Guidance for Employers

Why This Guidance is Being Issued

Assistants play a valuable role in enhancing the delivery of health and social care, contributing to high-quality services amid growing demands and workforce challenges. Their support enables health and social care professionals to optimise service user care and to fully utilise their expertise and focus on their specialised responsibilities. By ensuring that tasks requiring clinical skills and professional judgement are performed by appropriately trained and qualified individuals, employers can create a well-balanced team that enhances service user outcomes, improves efficiency and strengthens the overall health and social care system.

The Health and Social Care Professionals Council is issuing this guidance to help employers clarify the responsibilities of CORU registrants who delegate tasks to assistant grades or are responsible for their supervision. According to the Code of Professional Conduct and Ethics, registrants must delegate tasks only to individuals they believe possess the necessary knowledge, skills, competence, and experience to perform the task safely and effectively, or to those who are appropriately supervised. This guidance aims to support employers in enabling registrants to fulfil their responsibilities as outlined in their Code of Conduct.

In this guidance, the term delegation is used to refer to CORU registrants assigning the responsibility for performing a specific task to a health and social care assistant. Please note that the guidance and examples provided in this document are not intended to reflect the supervision by CORU registrants of new graduates in the health and social care professions or the referral by CORU registrants of service users to other health and social care professionals.

Proper delegation is essential to ensuring public safety, maintaining high standards of care and preventing complaints arising from inappropriate task allocation. Employers have a responsibility to provide clear direction on what can and cannot be delegated and to ensure that registrants and assistant staff understand and act within their respective roles and responsibilities.

Principles of Safe Delegation

Delegation is an essential part of effective team-based care, allowing professionals to deliver timely, service-user-centred services and to optimise their scope of practice. However, inappropriate delegation can compromise care quality, pose risks to service users and undermine professional standards. Registrants must adhere to the following principles:

1. Competence and Training: Registrants must only delegate tasks to individuals who have demonstrated the necessary competence, training, and understanding to perform the task safely and effectively. Registrants should keep a record of tasks they delegate to assistants.
2. Professional Judgement: Decisions to delegate must be grounded in professional judgement, taking into account the service user’s needs, the complexity of the task, the knowledge and competence of the assistant and the context in which care is delivered.
3. Accountability: Registrants remain accountable for the decision to delegate and for ensuring adequate supervision, support, and follow-up. The registrant is also responsible for escalating an issue as appropriate where clinical risk is identified.

Employers’ Responsibilities

Employers play a critical role in supporting registrants to adhere to these principles by providing a framework that prioritises safe and ethical delegation. CORU advises employers to take the following measures:

1. Clarity in Roles: Define and communicate clear job descriptions for assistants, which outline the process for the identification and selection of tasks for delegation. Ensure that these are in compliance with the legal and professional standards expected of registrants.
2. Clarity in Team Membership: Assistants must be clearly identified as assistants on their name badges so that their role is clear to service users, their circle of support and other health and social care professionals.
3. Training and Competency Assurance: Provide appropriate training to assistants on the tasks they will be delegated and establish processes to regularly assess and document their competencies. Keep records of all training completed by assistants.
4. Workforce Planning: Ensure sufficient numbers of registrants are employed to carry out clinical tasks, reducing the risk of inappropriate delegation due to staff shortages.
5. Supervision: Ensure that there is a structured system of ongoing supervision for of staff who have been delegated tasks.
6. Supportive Structures: Foster a culture of partnership and support where registrants feel empowered to voice concerns about delegation pressures.
7. Learning and Development: Foster a culture which supports the learning and development of professional competence of all members of the team.

Prohibited Delegation of Tasks Requiring Clinical Skills

Tasks requiring advanced judgement, registration-specific competencies and clinical skills must not be delegated to assistants. Examples include: 

• Conducting clinical assessments or diagnoses.
• Developing or progressing care or treatment plans, including the review and formal evaluation of their effectiveness.
• Undertaking complex interventions requiring professional expertise.

Employers must ensure registrants are not placed in situations where they feel compelled to delegate such tasks due to operational pressures or a lack of resources. 

Conclusion

CORU reiterates the importance of safeguarding service user safety and public trust through appropriate delegation practices. Employers and registrants must work collaboratively to ensure tasks are delegated safely and ethically. Adherence to this guidance enhances the quality of care provided to the service users and upholds professional standards.

For further guidance, registrants and employers are encouraged to refer to CORU’s Code of Professional Conduct and Ethics and other relevant regulatory frameworks.

This guidance is intended to provide clear, actionable guidance, emphasising the shared responsibilities of employers and registrants in maintaining the highest standards of health and social care practice and ethical conduct.