Anyone working in a UK pharmacy has bumped into both these terms at some point. PGD and PSD look almost identical on paper, both let you supply or hand out medicines without a normal handwritten prescription, and that overlap is exactly why so many pharmacists, technicians and locums end up mixing them up.
But they're built for completely different jobs. Use the wrong one and you're not just filling in the wrong form, you could end up working outside the law without even realising it. So here's the difference, laid out plainly, with the kind of detail you'd actually reach for on a busy shift at the counter.
If your pharmacy is reviewing its own PGD setup, Scripter Digital lets you browse current PGDs, and their pricing page is worth a look if you're considering a more structured way to manage them.
The short version
A Patient Specific Direction (PSD) is a written instruction from a prescriber for one named patient, written after that patient has been individually assessed. A Patient Group Direction (PGD) is a written instruction that lets certain healthcare professionals supply or give a medicine to a whole group of patients who fit a defined clinical situation, without the prescriber ever meeting each person first.
Put simply: PSD covers one patient and one prescriber's decision. PGD covers many patients under one pre-agreed protocol, signed off well in advance.
That's the headline. The detail underneath it is where most pharmacies trip up, so let's go through it.
Patient Specific Directions, explained
A PSD is the older, more familiar of the two. It's a written instruction, signed by a doctor, dentist or another independent prescriber, telling a named healthcare professional to supply or administer a specific medicine to one specific patient who's already been assessed.
A hospital drug chart is a good example. When a doctor writes up a patient's medication on the ward chart, that's effectively a PSD in action. A nurse or pharmacy technician can then give that medicine to the patient based on the prescriber's instruction, even though it isn't a formal FP10 prescription.
A few things worth knowing about PSDs:
- They cover one named patient only, assessed individually by the prescriber.
- Any prescriber can write one: doctor, dentist, independent prescribing pharmacist, nurse prescriber, and so on.
- There's no fixed template, but the instruction needs enough detail to act on safely, things like the patient's name, the medicine, dose, route, frequency and duration.
- There's no legal restriction on which trained healthcare professionals can act under a PSD, provided the instruction is clear enough to follow.
You'll see PSDs everywhere in hospital pharmacy and GP practices, and increasingly in community pharmacy too, particularly where an independent prescribing pharmacist has assessed someone and wants a colleague to handle the actual supply or administration.
Patient Group Directions, explained
A PGD works in a completely different way. Instead of being written for one person, it's a protocol authorised in advance for a whole group of patients who meet set criteria, drawn up before any of them have even walked in.
According to the legal definition set out in the Human Medicines Regulations 2012, a PGD is a written instruction for the supply or administration of a licensed medicine in an identified clinical situation, and it has to be signed by both a doctor or dentist and a pharmacist.
This is what makes things like flu clinics, travel vaccination services and emergency contraception supply possible in a community pharmacy without a prescription for every single customer. The pharmacy operates under a PGD that's already been authorised by the relevant body, usually NHS England, an integrated care board, or a local authority, and anyone who fits the criteria can be treated under it.
A few things worth knowing about PGDs:
- They cover an identified clinical situation, not a named individual.
- They need authorisation from an appropriate organisation before use, plus sign-off from a doctor or dentist and a pharmacist.
- Only the specific professions listed in Schedule 16 of the Human Medicines Regulations can act under a PGD. This includes pharmacists, nurses, paramedics, optometrists and physiotherapists among others, though healthcare assistants and, until recently, pharmacy technicians have been left out.
- Only medicines with a UK marketing authorisation can be included. Unlicensed medicines, most controlled drugs and off-label use are generally off limits.
- They expire and need regular review. An expired PGD can't legally be used, full stop, and staff should fall back on a PSD if that happens.
PGD vs PSD at a glance
| Feature | PSD | PGD |
|---|---|---|
| Who it covers | One named, assessed patient | A defined group of patients |
| When the patient is identified | Before the instruction is written | Not identified in advance |
| Who signs it | Any prescriber | A doctor or dentist and a pharmacist, plus organisational sign-off |
| Who can act under it | Any suitably trained professional named in the instruction | Only professions listed under Schedule 16 |
| Typical use | Drug charts, individual prescribing decisions handed to a colleague | Flu clinics, travel vaccines, emergency contraception, minor ailment schemes |
| Medicines covered | Broader, since it's an individual decision | Licensed medicines only, with caution on controlled drugs and antibiotics |
Why it actually matters day to day
This isn't just box-ticking for a CPD log. Get it wrong and there are real consequences.
If a pharmacy runs a vaccination clinic believing it's covered by a PGD, but that PGD has actually expired, or it doesn't cover the specific age group or vaccine batch being used, the supply isn't legally authorised. Same goes if a pharmacy technician administers something under what they think is a PGD, when their role isn't actually listed as eligible to work under one.
There's also a detail people often get wrong: PGDs shouldn't be used for administering Pharmacy (P) medicines, only for supplying them. And P and GSL medicines generally don't need a PGD or PSD at all when they're sold from a registered pharmacy under a pharmacist's supervision, since existing exemptions already cover that.
PGDs are meant to be the exception rather than the rule. The NHS Specialist Pharmacy Service is clear on this: individual prescribing or a PSD should remain the default wherever it's practical, with PGDs kept for situations where they genuinely improve patient access without compromising safety or governance.
What's changing heading into 2026
This area isn't static. From September 2026, newly registered pharmacists are entering the profession as independent prescribers straight from registration, which changes how PSDs get used in daily practice. As more pharmacists can assess and prescribe independently, PSDs become an even more useful way of delegating supply and administration to trained colleagues.
There's also a proposal on the table to extend PGD use to registered pharmacy technicians, who currently can only act under a PSD. If that goes through, it would free up independent prescribing pharmacists to spend more time on clinical consultations, while technicians take on a bigger share of supply and administration work under PGDs, especially in services like vaccination programmes.
Worth doing right now if you're on a pharmacy team: check your local PGDs regularly. Most NHS regions publish lists with expiry dates, and it's down to the clinician using the PGD to confirm it's still valid before relying on it.
The bottom line
A PSD is personal: one prescriber, one patient, one clear decision. A PGD is structural: a pre-agreed, authorised protocol that lets a defined group of healthcare professionals treat a defined group of patients without an individual prescription for every visit.
Both have a place in UK pharmacy, and both exist to make care faster and safer when used properly. The risk isn't really in using either tool, it's in confusing one for the other, or relying on a document that's quietly lapsed. Check your PGDs regularly, know exactly who on your team is legally covered to act under each one, and you'll keep your pharmacy on the right side of the rules while still giving patients the quick, accessible care they expect.