Delegation and Accountability NMC

Delegation and
accountability
SUPPLEMENTARY INFORMATION
TO THE NMC CODE
Introduction
The Nursing and Midwifery Council will soon become the regulator of nursing
associates, as well as nurses and midwives. We propose that nursing
associates will uphold the same Code as nurses and midwives – we’re
consulting people about this between 9 April and 2 July 2018.
Our legislation needs to be changed so that we can regulate a new profession.
When that is complete, we hope to open a new nursing associate part of our
register in January 2019.
We’ve heard from nurses and those training to becoming nursing associates
that they’d welcome support to understand what the regulation of nursing
associates means for them when they are working together. We’ve put
together this material to help people think about situations when they are
delegating tasks, or being given tasks to do by colleagues.
Definitions
Delegation is defined as the transfer to a competent individual, of the authority to
perform a specific task in a specified situation.
Accountability is the principle that individuals and organisations are responsible for
their actions and may be required to explain them to others.
Delegation of tasks from one individual to another occurs commonly in all health and
care settings.
Delegation of an activity may be from:

• one registered professional to another.
• a registered professional to an unregulated member of staff.
• a registered or unregistered person to a carer or family member.
As registered professionals, nurses and midwives are accountable for all aspects of
their practice, including accountability for what they choose to delegate, and agreement,
or not, to undertake activities which are delegated to them. This will also be applicable to
nursing associates.
What does the Code say about delegation?

The NMC Code sets out expectations of people on our register when they delegate to
others. These requirements apply, regardless of who the activity is being delegated to.
This may be another registered professional, a non-registered colleague, or a patient
or carer.
These expectations are that people on the NMC register:
• only delegate tasks and duties that are within the other person’s scope of
competence, making sure that they fully understand the instructions.
• make sure that everyone they delegate tasks to are adequately supervised and
supported so they can provide safe and compassionate care.
• confirm that the outcome of any task delegated to someone else meets the
required standard.
3
What does this mean in practice?
If you are delegating a task, it is your responsibility to make sure that:
• delegation does not harm the interests of people in your care
• the task is within the other person’s scope of competence
• the person you are delegating to understands the boundaries of their own competence
• the person you are delegating to understands the task
• the person you are delegating to is clear about the circumstances in which they must
refer back to you
• you take reasonable steps to identify any risks and whether any supervision might be
necessary
• you take reasonable steps to monitor the outcome of the delegated task.
Safe delegation from nurses to nursing

associates
We have been asked whether the forthcoming regulation of nursing associates will
change anything about accountability and delegation.
In relation to delegating activities to nursing associates, nurses (and others) can be
assured that nursing associates will:
• have met the NMC’s standards of proficiency for nursing associates
• know and uphold the same professional Code as nurses and midwives (subject to
consultation)
• revalidate every three years, providing evidence of their continued ability to practice
safely and effectively.
Nurses should also be aware that the nursing associate standards of proficiency will set out
the knowledge and skills required to join the nursing associate part of the register. In common
with other professionals, nursing associates may develop additional competences, and health
and care providers may have local policies and governance allowing suitably trained staff to
undertake additional procedures. In the future, a nurse delegating to a nursing associate
should be familiar with:
• the nursing associate standards of proficiency
• any additional assured competences achieved by the nursing associate to whom they
are delegating a task
• any national guidance about the deployment of nursing associates
• local policies and procedures that may allow nursing associates to carry out additional
procedures if trained and competent to do so.
4
The NMC Code requirements in relation to
accepting delegated activities1
The NMC Code sets out the responsibilities of people on our register when they
accept a delegated task. It states that nurses and midwives (and, in the future, 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.
Implications of the requirements

of the Code in relation to accepting
delegated tasks
If you are on the NMC register, and someone is delegating aspects of treatment and
care to you, it is your responsibility to make sure that:
• you understand the task and can perform it safely
• it is within the limits of your competence
• you understand your role in making decisions about the care or treatment in question
• you are clear about the expectations of the colleague who has delegated treatment
or care to you and the circumstances in which you should provide updates and/or
escalate to them.
1
Between 9 April and 2 July 2018 we’re consulting on our proposal
that the NMC Code should apply to nursing associates when they
join our register. We’ve produced a new introduction to the Code, but
the standards that follow remain broadly the same.
5
Delegation and accountability
When issues or incidents arise:
• If there is a risk of patient harm, or actual harm, an employer or service provider will
want to review the decisions and actions of both parties and establish whether the
root cause of an incident was unsafe delegation and/or inappropriate acceptance of
a task. This may raise concerns about the practice of one, or both parties, depending
on the circumstances.
• If an incident is sufficiently serious to raise a regulatory concern, and is referred to
the NMC for investigation, we will consider whether more than one person on our
register may have a case to answer.
Summary
The responsibilities of nurses and nursing associates where delegation is concerned do
not change in circumstances where 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.

Delegation and Accountability NMC

Uploaded by

Copyright:

Available Formats

Delegation and Accountability NMC

Uploaded by

Document Information

Original Title

Copyright

Available Formats

Share this document

Share or Embed Document

Sharing Options

Did you find this document useful?

Is this content inappropriate?

Copyright:

Available Formats

Delegation and Accountability NMC

Uploaded by

Copyright:

Available Formats

Delegation and

Delegation of an activity may be from:

What does the Code say about delegation?

Safe delegation from nurses to nursing

Implications of the requirements

You might also like