Which task is appropriate to delegate to a competent healthcare assistant?

Recording routine observations they are trained to take

Assessing and deciding on a patient's care plan

Interpreting a deteriorating patient's blood results

Deciding whether to escalate a sick patient

You delegate a task to an HCA who is competent and well supervised, and they carry it out correctly. Who is accountable for how it was done?

The HCA, for carrying out a task within their competence

You alone, for everything they do

An HCA tells you they have never been trained for a task you asked them to do. What should you do?

Not ask them to do it, and arrange the task another way

Insist they try, as the ward is busy

Tell them to work it out as they go

Before delegating, what should the registered nurse be satisfied about?

That the task is appropriate, the HCA is competent, and supervision fits

That the ward is short-staffed enough to justify it

That someone senior suggested it

An HCA reports an abnormal observation they recorded. What does this show about delegation done well?

The HCA understood their role, including reporting concerns to the nurse

The nurse should not have delegated at all

Reporting is unnecessary once a task is delegated

Part B5 of 8 Leading and Managing Care, Working in Teams Chapter 56 of 75

Delegating to Healthcare Assistants: Questions

NMC CBT practice on delegating to HCAs: what can be delegated, competence and supervision, retained accountability, and worked scenario answers.

Start reading ← Question bank outline ~5 min read

By JobLabs Editorial · UK healthcare reference editorial team

· July 16, 2026 · Updated Jul 17, 2026 · 2 min read

Delegating to healthcare assistants is part of everyday nursing leadership, and doing it safely is a skill the CBT tests. This chapter is the practical, ward-level side of accountability: which tasks, to whom, with what supervision.

What can and cannot be delegated

You delegate tasks that are within the HCA’s training, competence and role, with supervision matched to the task. Routine observations, personal care, and helping with eating and drinking are typical examples for a competent HCA. What you do not delegate is anything needing registered clinical judgement: assessment, interpreting results, decisions about care planning, or whether to escalate a deteriorating patient. Those stay with the registered nurse.

Accountability is shared, not passed off

Delegation does not empty your accountability. When you delegate appropriately, you remain accountable for the decision to delegate, for checking the person is competent, and for the level of supervision. The HCA is then accountable for how they carry out the task. So if a competent HCA performs a suitable, well-supervised task correctly, they own that execution, while you own the decision to delegate it. Understanding where the line sits is exactly what these questions probe.

Competence, both ways

Two-way honesty about competence matters. Before delegating, you satisfy yourself that the task suits the person and the supervision fits, rather than delegating just because someone is free or the ward is busy. And an HCA asked to do something they have never been trained for should feel able to say so, and you should not pressure them. When that happens, you arrange the task another way. Insisting, or reporting them for an honest recognition of their limits, would be unsafe.

Delegation working well

Good delegation includes the HCA knowing to report concerns back. An HCA who records an abnormal observation and tells the registered nurse is doing exactly the right thing, and the nurse then assesses and acts. That loop, delegate the task, keep the judgement, report back the findings, is delegation as it should work. Next: SBAR and clinical handover. Five delegation scenarios first.

Sources & further reading

Key takeaway from Delegating to Healthcare Assistants: Questions

Frequently asked questions

What tasks are appropriate to delegate to an HCA?

Tasks within their training, competence and role, such as routine observations, personal care, or helping with eating and drinking, with supervision matched to the task. You do not delegate clinical assessment, decisions needing registered judgement, or anything beyond their competence.

Do I keep any accountability after delegating a task?

Yes. You remain accountable for the decision to delegate, for checking the HCA is competent, and for the level of supervision. The HCA is accountable for how they carry out the task. Delegation shares responsibility; it does not remove yours for delegating well.

What if an HCA is asked to do something beyond their competence?

They should decline and say they are not competent, and you should not ask them to do it. Recognising the limits of competence protects patients, and an HCA who feels pressured to attempt an unfamiliar task should be supported to say no.

Check your understanding

Quick quiz: Delegating to Healthcare Assistants: Questions

5questions. Click an answer to see the explanation. Your score is saved on this device only.

1
Which task is appropriate to delegate to a competent healthcare assistant?
Recording routine observations is within a trained HCA's competence and role. Assessment, interpreting results, and decisions about escalation or care planning need registered clinical judgement and are not delegated to unregistered staff.
2
You delegate a task to an HCA who is competent and well supervised, and they carry it out correctly. Who is accountable for how it was done?
When you delegate appropriately, to a competent person with suitable supervision, the HCA is accountable for how they perform the task. You remain accountable for the decision to delegate and for supervision, but not for their competent execution of an appropriate task.
3
An HCA tells you they have never been trained for a task you asked them to do. What should you do?
You do not delegate a task to someone not competent to do it. When the HCA says they are untrained, you arrange it another way rather than pressuring them. Insisting, or penalising them for an honest recognition of their limits, would be unsafe and unfair.
4
Before delegating, what should the registered nurse be satisfied about?
Appropriate delegation depends on the task being suitable, the person being competent, and supervision matching the situation. Availability or staffing pressure alone does not justify handing over a task someone cannot safely do.
5
An HCA reports an abnormal observation they recorded. What does this show about delegation done well?
Good delegation includes the HCA knowing to report abnormal findings back to the registered nurse, who then assesses and acts. This is delegation working as intended, not overstepping. Silence about an abnormal result would be the real problem.