunisations to patient groups recommended to receive flu vaccine as part of the publicly funded flu immunisation programme without the necessity of a doctor’s prescription.

The publicly funded flu immunisation programme seeks to:

Provide a patient centred flu vaccination service which increases patient choice
Improve access to seasonal flu vaccination services
Increase uptake of seasonal flu vaccine among people aged 65 and over, clinically indicated groups (medically at risk) and to optimise coverage among target groups
Reduce hospital admissions related to seasonal flu
Develop processes across primary care providers to improve the uptake of seasonal flu vaccination

In autumn 2018, the flu PGDs required updating to reflect national changes to the flu vaccines recommended for use in 2018/19 by the UK expert advisory committee, the Joint Committee for Vaccination and Immunisation (JCVI). Representatives of the Primary Care professional groups who will use the PGDs in Jersey have been involved in their development. The PGDs have been approved by the HCS Chief Pharmacist and the Medical Director for Primary Care. A Ministerial Decision is now sought to authorise their use.

Appendix 1: Summary of Primary Care PGD development, approval and authorisation process.

Report written by Dr Linda Diggle, Head of Preventive Programmes

Report to support Ministerial Decision authorising use of Patient Group Directions by Primary Care Healthcare professionals for enabling flu immunisations Page 1 of 2