Delegated Healthcare in Homecare: Getting Roles, Risk and Accountability Right
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Why delegated healthcare needs stronger governance in homecare
Delegated healthcare tasks — such as insulin administration, catheter care or specialist wound support — are increasingly delivered in homecare settings. While delegation enables people to receive care at home, it introduces clinical risk if responsibilities are not clearly defined.
Commissioners expect providers to demonstrate that delegated healthcare is accepted deliberately, not by default. For related oversight frameworks, see Risk Management & Compliance and Regulatory Alignment.
What counts as delegated healthcare in homecare
Delegated healthcare refers to clinical tasks delegated by a regulated healthcare professional to a non-registered worker. In homecare, this may include:
- Insulin administration
- Catheter or stoma care
- PEG feeding support
- Specialist topical treatments
- Blood glucose monitoring
Not all tasks are appropriate for delegation. Providers must assess risk before acceptance.
Clarifying accountability and responsibility
One of the most common failures in delegated healthcare is blurred accountability.
Clinical accountability
The delegating professional retains accountability for the clinical decision to delegate and the task parameters.
Provider accountability
The provider is accountable for ensuring staff are trained, competent and supported to carry out the task safely.
Staff responsibility
Staff are responsible for following training, guidance and escalation instructions — and for declining tasks they are not competent to perform.
Assessing risk before accepting delegation
Providers should have a clear acceptance framework.
This should consider:
- Complexity and variability of the task
- Predictability of the person’s condition
- Environment and lone working factors
- Availability of clinical support
If risks cannot be controlled, delegation should not be accepted.
Embedding delegated tasks into care planning
Delegated healthcare must be fully reflected in care plans.
Care plans should include:
- Task instructions in plain language
- Frequency and timing requirements
- Red flags and escalation routes
- Limits of staff authority
What commissioners expect around delegated healthcare
Commissioners look for evidence that providers:
- Accept delegated tasks deliberately
- Define accountability clearly
- Assess and review risk
- Support staff with training and oversight
How to evidence delegated healthcare in tenders
In tenders, describe your delegated healthcare governance framework — acceptance criteria, accountability, training and review.
This reassures commissioners that clinical tasks are delivered safely within clear boundaries.
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