Last Updated on March 26, 2026

A new report on delegated healthcare activities, titled, The Care Workers’ View: Delegated Healthcare Activities, has been published. The report, from the Care Workers’ Charity (CWC), draws on 358 survey responses and two roundtables with care workers. It provides evidence on how clinical delegation operates across adult social care presently, and what is needed to make it safe, fair and sustainable for everyone involved.

According to the report, delegated healthcare activities, such as wound management, catheter care, PEG feeding and insulin administration traditionally carried out by registered healthcare professionals, are now a routine part of care delivery across adult social care settings. 68.87% of respondents reported being asked to perform these activities, across domiciliary care, supported living and residential environments. CWC’s report asks not whether delegation should happen, but whether the workforce delivering it is properly supported when it does.

The report continues to highlight that 93% of care workers who perform delegated healthcare activities have never received additional pay for doing so. One care worker reported earning £0.07 above the National Minimum Wage while routinely carrying out complex clinical interventions involving clinical risk, requiring precision and demanding a high level of trust from regulated professionals and families. CWC argues that the absence of any financial recognition not only reinforces the longstanding undervaluation of care work but undermines the workforce sustainability that the sector urgently needs.

In addition, the report states that training presents an equally serious picture with 6.17% of respondents receiving no training whatsoever for delegated healthcare activities. Of those who did receive training, the most common form was e-learning, which care workers consistently described as inadequate preparation for complex clinical tasks. Over a quarter of respondents had never had their competency formally assessed, and 31.5% reported that they received no supervision.

CWC’s report concludes that the implications of this situation extend beyond the care workforce. For people drawing on care, inconsistent training and absent supervision introduce real risk to the quality and safety of the support they receive. For the regulated healthcare professionals who delegate these tasks, the absence of robust oversight leaves accountability frameworks exposed. Delegation retains professional liability with the delegating clinician. Where governance is weak and supervision limited, that liability sits alongside the operational reality this report describes. Safe, ethical delegation requires adequate infrastructure at every level of the system.

Commenting on the new report, Karolina Gerlich, Chief Executive Officer at CWC, said, ‘This report reflects what care workers have been telling us for a long time that delegated healthcare activities are no longer exceptional. They are a standard feature of adult social care, and the systems around them must catch up. Care workers are willing, skilled and committed. What they need is training, clarity and the fair pau that this responsibility carries.’

This report was developed with input from CWC’s Advisory Board. Its priorities centre on clarity about what constitutes a delegated healthcare activity, mandatory and standardised practical training, transparent accountability frameworks and pay structures that reflect clinical responsibility. The report also highlights the specific vulnerability of migrant care workers on sponsored visas, for whom speaking up on these matters carries additional professional and personal risks.

Accompanying the report’s publication, CWC is calling for:

• Mandatory, standardised training delivered in practice settings, not solely through e-learning, with formal competency sign-off by a qualified professional.
• Pay structures that reflect the clinical responsibility that delegated healthcare activities carry, including clear career progression pathways for care workers who take on additional competencies.
• Enforceable protections for care workers who refuse unsafe or inappropriate delegation, with explicit safeguards for migrant care workers.

The full report is available to read here.

In other news, a new report warns that the worsening financial sustainability of adult hospices in England is not being met with the urgency it demands.