For care providers across the sector, delegated healthcare tasks are nothing new. Care workers have long supported people with increasingly complex needs, often working alongside community nurses and clinical teams to deliver care that would once have sat squarely within the NHS. 

So why is delegation back in the spotlight? 

The answer may lie in the broader direction of travel across health policy. The NHS 10-Year Health Plan sets out ambitions for more care delivered in communities, stronger neighbourhood teams and a shift away from hospital-based provision. While no explicit plan for social care is outlined within this, many in the sector recognise the implication: if more clinical care is to be delivered outside hospital walls, social care will inevitably form part of that delivery model. 

And with that implication comes a familiar question: what more might be expected of the social care workforce? 

 

A growing role or a formal recognition? 

Skills for Care has framed delegated healthcare activities as an opportunity, not an imposition. In a recent blog, the organisation highlights how delegation can “unlock new career opportunities” for care workers, strengthening professional identity and building confidence within the workforce. 

The argument is clear: when delegation is structured properly, with training, competency assessment and oversight from regulated professionals, it represents a form of recognition. It acknowledges that care workers are skilled practitioners capable of delivering increasingly complex support. 

The Guiding Principles for Delegated Healthcare Activities reinforce that delegation must be “person-centred, clinically appropriate, safe and effective,” with accountability remaining with the delegating health professional. In this framing, delegation is not about shifting responsibility, but about enabling more responsive, joined-up care. 

For some providers, this aligns with reality. Many services already support people with PEG feeding, diabetes management, catheter care or wound care under delegated arrangements. Formalising these processes brings clarity and consistency. 

But there remains a conversation around differing opinions.  

 

Integration or cost shifting? 

As integration between health and social care deepens, some sector leaders have questioned whether delegation is becoming less about empowerment and more about capacity management. 

If the NHS 10-Year Plan drives more care into community settings, and if district nursing teams remain stretched, there is a legitimate question about where clinical workload lands. For providers already grappling with workforce shortages, rising costs and tight local authority fees, the idea of taking on more clinically adjacent tasks raises practical concerns. 

Insurance brokers such as Howden have pointed out that delegated healthcare tasks alter a provider’s risk profile. Greater clinical complexity brings increased governance demands, documentation requirements and potential liability exposure. This is manageable but not without investment, which many providers in the sector are not currently well-placed to consider.  

There is also the question of remuneration. If expectations increase, should funding and pay structures evolve alongside them? Sector commentators have long argued that greater responsibility must be matched with recognition, development and fair reward. 

 

Workforce development or workforce stretch? 

Training providers have said that, quite rightly, the new guiding principles place significant emphasis on competency assessment and supervision. Delegation cannot be informal or assumed. It must be structured. 

However, the operational reality for many managers is that training time, backfill and supervision capacity are already stretched. The difference between delegation done well and delegation done poorly doesn’t lie in principle, but in implementation. 

Skills for Care stresses that delegation should support career progression and retention. And there is a compelling case here. In a sector where recruitment and retention remain pressing challenges, meaningful development pathways matter. 

Yet for some providers the worry remains: will care workers feel empowered or burdened? This delicate balance between professional growth and expectations outside scope of practice is where the conversation currently sits.  

 

A sector at a crossroads 

What makes this moment different is not that delegation exists. It is that the wider policy environment is shifting. The NHS 10-Year Health Plan speaks of prevention, neighbourhood teams and integrated delivery. Social care is central to that ambition. 

If adult social care is to be seen as an equal partner in integrated systems, its workforce must be recognised as skilled and clinically aware. Delegated healthcare activities are one tangible expression of that recognition. But integration cannot be a one-way street. 

For delegation to feel like progression rather than pressure, it must be accompanied by: 

• Clear governance frameworks 

• Robust training and supervision 

• Open conversations with commissioners to recognise the increased funding needs 

• Alignment between responsibility and reward 

Providers are pragmatic. They understand the direction of travel. Many are already operating in this space. The question now is not whether delegation will continue but how it will be shaped. Is this the formal recognition of what social care has long delivered? Or is it the quiet expansion of expectation in a system under strain? Perhaps, as with most things in adult social care, it is both. 

What is certain is that as integration accelerates, the voice of providers and the experience of the workforce must remain central to the conversation.