- Posted by
- Nick Mattick
14 December 2020
The official Faculty of Physician Associate guidance for GP is below.
PAs are currently unable to administer medication via a patient group direction (PGD) and this is unlikely to change post regulation, as it requires a change to the Human Medicines Regulations 2012, which is not planned at present. PAs can administer medications under a patient specific direction (PSD), which is a written instruction, signed by an authorised prescriber, for medicine(s) to be administered to a named person after the prescriber has assessed the patient.
This has to be on an individual patient-by-patient basis. This process is more commonly referred to as a 'prescription' in clinical practice, but the legislation refers to this method as a patient specific direction.
Under the GMC’s Ethical guidance “Prescribing at the recommendation of a professional colleague” a registered doctor may delegate the assessment of a patient to another professional, so long as that doctor is satisfied that the person to whom they delegate to has the qualifications, experience, knowledge and skills to make the assessment. As such, it is possible for a PA to assess a patient and then recommend a medication to a doctor for prescription, so long as that doctor is happy with this process. The format that this takes is decided at the local level, between the PA, their supervising consultant/GP and the employing organisation.
The supervising consultant/GP needs to ensure the PA has the necessary knowledge and competency to administer a medication (including pre, during, post issues, complications and other necessary procedures). The PA needs to ensure that the patient has a patient specific direction (PSD) signed by a prescriber prior to the administration of the medication.
Additionally, each employing organisation will have a medicines policy which will dictate which healthcare professionals are authorised to administer medications to patients within that organisation. These policies must be followed by the physician associate, no different than other healthcare professionals.
PAs should have been trained in administering a vaccination when studying to be a PA. There is a free online e-LfH course on immunisations and vaccines which PAs may wish to consider completing from e-LfH Immunisations/Vaccines.
All healthcare professionals advising on immunisation or administering vaccines must have received specific training in immunisation, including the recognition and treatment of anaphylaxis. They should maintain and update their professional knowledge and skills through appropriate training.
There is no mandatory need for PAs to complete the aforementioned course, unless your supervising consultant/GP wants to use the course as proof of competency or if you do not feel competent to safely administer vaccines, or recognise and treat complications such as, but not limited to, anaphylaxis. All PAs should be familiar with Immunisation against infectious disease - 'The Green Book' which details the requirements.
Vaccinations/immunisations would need to be prescribed via the patient specific direction method, as described above, and PAs cannot legally administer vaccinations/immunisations via patient group directions.
Health Education England e-Learning for Healthcare has worked in partnership with Public Health England and NHS England and NHS Improvement to develop the COVID-19 Vaccination e-learning programme. The e-learning programme is designed to provide the health and care workforce involved in the national COVID-19 vaccination programme with the knowledge they need to confidently promote high uptake of the vaccine and deliver the vaccine programme effectively.
The programme currently consists of one core knowledge session, which covers subjects including vaccine eligibility and legal aspects, and an accompanying multiple-choice assessment session. All those undertaking this e-learning should complete the core knowledge session as this is designed to provide essential knowledge about COVID-19 and the key principles of vaccination needed to deliver the vaccine.
This e-learning programme provides theoretical training. Practical training in vaccine administration, and assessment and sign-off competency is also required before administering the COVID-19 vaccine.
Learners should also complete the vaccine specific session(s), when available, which will provide more detailed information about the vaccine(s). The assessment sessions should be completed after each knowledge session. More vaccine-specific sessions will be added as and when more COVID-19 vaccines become available.
Additional, complementary, e-learning sessions including Basic Life Support, anaphylaxis and statutory and mandatory training are available to support vaccinators’ training and education.
For more information about the COVID-19 Vaccination programme, including details on how to access, visit the e-LfH website.