Agenda item

The Committee was invited to consider the amendments required to the Constitution to extend the authority of the Director of Public Health to have designated responsibility for signing Patient Group Directions on behalf of the authorising body (the Council). 

Patient Group Directions - PGDs - are written directions enabling suitably trained and accredited health professionals to supply and/or administer a named medicine to a group of patients who may not be individually identified prior to presentation for treatment.  Local Authorities now had the power to authorise PGDs relating to their health improvement responsibilities.

The legislation central to these changes was the Health and Social Care Act 2012 (the Act) which transferred responsibility for aspects of health improvement from the NHS to top tier Local Authorities.  The delivery of some health improvement services was dependent on PGDs. 

An identified individual must have responsibility for ensuring that PGDs were developed in line with legislation and local organisational policies and governance arrangements with full consideration of the service in which the PGD was to be used was stipulated within the enabling legislation. 

The Act required this person to be either the Chief Executive or the Director of Public Health (DPH).  Given that authorisation would entail judgments as to whether use of a PGD was consistent with appropriate professional relationships and provided advantages for patient care without compromising patient safety,a detailed knowledge of health improvement services would be necessary and hence this responsibility would be best placed under the remit of the Director of Public Health.

With regard to the development of PGDs within the Council, it was envisaged that a lead author who would normally be a consultant in public health, would be charged with engaging the support of a wider team of health professionals as necessary.

The resulting PGD would be scrutinised by a separate, multi-professional PGD Approval Group before final approval by the DPH.

It was proposed that the DPH, supported by the PGD Approval Group would publish an Annual Report detailing any PGDs authorised and information regarding their subsequent usage.  The Report would be shared with the chair and members of the Health and Wellbeing Board.

The proposed governance arrangements would give the Director of Public Health the responsibility to authorise PGDs on behalf of the Council having been scrutinised by an appropriately constituted PGD Approval Group which would assess and provide reassurance regarding PGDs, and related plans for implementation and audit, developed by separate PGD Working Groups and that as a consequence, these arrangements would ensure that PGDs in Havering improved outcomes and experience of care whilst preserving patient safety.

After some discussion during which it was agreed that in the setting-up of these PGDs provision should be made to ensure the Council was suitably insured/ indemnified against any claims against it,

The Committee RESOLVED to RECOMMEND to Council that:

The following paragraph be added to Section 3.9.1 in Part 3 of the Constitution relating to the Director of Public Health’s role:

(m) To authorise Patient Group Directions on behalf of the Council.