The Pharmaceutical Journal
Vol 270 No 7244 p499
12 April 2003

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DoH: Patient Group Directions (more)

PGDs for pharmacy supply in event of biological incidents released by DoH

The Department of Health has issued a set of patient group direction (PGD) templates that will enable pharmacists to supply treatment to people exposed to biological agents in mass casualty situations.

The templates include PGDs for the supply, by pharmacists and nurses, of ciprofloxacin tablets and doxycycline capsules to people known or suspected to have been exposed to anthrax, plague or tularaemia (a disease caused by the bacilus Francisella tularense). There is also a PGD for registered health care professionals to supply potassium iodate tablets to people thought to have been, or expected to be, exposed to radioactive iodine.

The Journal understands that the templates were developed by the Department some time ago but that they have been released to primary care organisations now that emergency planning is being co-ordinated at a local level.

Sonia Colwill, pharmaceutical adviser for South East London Strategic Health Authority, was made aware of the PGDs last week and told The Journal that she has sent them to PCT pharmacy advisers. "I have suggested that as a minimum they should take them to the appropriate committees and get them signed off and then deploy them in whatever local plans they have."

She added that PCTs would need to think about how the PGDs will be used and who will administer them.

Ms Colwill is also assistant director of pharmaceutical public health at Lambeth Primary Care Trust. The PCT is about to send information to local community pharmacists about what they should do in the event of an incident, such as if a contaminated person walks into the pharmacy. Although she could not give details of what pharmacists would be told, Ms Colwill said the information would be presented in a practical way. She added that Lambeth PCT was now involving pharmaceutical advisers and a community pharmacist in planning at a strategic level. "I think pharmacists will be involved in a reactive way," she said.

The PGDs for ciprofloxacin and doxycycline suggest that, if exposure to a biological agent has occurred or is suspected, an initial three days supply of treatment should be given as prophylaxis. The PGD gives information about who can be treated using the PGD (in both cases adults and children over 12 years). It also includes information about patients in whom the benefits of using either drug are likely to outweigh the potential risks.

PGDs for administration of atropine and pralidoxime by paramedics and nurses to patients with nerve agent poisoning have also been published on the Department's website. Others will be published as they are developed.