Covert administration of medicines is a complex issue which involves administering medicines in a disguised format, i.e., a medicine hidden in food, drink or given through a feeding tube without the knowledge or consent of the person receiving them. This means the person does not know they are taking a medicine. 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. Covert administration must be the least restrictive option after trying all other options.

Functional assessment should be performed to try to understand why the person is refusing to take their medicines. Alternative methods of administration should be considered. The legal framework for acting and making decisions on behalf of individuals who may lack capacity for certain decisions applies to all people aged over 16.

N.B. When a person 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.


Policy Details

Download: PDF version
Compiled by: Kamla Bhoyraz - Dementia Lead
Fraser Brown - Principal Pharmacist
Dr Josie Jenkinson- Old Age Consultant Psychiatrist
Ratified by: Medicines Management Committee / NMAHPG
Date Ratified: March 2024
Date Issued: April 2024
Review Date: March 2027
Target Audience: All clinical staff who handle medicines
Contact name: Kamla Bhoyraz


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