Accountability and delegation

The topic of accountability can seem a bit scary. Whenever we discuss accountability, we tend to do so in legal-type language, speaking about things like ‘duty of care’, ‘civil and criminal law’ and ‘vicarious liability.’ It sometimes looks and sounds as if accountability is all about ‘catching us out’, and that if we make one slip, we’ll be up in front of our employer on a disciplinary charge or, even worse, before the courts.

There’s no doubt that both these situations can arise. As a health care assistant, you’re trusted by patients/clients and your employer to perform your duties competently, safely and effectively. If you stray from the standard that’s expected of you, you’re letting your patients/clients and your employer down. You’ll be held accountable for what you’ve done, and yes, that can lead to disciplinary or court action, depending on the severity of the situation.

We don’t want to overplay the importance of accountability in this section, but we don’t want to play it down either, or its potential impact on you as a health care assistant. Accountability is all about protecting patients/clients, employers and individual health care workers from the effects of bad, negligent and unsafe practice. As such, it’s a vitally important part of health care.

We don’t want to scare you, but at the same time, we don’t want to suggest that accountability isn’t a key issue for you. It is a key issue for you – you have accountability through the role you perform, and you’ll be held accountable for your actions as part of that role.

But the fact of the matter is that if we carry out our duties as we’ve been trained, if we don’t try to step over the mark and do something we haven’t been trained to do, if we always act in what we believe is the patient’s/client’s best interest, and if we’re prepared to challenge a senior colleague who asks us to do something we don’t feel confident about, then we’ll realise that accountability isn’t something to be scared of – it’s something to take pride in.

Accountability is also part of delegation (which refers to a registered member of staff delegating a task to you and you accepting the task). Both the registered member of staff and you have accountability for ensuring the task you’ve been delegated is appropriate and will cause the patient/client no harm. If that isn’t the case, you are at liberty – indeed, you have a duty – to refuse to take on the task.

The RCN has provided an Accountability and delegation guidance [PDF file 478KB] [How to access PDF files].

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