The Society of Radiographers is reminding members to ensure they only administer Prescription Only Medicines when a valid Patient Specific Direction or Patient Group Direction is in place.
An increasing number of cases have seen radiographers administer Prescription Only Medicines (POM), such as intravenous contrast agents and other pharmacy medicines, including Barium Sulphate, without adequate processes in place.
Intravenous contrast agents, antispasmodic drugs (e.g. Buscopan) and most bowel preparations fall under the classification of POMs.
Radiographer administration without either a written Patient Specific Direction (PSD) or Patient Group Direction (PGD) is unlawful. Locally agreed clinical imaging protocol does not confer any legal authority to administer any medicine specified within that protocol.
'Unlawful practices should stop immediately'
Peter Higgs, south west regional officer for the SoR, said: “Members should be very clear that unlawful practices should stop immediately and if there is any doubt as to the validity of the PGD’s that may be in place a PSD forms the only acceptable method of prescribing these medicines. It must be noted that draft PGD’s or date expired PGD’s are not valid and administering medicines outside of the expressed requirements of the documents is not acceptable practice.”
A Patient Specific Direction (PSD) is the traditional written instruction, signed by a doctor, dentist, or non-medical prescriber for medicines to be supplied or administered to a named patient after the prescriber has assessed the patient on an individual basis.
PSDs can be written or electronic, and there is no standardised format. Locally developed documentation should clearly indicate where the PSD is located and how radiographers should use it.
Patient Group Directions (PGDs) are written instructions for supplying or administering medicines to patients, usually in planned circumstances. They require a significant amount of time and resources to develop and implement. Radiographers must be trained and authorised to use the PGD.
PGDs are not a form of prescribing.
Crucial to understand responsibilities and restrictions
Sue Johnson, professional officer for clinical imaging at the SoR, said: “Medicines legislation is complex, and while radiographers need to pay attention to being legally compliant or their registration is at risk, it's also crucial that other members understand their legal responsibilities and restrictions.
“I suggest that all members check that they have the correct authority to administer or supply any medicine within their scope of practice, whether it is a Prescription-Only Medicine (POM), pharmacy medicine, or General Sales List (GSL) medicine.”
A recent Health and Care Professions Council Hearing has demonstrated the regulator takes a “dim view” of radiographers working outside of this framework and confirmed radiographers are unable to administer drugs “in the patient interest” even when the clinical risk of doing so is minimal.
All members are advised to ensure the supply or administration of medicines is appropriately covered by a PSD or PGD and P medicines by a valid protocol.
Members working in nuclear medicine should ensure that they understand the exemption within the Human Medicines Regulations 2012, which allows the administration of POMs to a protocol linked to radionuclide exposure.
The registrant is responsible for supply and administration by these methods—members cannot rely on letters of indemnification from others to protect their registration.
Members can find more information online here.
If you have any questions, please contact [email protected].
(Image: Photo by sturti, via Getty Images)