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Rotavirus immunisations could cause 'administrative nightmare'

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General practices may face an 'administrative nightmare' when the rotavirus vaccination is added to the childhood immunisation schedule in July, nurses have warned.

NHS England has opted not to produce a Patient Group Direction (PGD) for the oral rotavirus vaccine, Rotarix, which is given in two doses at two and three months. This means non-prescribing nurses must obtain a Patient Specific Direction (PSD) for each child, on an individual basis.

Public Health England (PHE) is due to publish a template for clinical commissioning groups (CCGs) to issue PGDs for Rotarix, but was unable to confirm when this would happen or how long it might take CCGs to adapt the template for local implementation.

Sheffield-based nurse practitioner Anne Baird warned CCGs might find it difficult to produce PCGs before the programme begins in July and described the move as 'a retrograde step'.

She explained that, without a PGD, rotavirus immunisations might be delayed while nurses found GPs or nurse prescribers to authorise PSDs or nurses might administer the vaccine without PSDs being signed in advance, thus acting outside of the law.

'It is going to make it difficult for nurses to safely and legally administer the vaccine,' she said.

While latest guidance from NHS England states that 'the majority of clinical care should be provided on an individual, patient-specific basis', it admits that 'at present, a number of GP practices have been providing childhood immunisation via PGDs.'

It adds that 'this can continue, provided governance arrangements are in place and the requirements for PGDs are being complied with'. However, it also states: 'Consideration is being given to review what is included in the Green Book about the use of PGDs and PSDs.'

As Independent Nurse was going to press, NHS England was unable to provide any specific advice for nurses about the rotavirus campaign, but has simply suggested that when PGDs for childhood immunisations run out, practices should switch to using PSDs.

Ms Baird said: 'This is a very bad idea, which puts nurses in a difficult position. PGDs have worked well for years - why change that now?'

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