Overview

NHS Gloucestershire ICB has commissioned a local enhanced service to enable community pharmacists to supply specified Prescription Only Medicines (POMs) under Patient Group Directions (PGDs) without the need for a GP prescription. The service aligns with Pharmacy First and supports patients to receive timely treatment within community pharmacy.

The service will run from 1 July 2026 to 31 March 2027.
You can access the Service Specification and Service Level Agreement documents here: GICB PGD SLA and Service Specification GLOS v1.4 FINAL (002)

What is the aim of the service?

The service aims to:

  • Improve patient access to treatment for selected minor conditions.
  • Reduce unnecessary GP, Urgent Treatment Centre and A&E appointments.
  • Enable more patients to be treated in a single episode of care within community pharmacy.
  • Support consistent clinical pathways across Gloucestershire.
  • Make better use of community pharmacy clinical expertise and support the future transition to independent prescribing.

Conditions Included

The Community Pharmacy PGD Service covers four conditions:

Oral Candidiasis

Supply of:

  • Nystatin oral suspension 100,000 units/ml

Applicable for:

  • Patients aged 4 weeks to 4 months who meet the PGD criteria.

The full PGD on Nystatin for oral candidiasis can be accessed here: Nystatin for oral candidiasis v1DC

Conjunctivitis

Supply of:

  • Chloramphenicol eye drops and/or eye ointment

Applicable for:

  • Patients aged 31 days to 2 years who meet the PGD criteria.

The full PGD on Chloramphenicol for conjunctivitis can be accessed here: Chloramphenicol (conjunctivitis) under 2 years v1DC

Mild Skin Conditions

Supply of:

  • Hydrocortisone 1% cream

Applicable for:

  • Use on the face.
  • Children under 10 years of age who meet the PGD criteria.

The full PGD on Hydrocortisone for mild skin conditions can be accessed here: Hydrocortisone 1% cream oint v1DC

Otitis Externa

Supply of:

  • Dexamethasone 0.1% / Neomycin sulphate 0.5% / Acetic acid 2% ear spray (formally known as Otomize)

Applicable for:

  • Patients meeting the PGD inclusion criteria.

The full PGD on Neomycin dexamethasone acetic acid ear spray for otitis externa can be accessed here: Neomycin dexamethasone acetic acid ear spray for otitis externa v1DC

Who Can Participate?

Pharmacies must:

  • Be fully compliant with Community Pharmacy Contractual Framework (CPCF) requirements.
  • Be registered to provide the national Pharmacy First service.
  • Be able to access GP Connect / Access Record.
  • Have a compliant consultation room.
  • Be able to mobilise within the agreed timelines.
  • Meet all requirements within the Service Specification.

Pharmacist Requirements

Before delivering the service, pharmacists must:

  • Read and sign the relevant PGDs.
  • Confirm compliance via PharmOutcomes.
  • Complete the required training and learning requirements.
  • Maintain competence and work within their professional scope of practice.

Mandatory learning includes:

  • CPPE Consultation Skills
  • CPPE Sepsis
  • CPPE Safeguarding Level 2 (Adults and Children)
  • Antimicrobial Stewardship training
  • Relevant Gloucestershire antimicrobial guidelines
  • Conjunctivitis clinical guidance

For Otitis Externa, pharmacists should be competent in otoscopy and are strongly encouraged to complete relevant training.

Patient Pathway

Patients Can Access the Service Through:

Pharmacy First Referrals

Patients referred via NHS 111 or GP referral into Pharmacy First who, following assessment, meet PGD criteria.

Walk-in Presentations

Patients presenting directly to the pharmacy or signposted by another healthcare professional who meet the criteria for one of the four PGD conditions.

Consultation Requirements

Pharmacists must:

  • Assess patients against the relevant PGD inclusion and exclusion criteria.
  • Follow NICE guidance and local clinical pathways.
  • Provide counselling and safety-netting advice.
  • Access GP Connect / National Health Record where appropriate to support clinical decision-making.
  • Refer patients onward where treatment under the PGD is not appropriate.

Recording and Notification Requirements

For every supply made:

  • A PharmOutcomes consultation record must be completed.
  • A Post Event Message (PEM) must be sent to the patient’s registered GP (with patient consent).
  • Appropriate exemption status and prescription charge declarations must be recorded.

Key Points to Remember

  • Participation is voluntary but requires a signed Service Level Agreement.
  • All supplies must follow the PGD inclusion and exclusion criteria.
  • Pharmacies must provide the service consistently during opening hours.
  • Patient safety incidents must be reported via the Learning from Patient Safety Events (LFPSE) system.
  • The service complements Pharmacy First and does not replace it.