Ulipristal Acetate (EllaOne) PGD - Public Health Dorset

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Dorset

Health

This Patient Group Direction (PGD) must only be used by registered community pharmacists who have been named and authorised by their organisation to practice under it. The most recent and in date final signed version of the PGD should be used.

Patient Group Direction for the supply of

Ulipristal acetate 30mg (eliaOne®) by registered community pharmacists for

Emergency Contraception

in

Public Health Dorset Version number: 7 CHANGE HISTORY C'

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Vel'isi0n number;

c.trlan€le details

1

First draft based on Dorset HealthCare PGD for Ella One (PH Internal copy)

December 2015

2

Second draft (Shared with CCG - initial comments and review. London PGD provided for reference and to use in review)

January 2016

3

Third draft (PH Internal)

February 2016

4

Shared with Local Pharmaceutical Committee for comment and review ( including frontline use perspective)

February 2016

5

Amendments by CCG Medicines Management Team

February 2016

6

Final amendments, Medicines Management and Public Health Dorset

22nd March 2016

7

Final signed version

September 2016

Date

Valid from: 12th Sept 2016 Expiry date: 12th Apr 2019

Reference Number: 7 Review date: izv Sept 2018 1

PGD DEVELOPMENT

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Jeli> title arllcilor.gaflisatiierll

Amy L1oyd/JoWilson

Senior Health Programme Advisor/Head of Programmes, Public Health (~ Dorset, Dorset County Council

Amanda Moores / Claire Rossiter

Local Pharmaceutical Committee

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Hayley Braid / Brian Charlton

Medicines Management Team, Dorset CCG

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Date

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Other members of the PGD working group The organizations below hold current PGDs which were used to develop this PGD

Dorset HealthCare (Exp 31st January 2018) London C&SH PGD Template (Exp 2018) PGD AUTHORISATION Jab title amd

Name Senior doctor

Prescribing Lead, Dorset CCG

Dr Paul Mason Senior pharmacist

Date

Si!!lnatlllliie

ol1g;am'isation

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Katherine Gough

Head Of Medicines Management, Dorset CCG ~

Senior representative of professional group using the PGD

N/A

Person signing on behalf of authorising body

Dr Jane Horne Consultant in Public Health, Dorset County Council

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PGD ADOPTION BY THE PROVIDER r

Name

Job title and oli!!lanisatien

Si!!llilature

Date

Lead Pharmacist

Reference Number: 7 Review date: 12th Sept 2018

Valid from: izv Sept 2016 Expiry date: 12th Apr 2019 2

TRAINING AND COMPETENCY OF REGISTERED COMMUNITY PHARMACISTS WORKING UNDER THE PGD Requirements ef registere