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Explore the guiding principles for delegated healthcare activities in adult social care, supporting safe, person-centred delegation, governance and best practice.

The delegated healthcare activities guiding principles for health and social care were co-developed by ´óÏó´«Ã½, the Department of Health and Social Care and partners, including the Care Quality Commission (CQC).

They were first published in May 2023. Following an independent evaluation, they were updated in November 2024 to reflect learning from their implementation.

The independent evaluation also highlighted the complexity of decision-making across integrated health and social care systems. While the principles provide a strong foundation for good practice, there will be situations and challenges that require professional judgement and fall outside the scope of the guidance.

The guiding principles and supporting resources have been designed to be used alongside organisational policies and professional guidance. They can support good conversations, shared decision making and the effective implementation of delegated healthcare activities within adult social care. 

The guiding principles focus on four key areas to support delegation that is person-centred, clinically appropriate, safe and effective.

1. Person-centred care

Delegation should always start with the person.

People who draw on care and support, along with their families or representatives, where appropriate, should be involved in decisions about their care. They should have the opportunity to ask questions, understand why delegation is being considered and provide informed consent.

2. Governance, regulation and accountability

Safe and effective delegation relies on strong partnership working, clear accountability and robust governance arrangements.

Health and social care organisations should work together to build trust, establish clear roles and responsibilities, and ensure delegation takes place within appropriate regulatory and legal frameworks.

Everyone involved in delegated healthcare activities should feel confident to raise concerns if they believe a task cannot be carried out safely. 

3. Learning, development, skills and competence

Healthcare activities should only be delegated when care workers have received the appropriate learning, development and support to carry out the activity safely and confidently.

Training and competency requirements will vary depending on the complexity of the delegated activity and the individual's needs.

4. Monitoring and review

Delegated healthcare activities should always be supported by ongoing clinical oversight from the regulated healthcare professional who delegates the activity.

The healthcare professional remains responsible for monitoring and reviewing the person's healthcare plan, ensuring delegated activities continue to meet their needs safely and effectively.

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