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Over 20 years experience of training in the care sector
Call us on
020 3129 5667
Delegated healthcare activities are a routine part of adult social care for many workers in England. New government workforce data shows just how common they have become , and why providers need to be confident that delegation, training and competency arrangements are safe.
The Department of Health and Social Care’s 2025 Adult Social Care Workforce Survey found that 59% of people in direct-care roles said they carry out delegated healthcare activities sometimes or often. Of those workers, 66% said they had been shown, taught or trained how to carry them out.
That raises an important question: when healthcare activities are delegated, are roles, responsibilities and competence always clear?
What is a delegated healthcare activity?
A delegated healthcare activity is an activity that a regulated healthcare professional, such as a nurse or occupational therapist, delegates to a paid care worker or personal assistant.
Examples used in the government survey included blood glucose monitoring, pressure ulcer care, physiotherapy stretches, post-operative physiotherapy and supporting someone to follow a mental health plan.
Delegation can support people to receive care from workers they know, at times that fit their daily lives. When planned and supported properly, it can contribute to more personalised and coordinated care.
However, delegation should never simply mean transferring a task from one worker to another.
What does the latest workforce data tell us?
The government’s survey, published in July 2026, gathered responses from more than 3,000 people working in adult social care in England.
Among workers in direct-care roles, 59% said they sometimes or often carried out delegated activities. Of those, two-thirds said they had been shown, taught or trained.
Confidence was high: 86% of workers undertaking delegated activities said they felt confident doing them.
Confidence is encouraging, but it is not the same as demonstrated competence. A worker may feel comfortable completing an activity while still needing assessment, updated guidance or further support.
Who is responsible when a healthcare activity is delegated?
Safe delegation is a shared responsibility, but different people and organisations have different responsibilities.
Skills for Care’s national guiding principles state that the regulated healthcare professional remains responsible for deciding whether delegation is appropriate.
The social care provider is responsible for deciding whether it can safely accept the delegated activity and ensuring suitable governance, training and support are in place.
The care worker is responsible for carrying out the activity in accordance with the care plan, their training and assessed level of competence.
Workers should feel able to say when they are not confident or competent. Providers should also be prepared to raise concerns or decline a delegation if the necessary arrangements are not in place.
Training is only part of the picture
A certificate showing that a course has been completed does not necessarily demonstrate that someone can safely perform a delegated healthcare activity.
Skills for Care says healthcare activities should only be delegated when workers have received appropriate learning, development and support. Competency requirements will vary according to the activity and the person’s needs.
For some activities, workers may need:
General learning can help someone understand a condition or procedure, but practical competence may need to be assessed by an appropriately qualified person.
What happens when the person’s needs change?
Competence should not be treated as permanent.
The healthcare professional who delegates the activity should provide ongoing clinical oversight and continue to monitor and review the person’s healthcare plan.
Care workers are often well placed to notice changes because they may support the person regularly. They should know what to look for, what to record and who to contact if something no longer seems safe.
A worker who has been trained and assessed to complete an activity may need further guidance if the person’s condition changes, equipment is replaced or the care plan is updated.
The correct response is not to improvise. It is to stop, seek advice where necessary and follow the agreed escalation process.
Five questions providers should ask
Providers accepting delegated healthcare activities should be able to answer five practical questions:
If any answer is unclear, the delegation arrangements may need to be reviewed.
Why this matters for the future of social care
Delegated healthcare is likely to remain an important part of integrated health and social care.
It can give people greater choice and continuity and help care happen in familiar settings. It can also give experienced care workers opportunities to develop additional skills.
But expanding responsibilities must be matched by learning, competence, governance and support.
The latest workforce findings are a reminder that as care roles become more complex, providers need to understand not only what workers are doing, but whether they have been properly prepared to do it.
How CareTutor can support your workforce
CareTutor provides flexible health and social care learning that can support the knowledge behind safe, person-centred practice.
Digital learning should form part of a wider approach. Where a healthcare activity is delegated, providers must also ensure that any person-specific training, practical instruction, competency assessment and clinical oversight required for that activity are in place.
Want to strengthen the knowledge and confidence of your care workforce? Explore CareTutor’s training solutions and speak to our team about learning that supports safer, more capable care teams.