Appendix 8

Covert Medication Planning /Assessment

Name of patient / Patient Identifier Number
Location / DOB
1. What treatment is being considered for covert administration?
How will it be administered e.g. drinks, with food etc?
2. Why is this treatment medically necessary?
3. What alternatives did the team consider? (e.g. other ways to manage the person or other ways to administer treatment)
Why were these alternatives rejected?
4. Treatment may only be considered for a person who lacks capacity to consent to it. (Unless administered under the MHA 1983 - see below)
Outline the assessment of capacity. / Assessed by:
5. Treatment may be administered under the appropriate provisions of the MHA 1983 under Part 4.
What is the patient’s legal status?
Has a SOAD been involved in the decision? (if 3 months has passed since first administration of medication for mental disorder) / Legal status: Section 2, 3 etc. Date of detention:
6. Treatment may only be given if it is likely to benefit the person and it is in their best interests. What benefit will the person receive and how is it in their best interests?
7. Is this the least restrictive way to treat the person? Give reasons.
8. What are the person’s present views on the proposed treatment, if known?
9. Is there a valid and applicable
advance decision?
10. Has the person expressed views in the past that are relevant to the present treatment? If so, what were those views?
11. Who was involved in the decision?
N.B. A qualified pharmacist must give advice on administration if this involves crushing tablets or combining with food and drink.
N.B. If there is any person with power to consent (Lasting Power of Attorney; Court Deputy), then the treatment may only be administered covertly with that person’s consent, unless this is impracticable. / Practitioner staff involved:
Relatives or other carers involved:
12. Do any of those involved disagree with the proposed use of covert medication?
If so they must be informed of their right to challenge the treatment. / Yes/No
Date informed:
13. Will the covert administration be disclosed to the patient at a later date?
If not why and if so how and when?
When with the need for covert treatment be reviewed? / Date of first planned review:
Name / Designation
Date / Signed

1

Northumberland, Tyne and Wear NHS Foundation Trust

Appendix 8 - Covert medication care planning – V02 – Issue 2 –Sep17

Part of UHM-PGN -03 – Administration of Medicines - (NTW(C)17 – Medicine Policy)