Covert administration of medicines in adults: legal issues

Sue Dickinson, Director of Pharmacy, Regional Drug & Therapeutics Centre (Newcastle)Published Last updated See all updates

A summary of key legal issues, a pathway of actions and links to national guidance that should be considered with covert administration of medicines.

Covert administration

Covert administration is when medicines are given in a disguised form without the knowledge or consent of the person receiving them.

It is a complex issue. It involves a formal decision made between healthcare professionals and carers and should only take place in people who do not have capacity to consent to treatment (as defined in the Mental Capacity Act 2005).

Covert administration should not be confused with disguising a medicine to give it against a competent patient’s wishes. This would constitute a tort or civil wrong of trespass to the person.

Covert administration usually involves hiding oral medicines (tablets, capsules or liquids) in food or drink. But it can also apply to medicines by other forms of medicine administration, such as patches, injections, or medicines given by a feeding tube, if the person lacks capacity to consent and they don’t know they are taking that medicine.

Before covert administration of medicines takes place, carers and healthcare staff should refer to national guidance (see links provided below) and local policies and procedures.

Here we summarise some of the key legal issues for carers and healthcare professionals to consider, and provide a suggested pathway of actions to follow:

National guidance

National guidance on covert administration of medicines provides more detail and is available from:

Although the above guidance are intended mainly for covert administration in care home settings, the legal issues are similar in other care settings.

Any organisation where covert administration of medicines may take place should make sure they have local policies in place to support best practice.

Change history

  1. Minor editorial amendment to section on considering other options following user feedback
  1. Article published by Samantha Owen, Southampton Medicines Advice Service
  2. Published