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Practice dilemma: Delegating flu administration

You run a very busy practice and will struggle to administer the flu vaccine to all the vulnerable patients on your list, can you delegate this task to other practice staff?

Expert advice

Whenever you delegate to another member of the heathcare team, you remain responsible for the overall management of the patient, and for your decision to delegate. You also need to bear in mind paragraph 54 of Good Medical Practice (2006) which requires you to be satisfied that the colleague in question has the necessary qualifications, experience, knowledge and skills, and to pass on enough information about the patient and the treatment they need. 

You can entrust the administration of flu vaccinations to practice nurses through a patient group direction (PGD). This written document allows licensed medicines to be supplied or administered by a named health professional to a group of patients who meet defined criteria. The nurse administering the vaccination, or any medication under a PGD, is responsible for selecting appropriate patients and for obtaining consent or in the case of children parental authority.

The PGD must be authorised by your PCT which will usually have a policy on their use and may have developed a template for practices to use. The PGD, being a written document, acts as a protocol for the administration of the vaccines. You can get further advice on producing, authorising and using a PGD here.

You can also delegate flu vaccine administration to healthcare assistants but only under a patient specific direction (PSD). This is a written or electronic instruction from you or an independent nurse prescriber to supply and/or administer medicine directly to a named patient or several named patients. As the prescriber, you will still be responsible for assessing the patient; ensuring the health care assistant has been assessed and is competent to carry out the vaccination; and that your practice has a system in place to monitor the training and performance of health care assistants.  In addition, you or a nurse practitioner or nurse should be on the premises while the health care assistant carries out the vaccinations in case of need or emergency.

During the flu vaccine season, it's advisable that you have a system in place to ensure that all staff responsible for carrying out the procedure check the product licence and document details of the drug, mode and site of injection, as well as the batch number and expiry date. Details of the vaccination given should also be recorded in the patient's clinical record in case they experience an adverse reaction.

Dr Yvonne McCombie, is a former GP in St Andrews, Scotland and MDU medico-legal adviser.