Different types of medicines are available in patch form; some include painkillers, medicines to treat Parkinson’s disease, and medicines to control nausea and vomiting.

Application of Patches

  • The interval between patches can vary. Patches should be applied at the frequency determined by the prescriber.
  • The site of application should be rotated with each application in accordance with the manufacturer’s instructions. The manufacturer may recommend that the same site should be avoided for a certain length of time. This varies from patch to patch. Always check the patient information leaflet.
  • Patches should not be applied immediately after a person has had a bath or shower, as heat can increase the absorption of some medicines into the bloodstream.
  • Old patches should be removed, folded in half and safely disposed of, before applying a new patch.

Record keeping of Patches

  • The application of a patch should be recorded on the MAR chart.
  • The specific location of the patch should also be recorded. This may be on the MAR chart if there is sufficient space or using another template e.g. a body map or a patch chart.
  • When a patient is transferred between settings, staff should ensure that information around the date, time and site of application, are communicated.



The recording of drug sensitivity/allergy is important to avoid the inadvertent prescribing, dispensing and administration of an offending drug to the resident. Care home residents are a frail and vulnerable population who are at high risk of adverse drug reactions. There are large discrepancies between drug allergy records, residents care home records, medicines administration record charts and GP medical records. Furthermore, there is no routine system in place for people to keep a record of their own drug sensitivities / allergies. This can lead to confusion over which drugs can be taken safely and can result in residents inadvertently taking a drug they are allergic to.t settings. You can also style every aspect of this content in the module Design settings and even apply custom CSS to this text in the module Advanced settings.

» Read full EN Herts CCG guidance here
» Read full HVCCG guidance here

Emollients: new information about risk of severe and fatal burns with paraffin-containing and paraffin-free emollients

East and North Herts CCG have recently update their emollient formulary and guidance to ensure best use of NHS resources, all the recommended products are < £5/500g . For residents that have long term conditions that requires regular application of an emollients. Refer to updated guidance.

Epimax® paraffin-Free added as an option following a risk assessment – consider if fire risk is a significant issue e.g. patient prescribed oxygen. The recommended expiry date is 3 months for all products – if this is resulting in waste please ask the GP to review pack size prescribed.

» View further information

Warnings about the risk of severe and fatal burns are being extended to all paraffin-based emollients regardless of paraffin concentration. Data suggest there is also a risk for paraffin-free emollients.

Other Useful Resources

East and North Herts CCG  – Managing acute and urgent prescriptions in Care HomesClick here
East and North Herts CCG – Managing interim prescriptions (non-urgent, mid cycle requests) in Care HomeClick here
East and North Herts CCG – GPG CAS AlertsClick here
East and North Herts CCG – Medicines on transfer into Care HomeClick here
East and North Herts CCG – List of medications that can contribute to an increased risk of fallsClick here
East and North Herts CCG – Safe Handling of High Risk MedicinesClick here
Herts Valley CCG – List of medications that can contribute to an increased risk of fallsClick here
Herts Valley CCG Guidance on recording, maintaining and sharing drug sensitivity/allergy information in care homesClick here
Medicine pots IPC posterClick here