The Nursing Team – Accountability and Delegation
General practice is changing, and practice nursing teams are evolving to meet the increasing demands and pressures currently facing primary care. As a result, many general practice nurses (GPNs) are taking on more advanced roles, and more routine tasks are often delegated to healthcare assistants. It is therefore critical that GPNs are aware of the principles of delegation and accountability in order to maintain safe and effective practice ( source – Practice Nurse )
As a Registered nurse or Nurse Associate you have a legal responsibility to ensure that you are providing safe and competent care to any patient. All nurses should have an up-to-date registration with the NMC and should work within their level of competency and their contract. The trained nurse, GP or another qualified professional may delegate a task/role to other colleagues including HCA’s but should ensure, if delegation takes place, that:-
- the person who has been delegated a task has received appropriate training and can provide evidence of competency
- are supervised
- has appropriate indemnification
- receives regular training/updates and support
- has an up-to-date job description
Registered nurses have a duty of care and a legal liability to their patients. When delegating an activity, for example to an HCA or AP (Assistant Practitioner), they must ensure that it has been appropriately delegated.
Accepting a Delegated Task
The NMC Code sets out the responsibilities of people on their register when they accept a delegated task. It states that nurses and nursing associates must, as appropriate:
- make sure that patient and public safety is not affected. You work within the limits of your competence, exercising your professional ‘duty of candour’ and raising concerns immediately whenever you come across situations that put patients or public safety at risk.
- make a timely referral to another practitioner when any action, care or treatment is required.
- ask for help from a suitably qualified and experienced health and care professional to carry out any action or procedure that is beyond the limits of your competence.
- complete the necessary training before carrying out a new role
The responsibilities of nurses and nursing associates where delegation is concerned don’t change in circumstances if the person delegating and the person accepting a delegated task are both registered professionals. As a registered professional, whether you are someone delegating a task, or receiving a delegated task, you are accountable for your conduct and practice.
Employers have responsibilities too and accept vicarious liability for their employees, this means ensuring that their staff are:-
- Appropriately trained and supervised properly until they are competent
- Are working within their sphere of competence and in connection with their employment.
Useful Links and Publications
RCN – Accountability and Delegation (This page is currently under review)