Healthcare assistants and the flu vaccination

Ensure HCAs are not tasked to provide flu vaccinations under a Patient Group Direction.

OCTOBER will see the kick-off of flu vaccination campaigns in primary care settings across the UK. In recent weeks MDDUS has been receiving numerous advice calls on the role of healthcare assistants (HCAs) in providing flu vaccinations.

A common query is can HCAs administer vaccinations under a Patient Group Direction (PGD)? The short answer is "no" but this does not mean HCAs are not allowed to provide flu jabs under any circumstance. Some background detail may be helpful.

A majority of flu vaccinations provided by the NHS are via PGDs which are written instructions for the supply and/or administration of a named licensed medicine for a defined clinical condition. PGDs allow nurses and certain other registered healthcare professionals to administer a medicine directly to patients under a specified criteria without the need to see a doctor or other qualified prescriber. Examples might include immunisation programmes, family planning or travel clinics.

Among healthcare professionals authorised to administer drugs under a PGD are registered nurses, pharmacists, midwives, health visitors, ambulance paramedics and others. They can do so only as named individuals recorded on a standard PGD form. The Medicines Act 1968 defines an “authorised” person as one who is professionally regulated. HCAs do not fall into that category and are thus not allowed to administer prescription only medicines under a PGD.

An HCA would however be able to administer a flu jab if prescribed by a doctor or other qualified prescriber or via a Patient Specific Direction (PSD). A PSD is a written instruction from a doctor or dentist or other independent prescriber for a medicine to be supplied or administered to a named patient. It could be a prescription or simple written or electronic instruction in the patient’s notes. A PSD must state the name of the patient, the name and dose of the prescription only medicine to be administered and “show evidence to confirm that the patient has been considered as an individual”.

PSDs do not limit who can supply or administer the medicine and thus a suitably trained HCA can be tasked to give a flu vaccination to a named patient. It is a matter for the practice to ensure HCAs are competent to provide any relevant care and treatment and that they are adequately supervised.

In its explanatory guidance on Delegation and referral (2013) the General Medical Council states: ‘"When delegating care you must be satisfied that the person to whom you delegate has the knowledge, skills and experience to provide the relevant care or treatment; or that the person will be adequately supervised. When you delegate care you are still responsible for the overall management of the patient".

ACTION Ensure HCAs are not tasked to provide flu vaccinations under a Patient Group Direction. Suitably trained HCAs can do so only via a prescription or Patient Specific Direction for individual named patients.