Delegating medicines administration

A care worker supporting people with their medicines must be appropriately trained and competent to carry out this task.

Some medicines cannot be routinely administered by a care worker. For example injections (such as insulin) or medicines administered via a feeding tube are clinical or nursing tasks. A registered nurse (RN) can delegate the administration of these medicines to a care worker.

The RN must be confident that the care worker is competent to take on this task. Delegation must always be in the best interest of the person. Providers should also consider how to obtain consent.

Principles and responsibility

The Nursing and Midwifery Council (NMC) code says registrants must be accountable for their decisions to delegate tasks and duties to other people. It says they must:

• only delegate tasks and duties that are within the other person's competence
• make sure that everyone they delegate tasks to is adequately supervised and supported
• confirm that the outcome of any task they have delegated to someone else meets the required standard

Staff will need extra and more specific training and competency checks before undertaking these tasks. Read more about regular training and competency expectations.

The RN delegating the task must have full confidence that the care worker is competent to carry out the delegated task.

The care worker must:

• understand their limitations
• know when and how to seek help and escalate concerns
• make sure they are comfortable in carrying out the task safely and correctly

This should also include out of hours arrangements.

The care worker should know what to do if the person refuses their medicines. The care worker’s responsibilities should be covered:

• as part of their specific training to the delegated task
• in the provider’s policy

When a care worker accepts the delegated task, they are responsible for administering the medicines:

• in line with the prescribed instructions and
• as part of a specific and detailed care plan

Periodically the RN should make sure the care worker remains competent to carry out the delegated task.

The RN must make sure that everyone they delegate tasks to is adequately supervised and supported so they can provide safe and compassionate care

Both the RN and care worker should understand accountability, liability and responsibility. They should make a record of their understanding.

The Royal College of Nursing has published some guidance on the principles of delegation. Find out more