We are aware of concerns raised by practice nurses following recent immunisation training updates, where attendees were advised that guidance around Patient Specific Directions (PSDs) and consent has changed. We hope the following clarification is helpful.
Under the updated guidance, where a medication is being administered under a PSD, consent for the treatment must be obtained by the prescribing clinician. This requirement applies regardless of whether the prescriber is a GP, nurse prescriber, pharmacist prescriber, or another appropriately qualified prescriber. PSDs should clearly identify the named individual(s) to whom administration of the medication has been delegated.
Where a prescribing clinician has assessed the patient and documented the medicine to be given, together with the relevant instructions for its use, this can constitute a valid patient-specific authorisation. In these circumstances, practices may use their existing vaccine stock, with any necessary reimbursement claim or personally administered prescription documentation completed subsequently in line with local processes.
It is important to distinguish between consent for treatment and consent for administration of treatment:
In practical terms, this means there are two separate consent episodes:
Neither form of consent necessarily requires a signed consent form. Verbal consent is generally sufficient, provided it is appropriately documented in the patient’s clinical record.
A number of nurses have expressed concern that the updated guidance may require them to undertake a full consent discussion for every patient attending a vaccination clinic. This is not the case.
Where a prescriber has already assessed the patient, agreed that vaccination is appropriate, and documented the vaccine to be given, the decision to treat has already been made. The prescriber is responsible for obtaining and documenting consent for that treatment as part of the clinical assessment and treatment plan.
The role of the nurse, nursing associate or healthcare assistant administering the vaccine is different. They are not expected to repeat the prescribing consultation or re-obtain consent for the treatment itself. Instead, they should confirm immediately before administration that:
This is analogous to obtaining consent for the administration of an injection, rather than obtaining consent for the clinical decision to vaccinate.
In practice, for most flu clinics this may be as simple as confirming the patient’s identity, checking they are happy to proceed, answering any immediate questions and documenting that verbal consent for administration was obtained. A lengthy consent conversation is not required where the treatment decision has already been made by the prescriber and appropriately documented.
The key principle is that consent for treatment sits with the prescriber, while consent for administration sits with the person giving the vaccine. These are separate processes and should not be confused.
Since 1 October 2023, the NHS in England has retired the 2 Week Wait (2WW) performance standard and replaced it with the 28-day Faster Diagnosis Standard (FDS) as one of the key national cancer waiting time measures.
The current measure (FDS) states that a patient should have cancer diagnosed or ruled out within 28 days of an urgent referral. The national standard is that 75% of patients should receive this outcome within 28 days.
Unfortunately, the eRs does not reflect this change. This is now being investigated and as soon as we have further in formation we will give feedback.
NHS England has announced plans to expand the Pharmacy First service with the introduction of five new clinical prescribing pathways from autumn 2026. The proposed additions are:
The announcement represents a further step in the ongoing expansion of clinical services delivered through community pharmacy and reflects the growing role of pharmacist independent prescribers within primary care.
However, practices should be aware that the national media coverage may create the impression that these services are available immediately through all community pharmacies. This is not currently the case.
The new pathways are not yet live and are expected to be introduced gradually from autumn 2026. Initially, delivery will be limited to a relatively small number of participating pharmacies that have access to an appropriately qualified pharmacist independent prescriber (PIP) and meet the service requirements.
Further details are still awaited from the Department of Health and Social Care (DHSC) and NHS England, including clinical specifications, service documentation, commissioning arrangements, referral processes and implementation guidance. As a result, many operational aspects of the new pathways remain unclear at this stage.
In the meantime, the existing seven Pharmacy First pathways continue unchanged and patients should continue to access services through the current arrangements.
Practices may wish to be mindful of patient expectations over the coming months. It is likely that some patients will present to general practice expecting community pharmacies to be able to manage these conditions immediately, following media reports. Clear messaging may therefore be helpful until the new pathways are formally launched and become more widely available.
Further information is available from Community Pharmacy England: NHS England announce the new Pharmacy First prescribing pathways.
Practices are advised that the provider of deaf communication support services in Doncaster has changed.
The service, previously delivered by Clarion, is now provided by the Royal Association for Deaf People (RAD). The new service offers a range of communication support options, including:
The service is commissioned by Doncaster Council and funded for NHS use, enabling practices and other NHS providers to access communication support for patients with hearing loss or other communication needs.
Under the Accessible Information Standard, NHS organisations have a legal duty to identify, record, flag, share and meet the communication needs of patients with disabilities or sensory loss. This includes ensuring that patients who use BSL or other specialist communication methods are able to access healthcare on an equal basis with other patients.
Practices should therefore ensure that patients are not asked to rely on family members, friends or carers to interpret clinical consultations except in exceptional circumstances. Professional interpreters should be arranged whenever required to support informed consent, confidentiality and effective communication.
Unlike the previous arrangement, RAD operates a national network of communication professionals rather than relying on a dedicated local pool of interpreters within Doncaster.
This means that interpreters may travel from elsewhere in the country to support appointments in Doncaster. While this provides access to a wider range of specialist communication professionals, it may also mean that availability is dependent on advance booking and travel arrangements.
For this reason, practices are encouraged to:
Practices are encouraged to review local procedures and ensure that:
Practices are reminded that, since June, Wicker Pharmacy has been commissioned by NHS South Yorkshire Integrated Care Board (SYICB) to provide a regional COVID-19 triage and treatment service for eligible patients across South Yorkshire.
The service has been established to identify patients who may be at higher risk of developing serious illness from COVID-19 and to assess whether treatment with antiviral medicines is clinically appropriate. The service is delivered by specialist pharmacists and clinicians with experience in managing COVID-19 antiviral therapies.
Patients can access the service in two ways:
Following referral, the service undertakes the clinical triage process, reviews eligibility, assesses any relevant comorbidities and medication interactions, and arranges treatment where appropriate. This helps ensure that patients who may benefit from antiviral therapies are assessed promptly whilst reducing the administrative burden on general practice.
Given the time-sensitive nature of antiviral treatment, practices may wish to ensure that clinical and administrative staff are aware of the service and can signpost suitable patients appropriately. Patients who are potentially eligible should be encouraged to seek assessment as soon as possible after receiving a positive test result, as antiviral treatments are most effective when commenced within the recommended treatment window.
The service is available across South Yorkshire and provides a single point of access for assessment of eligible patients, helping to streamline pathways and ensure equitable access to treatment.
Further information, including eligibility criteria and referral details, can be found on the Wicker Pharmacy website:
NHS COVID-19 Triage and Treatment Service for South Yorkshire
Practices may also wish to add this resource to local signposting information and patient-facing communications, particularly during periods of increased COVID-19 activity.
With skin lesions accounting for a significant proportion of GP consultations and referrals, colleagues may be interested in a forthcoming educational webinar focusing on the practical assessment and management of pigmented skin lesions in primary care.
“Skin Cancer in a Nutshell” is a free 75-minute CPD session designed for GPs, practice nurses, ANPs, physician associates and other clinicians involved in the assessment of skin complaints. The webinar aims to provide practical, clinically relevant guidance to support day-to-day decision making when assessing suspicious skin lesions.
The session will focus on one of the most common dilemmas encountered in primary care:
Should the lesion be reassured, treated, monitored or referred?
Topics will include:
The webinar will be delivered by Dr Tim Cunliffe, GP with Extended Role (GPwER) in Dermatology and Skin Surgery, Skin Cancer Lead at South Tees Hospitals NHS Foundation Trust, former Executive Chair of the Primary Care Dermatology Society (PCDS), and author of the widely used PCDS educational website. Dr Cunliffe is also Joint Medical Director of The MOLE Clinic and has extensive experience in skin cancer diagnosis, management and education.
The session is being provided free of charge, contains no commercial content, and participants may be able to self-certify CPD in accordance with their professional requirements.
Date: Thursday 8 October 2026
Time: 6.45pm to 8.00pm
Format: Online via Microsoft Teams
Registration:
Register for the webinar
Further information about the Primary Care Dermatology Society can be found at PCDS.
Given increasing demand for skin cancer assessment and continuing pressure on dermatology services, this webinar may be of particular interest to clinicians looking to increase their confidence in the assessment and management of skin lesions within primary care.
Doncaster LMC is been a member of the LMC Buying Groups Federation.
Buying Group membership entitles practices to discounts on products and services provided by the Buying Group’s suppliers.
Membership is free and there is no obligation on practices to use all the suppliers. However, practices can save thousands of pounds a year just by switching to Buying Group suppliers. To view the pricing and discounts on offer you need to register for access to the Buying Group’s online portal: https://buying.plexusportal.co.uk/Register.
What is the purpose of the Buying Group and how does it work?
The sole purpose of the Buying Group is to save its member practices money by negotiating discounts on goods and services which practices regularly purchase. The Buying Group team negotiate with suppliers, after which they identify ‘approved’ suppliers, who guarantee to give you significant discounts over what you would otherwise pay for their services, in return for the Buying Group’s endorsement and help in making you aware of what they offer.
Does it cost us anything to be part of the group?
No, membership is free and members are free to use as many discounts as they wish.
Is there any obligation to take up the deals offered?
No. Each practice is free to take up or decline any of the deals the Buying Group have negotiated. If you wish to take advantage of any of the offers in question, you will be given contact details, and all communications take place between you and the individual supplier*.
*The Buying Group accepts no liability for any contract willingly entered into by a practice with an approved supplier. Practices are advised to check that the terms of any contract with suppliers are consistent with those the Buying Group have negotiated and are advised to inform the Buying Group team of any discrepancy. The Buying Group do not, however, accept any responsibility for any member practices’ failure to check the terms of the relevant contract and the principle of caveat emptor (buyer beware) applies in all cases. Your rights as a consumer under the Consumer Protection Act are unaffected. With respect to any services to which the provisions of the Financial Services Act 2000 might apply practices are advised to seek independent financial advice as may be appropriate.
What happens to my details?
When a practice signs up for Buying Group membership, they will keep your basic contact details (practice address) on a secure system. On the membership application form, they also ask you how they can use your personal data (i.e. your email address) but even if you do sign up to receive their emails you can stop them at any time by clicking the unsubscribe button.
What if I am not happy with the quality of goods and services supplied?
Always let the Buying Group know if you encounter any problems getting what you want, and they will endeavour to sort it out.
Contact the Buying Group
The Buying Group is managed by Plexus Support Services Ltd:
Tel: 0115 979 6910
Email: info@plexussupport.co.uk
Website: https://www.plexussupport.co.uk
