Covert administration is the administration of medicines in a disguised format, such as in food or drink, without the knowledge or consent of the person receiving them. Covert administration may be necessary when a patient persistently refuses medication that is considered essential for their health or quality of life and is judged not to have the mental capacity to understand the consequences of their refusal.
Covert administration should be distinguished from consenting patients who experience swallowing difficulties and take medication delivered in food or drink for ease of ingestion. In this situation the patient has both given consent and is aware that they are taking medication.
Before medication can be administered covertly, NICE advises that certain processes or steps should occur, these are:
- Assessment of the patient's mental capacity.
- 'Best interests' meeting.
- Formation of a management plan.