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Accountability and delegation

Accountability and delegation guide

Applying accountability and delegation principles in your workplace

The principles of accountability and delegation are relevant to all members of the nursing team, whether you're a registered nurse, health care assistant, health care support worker, assistant practitioner, nursing associate (in England) or student.

Introduction

Two smiling nurses walking down a corridor

The nursing team is made up of many different people bringing with them a range of skills, knowledge, and competence. 

The person in overall charge of the nursing care is the registered nurse, but they cannot perform every intervention or activity and therefore they will need to delegate aspects of care to colleagues. 

The  (2018), sets out what is expected in terms of accountability and delegation for registrants.

This resource explains the principles of accountability and delegation relevant to all members of the nursing team whether you are a nurse, health care assistant, assistant practitioner, nursing associate or nursing student working within the UK.

This guide aims to support safe practice and gives some practical examples of how it might be applied in practice and should be read alongside the NMC Code.

The principles of accountability and delegation explained in this resource can be applied to any member of the nursing team in any setting, including the wider nursing support workforce. This may include roles such as health care assistants, assistant practitioners, nursing assistants, senior carers, care assistants, trainee nursing associates and nursing associates (England only), nursing apprentices, registered nurses and nursing students.

Accountability

Accountability is the principle that individuals and organisations are responsible for their actions and may be required to explain them to others.

Delegation

Delegation is defined as the transfer to a competent individual, of the authority to perform a specific task in a specified situation.

(Supplementary information to the )

Accountability

Nurse giving training to other nurses

All members of the team are personally accountable for their actions to their service users, colleagues, regulatory body, employer and the law. There are three main considerations: organisational, team and personal accountability.

Organisational accountability

Does your employer have the appropriate policies, procedures, reporting and governance structures in place?

Team accountability

Is there an appropriate skill mix in your team to ensure effective delegation and to support the delivery of essential care services?

Personal accountability

Are you aware of your responsibilities, your own competence and educational needs?

Accountability in terms of the (2018), means being held to account for your actions and being able to explain how you used your professional judgement to make decisions, including decisions to delegate aspects of care.

In the event of patient harm or risk of harm, the NMC will review the decisions and actions of both the delegator and the delegatee.

Let's talk about accountability

Delegation

Image of nurses smiling and talking around a table

Delegation is the process by which the delegator allocates clinical or non-clinical treatment of care to a competent person. As the delegator you are accountable for your decision to delegate, and you remain accountable for the delegated task.

Registered nurses are responsible for managing the nursing care and are accountable for the appropriate delegation and supervision of care provided by others in the team.

The (2018) gives clear expectations for individuals on the NMC register when they delegate to others.

The NMC Code states under Practise effectively at section 11:

Be accountable for your decisions to delegate tasks and duties to other people. 

To achieve this, you must:

11.1 Only delegate tasks and duties that are within the other person’s scope of competence, making sure that they fully understand your instructions.

11.2 Make sure that everyone you delegate tasks to is adequately supervised and supported so they can provide safe and compassionate care.

11.3 Confirm that the outcome of any task you have delegated to someone else meets the required standard.