Using frameworks for administering medicines during COVID-19

Sandra Wolper, Associate Director, Medicines Use and Safety (SPS)Published Last updated See all updates

Frameworks to administer medicines continue to be used. Guidance is provided for electronic transfer of directions to administer during COVID-19.

Direction to administer

A direction to administer is a written instruction from a prescriber that indicates the intent for a medicine to be given to an individual patient by a suitably trained and competent person.

Types

A direction to administer may take the form of:

  • a patient specific direction
  • an FP10 prescription
  • the label on a box of medication

Requirements

What to include

A direction to administer should normally include:

  • the patient details
  • prescriber details
  • medication details (e.g. name, strength, dose, frequency, duration)

Signatures

The direction to administer needs either:

  1. The physical signature of the prescriber, or
  2. An electronic signature, with assurance that this has been added by the prescriber themselves.

If the prescriber is not known to the recipient, the regulatory register should be used to validate the authority.

Controlled Drugs

Direction to administer forms for Schedule 2 and 3 Controlled Drugs (CDs) are possible. These can be sent electronically via email as there is no legal requirement for these to have physical signatures because supply will have already been made.

Labelled ‘As Required’

Where the label does not specify a dose (e.g. medication administered via a syringe driver), a direction to administer is required.
There is no legal requirement in this circumstance for a patient specific direction; however, it is good practice to have it in place in order to ensure medicines are administered safely. A letter or entry in the patient’s record would be an example of a patient specific direction in this circumstance.

Practice during COVID-19

Where a physical signature could result in delayed patient care, a direction to administer transferred via secure email (e.g. nhs.net) is advisable.

This can be from the prescriber’s email address to the healthcare professional or generic team address.

The printed name of the prescriber on the direction to administer must match that on the sender’s email as assurance that it has come from the right person.

Prescription

A prescription is an authorisation against which a supply of medication is made (usually by a pharmacist). It can also be used as a direction to administer a medication to an individual.

Requirement

A prescription must comply with all legal requirements for prescriptions and controlled drugs (where applicable).

A prescription can be one of the following:

  • A patient specific direction
  • An FP10

Practice during COVID-19

No change

Medication Administration Record

A Medication Administration Record (MAR) is a document that records the administration of a medicine. It is predominantly used by social care staff for this purpose.

The MAR forms part of an accurate, complete and contemporaneous record of the administration of medicines.

Requirement

There is no legal requirement for the MAR to be physically signed by the prescriber. An emailed version e.g. from a community pharmacy, can be printed and accepted for use.

Practice during COVID-19

No change

Acknowledgements

This guidance has been developed as a consensus from the following organisations:

  • Primary and Community Care Pharmacy Network (PCCPN)
  • Queen’s Nursing Institute
  • Royal College of Nursing (RCN)
  • Specialist Pharmacy Service (SPS)

Change history

  1. Resource re-formatted and updated
  1. Published