Programme Name: BSc (Hons) in Health and Social Care (with Foundation Year)

Module Code: HSO4001

Module Title: Legal and Ethical Issues

Assessment Title: Legal and Ethical Issues – Accountability

Module Tutor: Dorothy Iguma

Student Number: 2023016

Date of Submission: 09/01/2023

Word count: 1925

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 Table of Contents

Introduction........................................................................................................................3

Main Body..........................................................................................................................3

Conclusion.........................................................................................................................7

Reference List....................................................................................................................8

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Introduction

The aim of this essay is to focus on the aspects of accountability and record keeping
along with understanding the associated legal and ethical issues.
The present essay will also discuss the role of healthcare professionals within a
healthcare setting in accordance with accountability and recordkeeping.

Main Body

The term Accountability can be referred to as responsibility from the perspective of

oversight. As per the statements of Petrakaki et al., (2021), accountability is defined as

an assurance that an organisation or an individual has been evaluated in accordance

with the behaviour or performance for which the responsibility is served.

In the context of a healthcare setting, accountability is defined as the ability of

healthcare professionals in performing different types of medical activities and

interventions. Ensuring and providing safe and quality care for service users is one of

the most important aspects of accountability (Ong et al., 2020).

Record Management or Record Keeping can be referred to as the process of gaining

access to information rights through the introduction of proper systems of registering as

well as maintaining information. As per the statements of Lee et al., (2020), record

keeping has been considered to be one of the key aspects of professional

accountability. This can be attributed to the fact that in terms of record keeping, nurses

should be specialised in maintaining their accountability because of the fact that

leakage of information often results in medical errors, message discrepancies, and

negative patient outcomes. This indicates the fact that legal and ethical issues share a

direct and positive relationship with accountability and record-keeping within a

healthcare setting.

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It has been observed that ethics and accountability are positively related to each other.

As per the views of Bittins et al., (2021), any healthcare system that has no

accountability often fails to normalise or enforce ethical codes and thus, also affects the

outcomes of the patient in a negative way. According to various medical research, it has

become evident that accountability and patient safety have been recognised as the

most accountable aspects of a healthcare organisation that are based on the

development of foundational ethical values in healthcare. In this context, Accreditation

can be referred to as official proof that all the operations such as record keeping,

maintenance of accountability, and compliance with ethical codes are being followed

with sufficient reliability as well as reasonable patient safety (Svensson, 2019).

Moreover, Accreditation has been considered to be one of the major contributors to the

development of a strong motivating factor for the adoption of checklists and a safety

culture. In addition, one of the main benefits of accreditation is related to the fact that it

helps in improving patient outcomes as well as makes a reduction in adverse events.

Record keeping and accountability by the nurse provide greater amounts of the correct

information related to treatments and caregiving. Swartz and Collins (2019) have opined

that good record-keeping by nurses also provides greater accountability of them to the

patients and thus, allows them to identify medical problems along with the development

of several mitigation strategies for reducing the emergence of medical errors. On the

other hand, in accordance with the patients and their family members, accountability

and record-keeping within a healthcare setting play an important role that aids in the

development of better communication with doctors and nurses. According to the

opinions of Kirk et al., (2022), this has been proven to be beneficial pertaining to the fact

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that proper record management provides an overview of the healthcare status of the

service users on the basis of previous medical records. Moreover, record-keeping and

accountability also help in determining the stages of treatment and therapy for the

concerned medical conditions that ultimately provide benefits to the service users and

their family members (Bell et al., 2019).

Furthermore, in accordance with the employers within a healthcare setting, it has been

observed that proper information along with management of the records also aids the

supervisors in making potential future decisions. Inoue et al., (2019) have mentioned

that the accuracy and clarity of medical records have been considered to be paramount

in terms of forming effective communication between healthcare professionals and

service users. This is particularly important because of the fact that employers are able

to meet the needs of the patients in an effective and comprehensive manner. In the

case of professional regulators such as “The Care Quality Commission” (CQC), the

primary aim of this organisation is to provide health and social care services in order to

protect the treatment rights of service users (CQC, 2022). In this context, record-

keeping and accountability have been advantageous in addressing the major quality

issues related to health and social care.

The Care worker’s accountability

In accordance with the professional regulators, the nurse and their accountability help in

the development of a High-performing Organisation (Smith, 2021). This indicates the

fact that a nurse is first accountable for oneself by getting proper training along with the

development of skills and knowledge that are required for performing within a

healthcare setting in a successful manner.

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A care worker is accountable to oneself by attending appropriate training such as Health

and Safety, Safeguarding or Medication training, to ensure his professional behaviour

will not harm those he supports.

The “implied promise” is part of nurse’s self-accountability and refers to the

responsibility of maintaining patient confidentiality.

In addition, to maintain the confidentiality of the personal record of the patients, the

“Data Protection Act 2018” of the UK has been recognised to be most helpful

(Legislation, 2022).

The duty of confidence that nurses have, can be breached if it’s in the best interest of

the patient or the public, when it’s required by law or when the patient consents for the

information to be disclosed. An example when confidentiality can be breached in the

public’s interest might be when the nurse has a reasonable belief that the service user

intends to commit a criminal act. Child abuse is another example when confidentiality

can be breached in the public’s interest and must be reported to the authorities (Legal

knowledgebase, 2022).

Nurses are accountable for the service users to explain what their treatment implies, in

order for them to be able to give an informed consent, this being a legal obligation of

nurses and an important ethical standard nurses must abide by.

Healthcare professionals are also accountable to assess the capacity of a service user

to give consent. If the patient lacks capacity to give consent, the medical professional is

accountable to decide based on the patient’s best interest (when there’s no one

appointed to make decision on the patient’s behalf or when the patient has not made an

advanced decision).

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Moreover, The Care Act (2014) outlines the legal and ethical obligation of nurses to

prioritise service users’ needs and act in their best interest.

Furthermore, it has been observed that to address the varying needs of the patients, the

nurses are also required to develop different communication skills such as auditory and

visual. These have been proven to be advantageous for service users in terms of

developing a trusted relationship with their nurses (CQC, 2022).

Safeguarding the rights and treatments of patients has gained equal importance in

terms of protecting service users from the unequal distribution of resource allocation

and medical treatment.

The Health and Safety at Work Act (1974) shows how nurses are accountable to

oneself, patients and public, by having the duty to take appropriate measures for their

own health and to report any health concerns that might endanger the service users or

others they may come in contact with.

Nurses are also accountable to the employer, having the legal obligation to respect the

terms of their contract and act in line with professional ethics.

In addition, the nurses also demonstrate accountability through record keeping, working

safely, and following guidelines.

The Nursing and Midwifery Council is the regulator for nursing professions in UK,

therefore nurses are required to follow the principles and standards outlined in The

Code, being accountable to the professional regulators.

Moreover, the responsibility to act in accordance with The Code outlines how nurses

are also accountable to the public, as they are expected to prioritise the public’s safety

(NMC, 2023).

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Nurses are accountable to follow NICE guidelines and to report any medicine errors, an

accurate record keeping being therefore a paramount responsibility and a legal

obligation.

Furthermore, nurses are accountable to CQC, being required to report safety incidents,

such as the death of a service user (CQC, 2022).

The Employer’s accountability

The accountability of the employers is often regarded as the hallmark of an organisation

pertaining to the fact that their accountability is answerable to the treatments and well-

being of the service users. In this regard, employers are also compelled to follow the

code of ethics to maintain the ethical and legal issues of medical record keeping

(Gaitens et al., 2019). Moreover, ethical conduct includes following the principles of

“beneficence, respect for human dignity, veracity, fidelity, loyalty, and patient

autonomy”.

Employers are also accountable to professional regulators and hold the responsibility to

verify that their employees, such as nurses, are registered with an appropriate regulated

body.

Furthermore, the employers within a healthcare setting are also accountable for giving

proper training to the employees, to select the candidates who are reliable for building

an organisational reputation. This is also associated with record keeping pertaining to

the fact that it helps in the selection of talented candidates from the training groups

(Babri et al., 2021).

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Moreover, employers hold the responsibility of maintaining the safety aspects of staff

and patients through the implementation of all the national standards of a healthcare

organisation.

Health and Safety at Work Act also shows how employers are accountable to their

employees to prioritize and protect the health of their employees and ensure they work

in safe circumstances.

Professional regulators’ accountability

The primary goal of professional regulators such as CQC is to treat all service users

across the globe with proper respect and dignity. This is in accordance with the

accountability of professional regulators for the patients.

Moreover, to maintain the accountability of professional regulators towards the

organisation, it has been observed that proper accountability and record-keeping aid in

the development of a high-performing organisation. This indicates the fact that not only

employers, but also professional regulators help in the formation of high-performing

organisations in the long run (Pereira et al., 2020). This indicates the fact that CQC and

other body regulators like NMC have been considered to be accountable to staff by

providing the expected standards, accurately informing their members, and providing

certification. For instance, NMCs as well as CQCs are also held accountable to certify

nurses through providing them with a perceptual framework to identify them and keep a

record of their work. In this context, it also indicates the fact that record-keeping has

been proven to be advantageous in providing certification to nurses (Schoenberg,

2022).

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Conclusion

It can be concluded that accountability is referred to as the responsibilities of different

healthcare professionals such as nurses and professional regulators in terms of

providing patients with appropriate service care. It is also defined as the ability of

healthcare professionals to develop a trusted relationship with service users by

protecting their confidentiality and anonymity as well as safeguarding their rights and

treatments.

Through the implementation of the various national standards, policies and frameworks,

the employers within a healthcare organisation help in the development of a strong

organisational reputation. This indicates the fact that not only the employers are

responsible for creating an organisational reputation but also the other professional

regulators such as CQC serve the accountability of maintaining the reputation of the

healthcare organisation through treating all the service users with respect and dignity.

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corporate codes of ethics’, Journal of Business Ethics, 168(1), pp.71-108.

Bell, J.F., Whitney, R.L. and Young, H.M. (2019) ‘Family caregiving in serious illness in

the United States: Recommendations to support an invisible workforce’, Journal of the

American Geriatrics Society, 67(S2), pp. S451-S456.

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January 2023).

Cho, I. and Bates, D.W. (2018) ‘Behavioral economics interventions in clinical decision

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CQC (2022) Report into how data is safely and securely managed in the NHS. Available

at: https://www.cqc.org.uk/sites/default/files/20160701%20Data%20security%20review

%20FINAL%20for%20web.pdf (Accessed: 03 December 2022).

CQC (2022) Reporting medicine related incidents. Available at:

https://www.cqc.org.uk/guidance-providers/adult-social-care/reporting-medicine-related-

incidents (Accessed: 08 January 2023).

Data Protection Act (1998). Available at: Data Protection Act 1998 (legislation.gov.uk)

(Accessed: 08 January 2023).

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Gaitens, J., Condon, M., Fernandes, E. and McDiarmid, M. (2021) ‘COVID-19 and

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