Delegated Healthcare Activities
An implementation
toolkit for health
and social care leaders
This toolkit provides a checklist to guide the effective and sustainable implementation of DHA. Sections include:
Deciding who will
take part in DHA
Training and
competency
Key considerations are presented in each section and are informed by our research on implementing Delegated Healthcare Activities in Greater Manchester (GM). The toolkit is not intended to be prescriptive, and decisions/solutions will need to be tailored according to local policies, structures and circumstances. However, learning generated from the GM experiences is important and may assist the roll-out of DHA in other geographical areas/localities.
Introduction
There is increasing policy and practitioner interest in the delegation of healthcare activities (DHAs) from primary healthcare teams to adult social care providers and workers, given the wide range of benefits that can result. Delegation offers an opportunity to offer more integrated, person-centred ways of working and improve quality of care. It can mean interventions are delivered at a time, place and by individuals most appropriate for the person drawing on services.
DHA can address the fragmentation of provision that can result from the design of the existing health and social care services, reducing inefficiencies in the process. Delegation also supports optimising the knowledge and skills of both the health and care workforces, allowing healthcare workers to prioritise more complex cases and adult social care workers to upskill and develop new knowledge. This could potentially improve recruitment and retention by reducing the intensity of work for the former and improve job satisfaction and career progression for the latter.
Delegation can, however, be complex and challenging, particularly where it spans public/ private sector boundaries. There are potential risks of harm to people and regulatory non-compliance if not managed effectively. Careful deliberation and planning are essential, and a number of important issues require consideration. With this in mind, this toolkit is designed to support health and social care leaders to introduce DHAs in safe, effective, sustainable and person-centred ways. It is based on evidence from an NIHR-funded project that explored processes, experiences and outcomes of delegation from district nursing teams to adult social care workers in GM. Nearly 100 interviews were conducted with senior leaders in health and social care, district nurses, adults social care managers and frontline care workers, and people who use services and their carers. There was a particular emphasis on three GM boroughs that have well-established DHAs programmes, and these insights were combined with the views of senior leaders in the other seven GM boroughs, where DHAs are not yet embedded. This offered further understanding of factors which both facilitate and/or inhibit uptake of DHAs. More information on the project can be found here Research: Delegated healthcare in Greater Manchester | Manchester Metropolitan University
This research was funded by the National
Institute for Health and Care Research
(NIHR206546).
The views expressed are those of the author(s) and not necessarily those of the NIHR or the Department of Health and Social Care.
