accountability

[Guest guest]

Dear all

I was quite concerned about the implied implications of the discussions earlier in the week around accountability - as some people reading the discussion might think that a qualified HV or SN holding a caseload was ultimately accountable for everything that happened to any clients on that caseload whether she had had contact with them, knew them or not.

Obviously this is not true - a HV/SN can only be held accountable for work she does and this might include inappropriate delegation to a team member or failing to follow the agreed programme of visiting and not raising it as an issue if she does not have the time to do so - she cannot be accountable for missing something on a family she has not seen if the policy is to only do so many visits or to delegate work to others in the team. The issue is the competency and of course the education and training of the team member the work is delegated to. If that person is a registered nurse then he/she has their own accountability and to only do things they feel they are competent to do.

IF the team member is a nursery nurse or an HCA and the trust policy is for them to do the work as a delegate task then they as an employee and the Trust has the accountability as does the manager of the service.

Lamming in his report on Climbie was very clear about managerial accountability - and it is well worth a revisit.

I feel very strongly that accountability today within a multi agency and multi professional agenda is a much wider issue than the NMC imply in the code of conduct and I think requires much wider debate.

Margaret