Delegated healthcare


clinical oversight to make it effective and sustainable. DHSC and Skills for Care are working together with sector partners on how to address the challenges that have been surfaced since the publication of the principles. A collaborative and inclusive approach across health and care systems is key to decision-making around appropriate funding arrangements to support learning and development and clinical oversight. The principles have been designed to complement existing practice and to be adapted locally. It is not a one-size fits all approach.


The principles can fit with and develop upon what providers are already doing where delegation is working well or could work well for the person, ensuring consistent local approaches to delegation and a collaborative way of working. This is an important step towards an


integrated way of working across health, social care, and other services (such as housing and community services). Integrated health and care aims to


provide a joined up and seamless approach to enable people to access the support they need to live their lives to the fullest. It is vital that delegation is person-


centred, safe, and effective, and that is what these principles will support.


Deborah Sturdy, chief nurse for adult social care The Guiding principles for delegated healthcare are, in my view, long overdue. They give shape, form, and validity to skills, assessments, and actions already undertaken by care professionals across a wide variety of settings. These colleagues often work on their own and I know they take their responsibilities extremely seriously.


Part of this responsibility involves


Our workforce in care homes would gladly rise to the challenge of delegated healthcare activities


maintaining care recipients’ choice and control over the support they need and want. They have a right to dignity and autonomy in their lives and we must be facilitators and protectors of both. These principles help us do this with even greater rigour.


Of course, we need to balance personal liberty with appropriate and necessary healthcare interventions, overseen by delegators and carried out by designated care colleagues. It can be a complex professional relationship at times, which is another reason these principles offer much needed clarity.


During the pandemic, we saw care


workers take on additional roles and responsibilities to meet the needs of people isolated at home, particularly in cases where NHS services were unable to provide support in times of acute pressure. Without care colleagues ‘stepping up’


in this way, essential care and support interventions would have been missed and many more people in vulnerable situations would have seen their conditions inevitably deteriorate.


This gap in service provision filled by care colleagues already known to individuals receiving ongoing support, further cemented long-standing and trusted relationships. Then as now, this continuity of comprehensive care was invaluable in maintaining a person’s ability to live in the place of their choice. Clinical safety is vital, of course. It is not enough to simply undertake an intervention, such as enteral feeding, without the requisite knowledge to provide the physical care.


What is essential is understanding why the intervention is being done, how to perform it safely, and what to look for if things start to deteriorate, along with the critical actions to be taken, including reporting and recording.


It is vital that care colleagues are given the


knowledge and skills training to deliver best practice and minimise risk. The principles of delegation set out these expectations, which can only help to provide peace of mind to those giving and receiving care. Delegating care is a clear responsibility of the registered practitioner. They must maintain care oversight and be ultimately accountable for it. This means they must have the utmost confidence in the individual to whom they delegate. The delegation principles reinforce this accountability, alongside the NMC Code of Conduct and appropriate registration bodies. We cannot and should not assume delegation is simply spreading the workload. It is an opportunity for upskilling and creating development opportunities, but always within the framework of appropriateness and safety. The advent of the enhanced care worker role, care workforce pathway, and other learning and development opportunities mean we can deliver even better care and more satisfying and challenging care roles. The principles support this endeavour and I am proud to have played my part in making them a reality.


Melanie Weatherley, director, Walnut Care Delegation of healthcare activities to suitably competent care staff is not new. Community nursing teams have always passed on their knowledge to staff in care homes and home care to enable them to


May 2024 www.thecarehomeenvironment.com 25


Page 1  |  Page 2  |  Page 3  |  Page 4  |  Page 5  |  Page 6  |  Page 7  |  Page 8  |  Page 9  |  Page 10  |  Page 11  |  Page 12  |  Page 13  |  Page 14  |  Page 15  |  Page 16  |  Page 17  |  Page 18  |  Page 19  |  Page 20  |  Page 21  |  Page 22  |  Page 23  |  Page 24  |  Page 25  |  Page 26  |  Page 27  |  Page 28  |  Page 29  |  Page 30  |  Page 31  |  Page 32  |  Page 33  |  Page 34  |  Page 35  |  Page 36  |  Page 37  |  Page 38  |  Page 39  |  Page 40  |  Page 41  |  Page 42  |  Page 43  |  Page 44