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An NHS Tayside Generic Symptomatic Relief Policy exists to facilitate prompt treatment of commonly occurring symptoms through empowering nursing staff to utilise their clinical judgement in administering those medicines included in the policy without recourse to a medical practitioner. Symptomatic relief policies make effective use of nursing knowledge and skills and maximise use of medical and nursing resources. More importantly, Symptomatic relief policies, used appropriately, can enhance patient care and their experience in a number of ways: Timely access to medication Reduces waiting time for medications Medicines in the current generic policy have been identified by pharmacy, medical and nursing staff because of their commonality of use across a range of specialities and patient / client groups.
23.1	Symptomatic relief prescribing in hospital: Prescribing Symptomatic Relief
	"Generic Symptomatic Relief" must be prescribed on the medicines prescription chart (THB (MR) 024SS/LS/DS) and a Symptomatic Relief Prescription Chart (THB (MR) 024SR) must also be completed. any items which would be inappropriate for an individual patient must be deleted by scoring a line through the corresponding item and dating and signing by the prescriber.
23.2	Symptomatic relief prescribing in hospital: Administering Symptomatic Relief
	Medicines may be administered by Registered Nurses using their professional judgement of the patients needs in accordance with procedures set out in Section 20 of this manual. A maximum of 2 doses in 24 hours of any medicine contained within the Generic Symptomatic relief Policy may be given unless a lesser dose is stated. If a pattern of regular usage evolves or the patients requirements exceed this – the nurses must contact / refer to a registered medical practitioner for advice and patient review.
23.3	Symptomatic relief prescribing in hospital: Speciality Specific Symptomatic Relief Policies
	Differing needs may exist for specific patient groups, which are not addressed through the Generic Symptomatic Relief Policy. Development of speciality specific adjuncts to the generic policy or speciality specific policies needs to be considered very carefully. All proposed developments must be discussed in the first instance with the clinical pharmacist and must be agreed and ratified by NHS Tayside Area Drugs and Therapeutics Committee.
23.4	Symptomatic relief prescribing in hospital: Patient Group Directions
	A Patient Group Direction is a specific written instruction for the supply or administration of medicines by nurses, pharmacists or certain other health professionals to groups of patients, who may not be individually identified before presentation for treatment. It is not intended that Patient Group Directions are used to replace individualised care, using individual patient prescriptions where this is feasible. The Patient Group Direction is signed by senior doctors (or dentists) and pharmacists along with any other appropriate health professionals such as nurses, physiotherapists etc who have been involved in developing the direction. The Patient Group Direction must be authorised by NHS Tayside Drug and Therapeutics Committee. Policy for Patient Group Directions is set out in NHS HDL (2001) 7. Further advice on whether a PGD is appropriate, and how it will be developed and approved are available from clinical pharmacists and on the Pharmacy Service PGD Staffnet site