Each healthcare organisation may have different policies for covert administration of medicine – that is the administration of any drug to a patient without their knowledge or consent, in a disguised form – but they will contain the same core components. Here are some examples: 

• Establish the reason why the person does not want to take the medicine(s)
• Ensure suitable alternative treatments have been explored
• Establish the medicine is essential
• Establish the person lacks the mental capacity to consent/make the decision themselves
• Have a discussion about the person’s best interests involving multidisciplinary team (MDT) and family/carers
• Involve the pharmacist
• Document all activity appropriately
• Review capacity and treatment plan regularly.

There are also considerations when administering medicines covertly: 

• Acceptability to the patient
• Relationship with food and drink
• Knowledge/training of staff
• Is there an alternative formulation
• Consequences of crushing/opening. 

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