What do we mean by accountability?

Accountability may be one of the most frequently used words in our profession. The Nursing and Midwifery Council (NMC)(2018)Code recognises that:

‘The professions we regulate have different knowledge and skills … They can work in diverse contexts and have different levels of autonomy and responsibility. However, all of the professions we regulate exercise professional judgement and are accountable for their work.’

The Code also says that we must:

‘Be accountable for your decisions to delegate tasks and duties to other people.’

Cornock (2014) explored the legal principles of responsibility and accountability in professional health care, reflecting that there is a trident of responsibility, accountability, and liability – the three terms may be seen to form a hierarchy with responsibility being the least onerous, moving through accountability, to liability having the most potential impact.

Cornock (2014) helpfully suggested that ‘professional accountability’ therefore refers to the autonomous health professional who has the knowledge, competence and authority to practice in the way that they see fit, according to their professional training; to act or not to act, using their own judgment to decide what treatment is necessary; the freedom to decide how best to deliver that treatment; and the ability to justify their action or inaction based on their knowledge and expertise.