Delegation and Accountability Questions

Delegation is how care gets shared across a team, and doing it well is a skill the CBT takes seriously. The core idea sounds simple and is easy to get wrong: you can delegate a task, but you cannot delegate the accountability for delegating it.

When you hand a task to someone else, you stay accountable for three things: the decision to delegate, whether the person is competent for the task, and whether the supervision fits. The person doing the task then carries their own accountability for how they perform it.

What you can and cannot hand over

You delegate tasks that are within the other person’s competence and role, that serve the patient’s interest, and that you can supervise appropriately. You do not delegate tasks that need registered clinical judgement, such as assessment or decisions about care, to unregistered staff. A busy shift does not widen what can be safely delegated. If the workload is unsafe, that is the thing to escalate, not the threshold for delegation.

Accountability runs both ways

The person you delegate to is not a passive pair of hands. They are accountable for carrying the task out properly, and for speaking up if they are not competent or comfortable to do it. A healthcare assistant asked to do something they have never been trained for should decline and say so, just as you would. Questions often turn on this: the safe answer is the one where the person recognises the limit of their own competence.

Matching supervision to competence

Students and newer staff learn by doing, but the supervision has to match the situation. A first attempt at a procedure needs direct supervision. Signing something off without watching it, or leaving an inexperienced person to work alone, are the wrong answers, and the second is also dishonest record keeping.

The pattern to carry into the exam: right task, right person, right supervision, and honesty from everyone about what they can safely do. Next: duty of candour. Five delegation scenarios first.