‘Duty of care’ is a phrase used to describe the obligations implicit in your role as a health or social care worker. As a health or social care worker you
owe a duty of care to your patients/service users, your colleagues, your employer, yourself and the public interest. Everyone has a duty of care – it is not
something that you can opt out of. The duty of care applies to all staff of all occupations and levels. It applies to those working part time or full time, those in agency or temporary roles as well as students and volunteers. You have a duty of care, whether you are a registered professional or nonregistered. It applies to everyone, from nurses to porters, cleaners to receptionists, paramedics to therapists and technicians to social workers. The duty of care to a patient or service user exists from the moment they are accepted for treatment or a task is accepted and they begin to receive services. This may be, for example, on admission to a ward, acceptance onto a caseload or once registered at an accident and emergency department. You have a duty of care to all patients or service users even if you are not directly responsible for their care. All health and social care organisations, whether they are public, private or voluntary organisations, also have a duty of care. Their duty of care is to provide a comprehensive service to citizens and to demonstrate that, within the available resources, the appropriate priorities are chosen. They must also ensure that those people who are providing care are able to do so safely. Just because an employee or employer cannot do everything that they believe needs to be done, does not mean they have breached their duty of care. There are not limitless resources available, therefore the obligation of an employee and employer is to ensure that what is actually done is done safely and in an appropriate and timely manner. They should also make it clear what cannot be done.

Your duty of care means that you must aim to provide high quality care to the best of your ability and say if there are any reasons why you may be unable to do so. You must adhere to a standard of reasonable care and you are expected to:

keep your knowledge and skills up to date
provide a service of no less a quality than that to be expected based on the skills, responsibilities, and range of activities within your particular trade or profession
be in a position to know what must be done to ensure that the service is provided safely
keep accurate and contemporaneous records of your work
not delegate work, or accept delegated work, unless it is clear that the person to whom the work is delegated is competent to carry out the work concerned in a safe and appropriately skilled manner
protect confidential information except where the wider duty of care or the public interest might justify disclosure

In addition to these expectations, all employees have obligations and rights arising from their contract of employment. These may be found in various documents. For example:

the statement of terms and conditions of employment which must include details of the salary paid, holiday entitlement, and so on
other documents which are drawn to the attention of the employee – such as disciplinary procedures, job descriptions, clinical protocols and standards, work rules (on everything from parking to health and safety)
statutory terms which are assumed to apply to all contracts (eg health and safety legislation, anti-discrimination legislation, unfair dismissal and redundancy rights, the right to ‘blow the whistle’)

All contracts of employment also include ‘implied duties’. These exist whether or not they are actually written down as part of the contract. They include an obligation for the employee to work in accordance with lawful orders, co-operate with their employer, serve the employer faithfully and honestly and exercise skill and care in the performance of their work. In return, the employer is obliged to pay agreed wages for duties performed or which the employee is ready to perform, provide a safe working environment, act in good faith and behave reasonably towards the employee. It is the responsibility of employers to provide all staff with clear roles and responsibilities, along with the appropriate training. As a practitioner you should not be asked to perform any task which is beyond your level of competence. If you are being asked to take on tasks which you are not properly equipped or trained to do then you should decline to do the task and explain why. If you are under pressure and worried about what will happen if you decline to do a task then you should seek advice from your local trade union rep.