Prescribing for Travel Vaccines

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There are three ways a travel vaccine can be administered

1. under a PGD (Patient Group Direction)

2. under a PSD (Patient Specific Direction)

3. by a medical or non medical prescriber (using an FP10 [GP10 in Scotland] for an NHS vaccine and a private prescription if the vaccine is to be administered as an non NHS vaccine).

Background information

  • Legislation passed in 2000 brought PGDs and PSDs into existence and at that time we were administering most travel vaccines under PGDs.
  • However, during 2007/2008 it became clear that the only travel vaccines that could be given under a PGD in an NHS setting were the NHS vaccines.  (These were and still are hepatitis A, typhoid, polio, cholera and ANY vaccine that has one of these disease protections within it e.g. Revaxis is combined tetanus, polio and diphtheria, so is NHS for travel in an NHS setting; also hepatitis A and B combined is provided as an NHS provision).
  • From 2008 all private travel vaccines administered in an NHS setting had to be administered using a prescription or PSD which had to be signed before the vaccines were administered.
  • Currently (2019) NHS travel vaccine template PGDs in England are prepared by Public Health England and can be found HERE  however they cannot be used until signed off (in Section 2, usually found on page 4) by your organisation that has the legal authority to authorise the PGD – to read a blog with more information about the regional teams for this see here
  • However, if you do not have a PGD for an NHS travel vaccine you could still administer the drug under a PSD on by a prescription – with both methods the PSD or prescription must be signed by the prescriber before administration (see below for more details on PSDs).

What detail must be on a PSD?

A PSD, signed by a qualified, registered prescriber, at a minimum should specify:

  • Name of patient and/or other individual patient identifiers
  • Name, form and strength of medicine (generic or brand name where
  • appropriate)
  • Route of administration
  • Dose
  • Frequency
  • Start and finish dates.
  • Signature of prescriber

For further details see this document from NHS England and from the MHRA archived information here  and directly from the Specialist Pharmacy Service here

Giving Private Travel Vaccines under a PGD in an NHS setting

In September 2015 a new development regarding Private Travel Vaccines and the writing of PGDs in a GP surgery occurred – here is the detail

The Human Medicines Regulations 2012 came into force on 14th August 2012 and it would appear that within the statutory document, an exemption was made for the provision of prescribing within private practice.  This information regarding the changes from 2012 does not appear to have been known by the travel medicine community but this now means that in England a PGD can now be used for the provision of private vaccines in this NHS setting

Where was the evidence?

The Care Quality Commission published guidance in their GP Mythbuster 19: Patient Group Directions (PGDs) / Patient Specific Directions (PSDs) published in December 2014 found HERE

In January 2016 the BMA published guidance on PGDs and PSDs which was then updated in December 2018 found at HEREThe full guidance document is found and is downloadable at the bottom of this webpage.

What resources are there to help with PGD development?

In the resources section of the information regarding PGDs on the NICE website, a Patient Group Direction template has been provided and it would seem sensible to follow this format when developing a private vaccine PGD.  See HERE

Other resources to help on the subject

How long should a PGD be kept after it has expired (The same rules apply to PGD records as to all other patient records. For adults, all PGD documentation must be kept for eight years, and for children until the child is 25 years old, or for eight years after a child’s death.) – see HERE

Public Health England PGD templates HERE

MHRA website on PGDs HERE

NHS PGD website HERE and SEARCH PGDs 

NICE site for PGDs HERE 

Information on retaining PGDs HERE

NaTHNaC Medicines Management resources for PGDs and other links HERE

NMC Medicines Management leading you to the latest documentation HERE

In August 2015 I wrote a travel health update in Practice Nurse Journal – please click HERE or on the image to the left below. Thanks go to Practice Nurse for allowing me to publish this article on my website.  Thanks also to Elaine Biscoe (National Practice Nursing Advisor) and Brian Brown (National Medicines Manager) at the CQC for their help informing me of these changes.

For the BMA guidance on PGDs and PSDs go the the website HERE

For the travel risk assessment and travel risk management forms see items no. 1 and 2 in TOOLS – click HERE.  The travel risk management form has a sample PSD included within it.

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