Principle Activities for Coordination of Healthcare – (including Delegation)

A growing number of people with support needs, including complex care, long‑term health conditions, living in their own homes rather than in clinical settings. As a result, they require care and support to enable them to live well in their communities.  Delegation of healthcare interventions, mainly by the registered nurse, is commonplace across Health and Social Care (HSC) Trusts, independent providers and third‑party agencies in NI. When done well, it enables timely, flexible, and person‑centred care, improves continuity and maximises workforce capability by utilising our collective workforce skills efficiently.

Nurses and midwives play a vital role in ensuring that healthcare interventions are carried out safely, effectively and in a way that aligns with what matters most to the individual. They contribute directly to the development of a personalised care plan that:

• Reflects the person’s individual goals and health priorities;
• Clearly outlines required health care interventions and how they will be delivered;
• Sets expectations for monitoring, review and follow‑up; and
• Defines clear processes for escalation if a person’s condition changes.

The Five steps outlined in infographic figure 1, primarily refer to the principle activities community nurses undertake in supporting the neighbourhood model of care to enable people to live ‘closer to home’. This requires them to lead on health care interventions across the wider support team/organisations.

For Staff: By clarifying each step of the care journey and defining who is responsible for what, provides transparency for both staff and the person receiving care. This structured approach enhances safety, reduces uncertainty, and ensures that everyone involved understands their role within the overall support plan.

For the person receiving support: A proactive, nurse/midwife‑led approach to coordinating health care interventions supports people to have greater choice, control, and confidence in their care. It also ensures they know which member of staff is expected to deliver each part of the intervention, strengthening continuity and trust.

Ultimately, this coordinated and person‑centred approach leads to better outcomes and improved experiences for individuals and their families.

Figure 1: Process Map to Guide Nurses in Coordination of Care

As more people receive care in community settings, nurses and midwives play a key role in coordinating healthcare interventions to ensure safe, person-centred care and positive outcomes. Effective coordination supports the delivery of the right care, by the right person, at the right time and in the right place.

This process map supports nurses to coordinate care effectively by providing a structured approach from holistic assessment to implementation, monitoring, and review. It promotes person-centred, outcomes-focused care and supports shared decision-making across professionals, teams, and agencies, including social care practitioners and classroom assistants. Clear guidance on advice, referral, allocation, and delegation helps ensure care is delivered safely by the right people at the right time. The process also reinforces nursing accountability through professional judgement, communication, documentation, and ongoing oversight, in line with the NMC Code. While care delivery may be shared, the nurse retains responsibility for leadership, governance, and assurance of safe, high-quality care.