Accountability to the Employer
Both employers and employees owe a duty of care to the patient or client and these will be detailed within the standards, policies and protocols of care published by the Health Board. In turn the Health Board must have indemnity insurance in relation to the delivery of care by them and their employees. As such, the Health Board has vicarious liability for its employees when they are acting within the course of their employment to deliver care. Vicarious liability of the employer is defined as:
"Indirect liability of the employer i.e. the Trust is responsible for the faults of others, mainly its employees" (Dimond, 2005).
It is important to recognise that the responsibility of the employer does not negate the responsibility of the individual employee. Any contractual agreements relating to conditions of employment, for example, hours of duty and hospital polices relating to confidentiality of information are all governed by contract legislation. Within the terms of the Employment Act (1980) the employing authority and the professional require to develop an employment contract detailing the overall responsibilities and duties of any professional. These duties detail the actions undertaken by the employee for which the employer will be held vicariously liable, and should be linked to Health Board procedures and standards that must be demonstrated by the employee when undertaking their role. For example, a nurse undertaking an advanced practice role will require to have a contract of employment and a detailed advanced practitioner job description with the Health Board describing:
- the band, qualifications, and minimum preparation for the role
- the scope of practice of the particular advanced role highlighting the activities and limitations of the role
- the supervision, continuing education arrangements and management structure underpinning this new role
- and increasingly means of audit, evaluation and outcome data for the role
It is also advisable that this role definition is accompanied by an accessible outline of the patient interventions that would be expected to be undertaken by this advanced practitioner referring to the policy and evidence base resource of the particular health board. If the practitioner undertakes further development for new or expanded roles and activities it is important that this is agreed with the employee and amendments made to the job description.
