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Aipedia: Nurses and allied health professionals
Registrants who delegate AI-assisted tasks to support workers remain accountable for the decision to delegate and must confirm the outcome meets the required standard. A support worker should not be told that the system will catch problems.
Part of: AI in nurses and allied health professionals
In short
Healthcare assistants, nursing associates and AHP support workers may use AI tools: entering observations into deterioration systems, running eMAR rounds, supervising app-based exercise or drafting notes with a scribe. NMC Code 11.1 to 11.3 requires delegation only within the other person's competence, adequate supervision, and confirmation that the outcome meets the required standard. HCPC 4.1 to 4.2 requires delegation only to people with the knowledge, skills and experience needed, with ongoing supervision. Nursing associates are NMC registrants in their own right. Indemnity for support staff usually comes through the employer.
On wards, healthcare assistants take observations that feed deterioration models. In care homes, carers and nursing associates give medicines using eMAR systems with automated checks. Physiotherapy and occupational therapy assistants supervise patients on digital rehab programmes. Support workers in community teams may photograph wounds with AI measurement apps or dictate visit notes into a scribe. Each task looks routine, but each involves interpreting or acting on an AI output.
Nursing associates, regulated by the NMC in England, are accountable under the Code themselves, but registered nurses delegating to them still carry the duties above.
Illustrative scenario: a registered nurse tells a healthcare assistant to take observations and "the system will tell you if anyone needs escalating". A patient becomes newly confused, but the score stays below the alert threshold, so the assistant does not report it. The nurse is not told until the patient has deteriorated significantly. The review finds the delegation instruction relied on the algorithm instead of the assistant's observation and reporting.
Similar problems arise when a rehab assistant lets an app progress a programme without checking with the physiotherapist, or a carer overrides a medicines alert they do not understand.
Competence with an AI tool is more than knowing which buttons to press. A support worker needs to understand what the tool measures, what it cannot see, and what to do when their own observation and the tool disagree. They also need to know the downtime process if the system fails mid-shift. Where training is provided by the supplier, registrants should check it covers these limits and not only operation. Delegating registrants should be able to show, if asked, that the person had been trained on the specific tool, that instructions were clear, and that there was a route to raise concerns. Short records of competency sign-off and supervision arrangements can be useful evidence.
NMC 11.3 asks for more than a glance at the system. Practical ways to confirm the outcome include reviewing observations and scores yourself at set points, reading notes drafted by support staff before they are finalised, sampling app-progressed programmes, and checking medicines records after rounds. Instructions should cover what the tool does not do: report any concern, not only alerts. Where a support worker uses a scribe, the registrant who countersigns or relies on the note should treat it as their own record for checking purposes.
Support workers who are not registered are not subject to the statutory indemnity requirement that applies to registrants under SI 2014/1887. In NHS settings, employed support staff are usually covered by the employer. In private settings, the employer's insurance usually responds, and terms vary. A self-employed AHP or nurse who employs assistants should check that their policy covers the acts of employees and delegated tasks, including those involving AI tools. A claim may name both the person who delegated and the employer. See healthcare treatment liability.
Related: deterioration alerts, medicines administration, AI scribes and records and the nursing and allied health AI hub.
Apex arranges indemnity for clinics and care providers employing support staff. A broker checks your policy covers delegated and AI-assisted work by your team.
You are accountable for the decision to delegate and for supervision. NMC 11.1 to 11.3 require delegation within competence, adequate supervision and confirming the outcome. Clear instructions to report any concern help protect patients and you.
Yes. Nursing associates are NMC registrants in England and must follow the Code. A registered nurse delegating to them still has delegation and supervision duties under NMC 11.1 to 11.3.
Unregistered support workers are not subject to the statutory indemnity requirement for registrants. They are usually covered through their employer. Self-employed registrants who employ assistants should check their policy covers employees' acts.
Tell us about your practice and the work you do. A broker will review how your current cover treats AI-assisted work, or arrange new cover. No fee for a quote. Or call 0117 325 0027.
Start an indemnity quote Request a callbackApex Insurance Brokers Limited is authorised and regulated by the Financial Conduct Authority. Registered in England and Wales, company number 07014570. This page is general information about how AI is used in the profession and how insurance may respond. It is not legal, regulatory or insurance advice on your circumstances, and it does not guarantee that cover will be available or on what terms.
