POLICY FOR PATIENT GROUP DIRECTIONS (PGD) - NHS

PATIENTGROUPDIRECTION(PGD)(PGD)[NAME OF DRUG] FOR [CLINICAL CONDITION BEING MANAGED]POM/P/GSLFOR USE BY [BODY OF HEALTHCARE PROFESSIONALS] EMPLOYED BY/WORKING ONBEHALF OF [NAME OF SERVICE]Equality Impact Assessment ToolTo be completed and attached to any procedural document when submitted to the appropriatecommittee for consideration and approval.1. Does the policy/guidance affect onegroup less or more favourably thananother on the basis of:• Race• Ethnic origins (including gypsies andtravellers)• Nationality• Gender• Culture• Religion or belief• Sexual orientation including lesbian,gay and bisexual people• Age2. Is there any evidence that some groupsare affected differently?3. If you have identified potentialdiscrimination, are any exceptionsvalid, legal and/or justifiable?4. Is the impact of the policy/guidancelikely to be negative?5. If so can the impact be avoided?6. What alternatives are there to achievingthe policy/guidance without the impact?7. Can we reduce the impact by takingdifferent action?Yes/NoCommentsIf you have identified a potential discriminatory impact of this procedural document, please refer it tothe Policy Administrator, together with any suggestions as to the action required to avoid/reduce thisimpact.For advice in respect of answering the above questions, please contact the Policy Administrator.Date approved:Review date:Ref : Page 2 of 23