Please see the below useful information relating to when vitamin D suppliments can and cannot be prescribed.
NHSE guidance (See below PDF or Click here to download) recommends that vitamin supplements, including low dose vitamin D for prophylaxis of deficiency and maintenance of vitamin D levels following treatment for deficiency, should in most cases be purchased over the counter and not prescribed. Vitamin D products, usually in combination with calcium, can however be prescribed for the treatment of conditions such as osteoporosis. Vitamin D products, apart from the prescription only formulations, are classified as food supplements rather than medicines.
CQC also have some really good information regarding vitamin D and care homes click here.
They state that providers must make sure that people have enough to eat and drink to meet their nutrition and hydration needs (regulation 14 of Health and Social Care Act), including support to take nutritional supplements, where required. They also mention the PHE recommendation of an average daily intake of 10micrograms and the use of over the counter vitamin D supplements.
An enquiry was made to a CQC inspector about whether it was acceptable for a home to request that the resident or family purchase OTC vitamin D or whether it should be purchased by the care home as part of their regulation 14 obligations. The advice received was that it is acceptable for care homes to ask residents and families to buy them but providers might choose to as well. CQC would not penalise a home for not purchasing Vitamin D supplements for residents as this is a recommendation not a requirement from PHE.
It is important to note that vitamin D cannot be given under a homely remedies policy.
Homely remedies are for the short-term treatment of minor ailments such as headache, constipation etc.
Supplements, including vitamin D, should be administered under self-care or OTC policies, but only with consent and following a risk assessment of suitability. The advice is to complete a risk assessment form for each consenting resident and if there were any specific queries regarding suitability, to raise them with the GP at a virtual ward round. The risk assessment should be recorded in the care plan.
The administration of supplements must be recorded in either daily notes, nutrition records or on the MAR sheet, which is the preferred method as there is a clear audit trail. This will require 2 suitably trained staff to transcribe the supplement onto the MAR sheet.
Some former CCGs have been proactively asking GPs not to prescribe vitamin D supplements for care home residents.