Covert Administration

Covert administration is when medicines are administered in a disguised format without the persons knowledge or consent.

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This could be medicines hidden in food, drink or given through a feeding tube without the knowledge or consent of the patient receiving them. This means the patient does not know they are taking a medicine.

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When the patient has mental capacity to make the decision about whether to take a medicine, they have the right to refuse that medicine. They have this right, even if that refusal appears ill-judged to staff or family members who are caring for them.

Covert administration is only likely to be necessary or appropriate where:

• a person actively refuses their medicine and

• that person is assessed not to have the capacity to understand the consequences of their refusal. Such capacity is determined by the Mental Capacity Act 2005 and

• the medicine is deemed essential to the person’s health and wellbeing.

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Covert administration must be the least restrictive option after trying all other options (e.g. medicines offered by different staff members, medicines offered at different times of day, alternative forms of medication such as liquids, etc.)

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The decision-making process must be easy to follow and clearly documented.