NMC Code Section 11: Be Accountable for Delegated Care

Section 11 of the Code is the delegation standard.

“Be accountable for your decisions to delegate tasks and duties to other people.”

Sub-clauses:

• 11.1 Only delegate tasks and duties that are within the other person’s scope of competence, making sure that they fully understand your instructions.
• 11.2 Make sure that everyone you delegate tasks to is adequately supervised and supported so they can provide safe and compassionate care.
• 11.3 Confirm that the outcome of any task you have delegated to someone else meets the required standard.

Delegation is not transfer of accountability. The registrant who delegates retains accountability for the decision to delegate, even though the delegate is accountable for their action.

What it means in practice

Safe delegation has four components:

1. The right task. Something that can be safely delegated: within scope of the role you’re delegating to, not requiring registered judgement, not safety-critical in ways the delegate isn’t trained for.

2. The right person. Someone competent to do the task, available, with capacity to take it on.

3. The right communication. Clear instructions, opportunity for the delegate to ask questions, clear escalation path if something changes.

4. The right follow-through. Checking the outcome, addressing any issues, supporting the delegate if the task was difficult.

The classic test: would you delegate this task to this person knowing what you know about both? If yes, the delegation is sound. If you’d have hesitations, those hesitations matter.

Common breaches

Section 11 breaches in fitness-to-practise cases:

• Delegation beyond competence: asking a colleague to do something they weren’t trained for, particularly under time pressure.
• Inadequate supervision: delegating and then failing to check, supervise, or follow up.
• Unclear instructions: delegation that the delegate didn’t fully understand.
• Delegation to avoid responsibility: assigning a difficult task to a junior to keep distance from a problem.

The “I told them to do it” defence doesn’t work in fitness-to-practise hearings. The Code’s wording places accountability for the delegation decision firmly on the registrant.

CPD that maps to Section 11

• Delegation and supervision training.
• Leadership development at ward and team leader level.
• Clinical supervision training.
• Role-based competency frameworks: knowing what HCAs, nursing associates and nurses at different bands can do.
• Accountability frameworks: RCN and NMC both publish guidance.

Common reflective account themes

Strong Section 11 accounts describe:

• A specific delegation decision you made, what you weighed, and how it turned out.
• A delegation that went wrong and what you learned about your future delegation practice.
• A supervisory relationship where your follow-through made a difference.
• A delegation you declined to do because you weren’t satisfied the person was competent.

The accounts that work involve clear judgement and recognition of accountability. The accounts that don’t work either downplay the registrant’s role (“I told them”) or overstate it (“I should have done it myself”).

Where Section 11 connects to other sections

• Section 8 (cooperative working): delegation is cooperative working in action.
• Section 13 (limits of competence): knowing what’s within your scope to delegate.
• Section 19 (reduce harm): bad delegation causes harm.

The next chapter covers Code Section 12: having appropriate indemnity arrangements (covered in detail in the requirements section, but with a specific Code Section dimension).