Homely remedies, such as PRN (as-needed) paracetamol, can be an important part of symptom management in care homes. However, there is often confusion about whether a GP must authorise their use. This guidance aims to clarify the responsibilities of care home staff and GPs in the administration of non-prescription medications in CQC-registered care homes.
No, a GP does not have to authorise homely remedies. The National Institute for Health and Care Excellence (NICE) guidance NG67, which covers medicines management in care homes, does not require GP authorisation for the administration of homely remedies, including PRN paracetamol. Instead, care homes should have their own homely remedies policy, which is agreed upon and regularly reviewed.
Who is Responsible?
Care Home Providers: The care home must have a written policy on homely remedies, which includes clear guidelines on which medicines can be administered, under what circumstances, and for how long before seeking further medical advice.
Pharmacists: Care homes are encouraged to work with a pharmacist to ensure their homely remedies policy is safe, appropriate, and up to date. Pharmacists can advise on suitable medicines and provide staff training.
Senior Care Staff: Appropriately trained care home staff can administer homely remedies as per the policy without the need for direct GP authorisation. Staff should document administration accurately and monitor the resident’s response.
GPs: A GP’s role is to provide medical advice if the resident’s condition requires review. While GPs may be asked to comment on a homely remedies policy, they are not required to formally authorise the use of specific medications under this system.
If the resident’s condition does not improve within the timeframe outlined in the homely remedies policy.
If the resident experiences side effects or an adverse reaction.
If symptoms worsen or new symptoms arise.
If the resident requires frequent PRN medication, suggesting an underlying issue that needs medical attention.
Ensure the homely remedies policy is in place and reviewed regularly.
Clearly document the administration of homely remedies in the resident’s records.
Provide staff with appropriate training on when and how to use these medicines.
Store homely remedies safely and ensure they are within expiry dates.
Care homes should feel confident in administering homely remedies within the framework of their own policies and guidance from pharmacists. GPs do not need to authorise the administration of PRN paracetamol or other homely remedies but can provide clinical advice when necessary. By following best practices, care homes can ensure safe and effective medication management for their residents.
For further information, care homes should refer to NICE NG67: Managing Medicines in Care Homes or consult a community pharmacist for guidance on their homely remedies policy.