Learnings from Gosport: Accountability

What went wrong at Gosport?

The Gosport Independent Panel highlighted a lack of accountability by nurses for the care given and the consequence of that care. This was evident in:

• record keeping
• decision making
• lack of challenge to the system, others and the management of the service
• lack of understanding of the Code.

What our Code says

Our Code of Conduct says that as a professional you must, ‘Be accountable for your decisions to delegate tasks and duties to other people'. To achieve this, you must:

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

What our standards say

Our current nursing standards say patients and the public can be confident that all registered nurses will:

"act to protect the public, and be responsible and accountable for safe, person-centred, evidence-based nursing practice".

They also say nurses must be:

"responsible and accountable for safe, compassionate, person-centred, evidence-based nursing".

Our current midwifery standards say:

"Patients and the public can be confident that all registered midwives will assume full responsibility and accountability for their practice as midwives".

Our current nursing associate standards say:

"Nursing associates act in the best interests of people, putting them first and providing nursing care that is person-centred, safe and compassionate. They act professionally at all times and use their knowledge and experience to make evidence based decisions and solve problems. They recognise and work within the limits of their competence and are responsible for their actions".

Accountability today

Registered nurses, midwives and nursing associates must uphold, as part of their registration, professional standards set out in the Code.

These standards must be applied across all practice settings.

The process of Revalidation, introduced in 2016, encourages reflective practice and raises awareness of the Code and professional standards expected of nursing and midwifery professionals.

Guidance published in 2018 sets out more details for nurses, midwives and nursing associates about delegation and accountability.