GP Practice Authorisation

Note to lead GP authorising use of this PGD within their practice

PGDs DO NOT REMOVE INHERENT PROFESSIONAL OBLIGATIONS OR ACCOUNTABILITY.

It is the responsibility of each professional to practise only within the bounds of their own competence and in accordance with their own Code of Professional Conduct.

GPs should only sign-offnurses who have received the required training and are competent to work to this PGD. Authorised nurses should be provided with an individual copy of the PGD, which they should also sign to declare themselves competent. A copy of the signed document should be kept by the individual nurse. The authorising GP should retain the signed individual authorisation page.

I have read and understood the Patient Group Direction and authorise the following nurse(s) to administer the specified vaccinesin accordance with this PGD.

Name of Nurse / Signature / Authorising GP / Signature / Date

Reference Number: NHS England (London Region): PGD Seasonal Flu (Nurses) v1.2

Valid from: 1st September 2013

Review date: 31st March 2014

Expiry date: 31st March 2014

Nurse’s agreement to practise

PGDs DO NOT REMOVE INHERENT PROFESSIONAL OBLIGATIONS OR ACCOUNTABILITY.

It is the responsibility of each professional to practise only within the bounds of their own competence and in accordance with their own Code of Professional Conduct.

DECLARATION by Nurse:

  • I have been appropriately trained to understand the criteria listed, and the techniques and record-keeping required to administer seasonal influenza vaccine in accordance with this Patient Group Direction;
  • The training has included both the theoretical and practical aspects of the techniques required to administer vaccines by the following routes (please tick as appropriate):
  • Intramuscular injection□
  • Subcutaneous injection□
  • I confirm that I have been assessed for my knowledge and clinical competency, and EITHER am experienced in administering vaccines in the past 12 months, OR I have been observed administering vaccines in practice;
  • I confirm that I am competent to undertake administration of influenza vaccines;
  • I confirm that I will ensure that I remain up to date in all aspects of the administration of influenza vaccines.

Nurse’s Name:…………………………….

NMC Registration PIN:……………………….

Expiry Date: ……………………….

Signature: …..…………………..Date: ……………………….

Reference Number: NHS England (London Region): PGD Seasonal Flu (Nurses) v1.2

Valid from: 1st September 2013

Review date: 31st March 2014

Expiry date: 31st March 2014