Accountability in Health & Social Care: A Legal and Ethical Analysis

This essay examines accountability in health and social care, highlighting its legal and ethical dimensions. It references the Francis Report and the Health and Social Care Act 2013, emphasizing the importance of accountability to regulatory bodies, clients, and colleagues. The discussion covers health inequalities, the role of NHS reforms, and the significance of accurate record keeping. Key ethical principles such as autonomy, beneficence, non-maleficence, and justice are explored, along with legal duties related to patient confidentiality and consent. The essay concludes that medical professionals must adhere to codes of conduct to protect patient rights and maintain standards in healthcare.

Legal and Ethical
Issues-Accountability

Table of Contents
INTRODUCTION ..........................................................................................................................3
TASK ..............................................................................................................................................4
CONCLUSION ...............................................................................................................................7
REFERENCES................................................................................................................................9

INTRODUCTION
Accountability simply means responsible to someone. The health and social care
professionals are held accountable for their action and obliged to perform their duty. Care
workers are not only accountable to their regulatory bodies but also their clients, employers,
colleagues and themselves. Accountability allows them to maintain proper records and work
safely. In the year 2013, Francis report was published and has identified five essential themes to
provide fundamental rules and nursing standards to develop cultural health system and
coordinate heath care for patients. The recent amendment in the English National Health Service
(NHS) has established the accountability system for health care services. Health care
professional are basically the qualified health professionals which plays significant role in
promoting health sector and deliver the best services to their clients. According to Health and
Social Care Act, 2013, considerable effort has been made to provide NHS legislation to widened
up the accountability framework to follow the ethical and legal standards in social and health
care sector (Ballantyne, 2019). The health care professional are legally and ethically responsible
to protect their patient and exercised their code of ethics as a profession for which they are
assumed to adhere. They are not only answerable to other's action but also for one's own action.
This essay will cover the different aspect of accountability in health and social care, its different
legal previsions and various ethical principles that are applicable on medical practitioners.
Further, it will analyse the importance of accurate record keeping.
TASK
According to the Professor Sir Michael Marmot (Health Equity in England:The Marmot
Review 10 Years On, 2020), health inequalities was largely observed which enhanced the
worries of the UK government and leads to 'unjust and unnecessary' treatment with patients. The
UK has observed the slow rise in life expectancy of population especially women, forced the
government to take necessary measure to legally recognise the rights of the patients. The major
changes has been adopted after the implementation of NHS reform in the year 2013 that has
increased the different approaches of accountability and achieved the greater control over the
health care practitioners (Ellis and Ellis, 2021). The professional accountability provides
guidance to social and health care workers on how to manage and maintain the proper records of

all their actions. Accountability has different meaning in health, law and ethics. It is an essential
element to maintain relationship between client and health professional. It helps to secure the
interest of their clients and able to justify their action by legally and ethically exercising their
professional duties. However, it complies with privacy laws and ethical codes of conduct to
maintain the client's confidentiality and safety (Bowman, Huxtable, Razai and Gallagher, 2021).
For clients, accountability usually means identifying the better treatment plan and meditational
procedure to cure the disease. It influence the mental and physical health and encourage the
patient to participate in their treatment under the best health professionals. Accountability is
complex procedure and covers all the aspects of health care system including government
policies , training programs, counselling procedure etc. If an of the health professionals and
employers is failed to comply with their ethical and legal duties, then they are accountable for his
action to the authorities and will be penalised for their derogatory action. It ensure meaningful
efforts and collective engagement with the government to bring more accessible and better
healthcare system in the society.
The Francis Inquiry plays crucial role in identifying all the barriers that were faced by the
UK health care system and address the some of the vital issues related to lack of legislation that
are able to improve public confidence. The UK Law commission has reviewed the issues and
made key changes in regulatory model to ensure public protection and promote safety, health and
care of the general public. It is a legal obligation over the medical professional to provide clear
justification to the interested parties or clients for their action. In relation to health and care
sector, it involves following aspects which means individual professional is responsible for his
own act (Kaur and Lodhia, 2019). As an employer, they are responsible for the work they done
within an organisation and accountability in respect to other's involves the conduct and
behaviour towards colleagues and other staff members. The health and Social Care Act of 2012
introduced the separate legal entity which is known as NHS Trust Development Authority. This
authority is responsible to laid down the duty to promote apprehension of heath service and
mandate the accountability to patient and, public, employer and other statutory regulatory bodies.
The Health and Well being Boards has been established to promote integrated health system and
increase accountability in order to legally and ethically recognise their duties towards the society
(Stuteville, 2022). WHO plays significant role in reducing health inequalities and foster the
health equity commitments.

Accountability has positive impact on the economy secure the human right of the
individual. It is based on different approaches which includes human right, non discrimination,
transparency and guide the service provider to act in such manner. Accountability cover wide
range of definition and it is required at various levels which includes judicial accountability
through international court, Quasi judicial accountability through enforcement of International
human right body (Montreuil, Martineau and Racine, 2019). However, Caulfield has been
introduced the four pillars of accountability in the year 2001. In which, first pillar of
accountability is considered as professional accountability which is fundamental duty of
professional practitioner to secure the interest of patient. Whereas second pillar of accountability
is dealing with ethical accountability as practitioner are obliged to act in fair and reasonable
manner to cure the disease. The fourth pillar of accountability is employment accountability as
the employees are responsible at workplace for whatever the act they are doing within the
organisation. Therefore, the NMC( Nursing & Midwifery Council) identified the professional
accountability as the integral part of ascertaining the professional knowledge and skill to deal
with variety of circumstances that may arise at professional workplace.
The legislative body has been made to impose the duty on the medical practitioner to
exercise their ethical duty towards their patients to ensure their safety and care according to
Code of Professional Conduct. The health service provider are accountable to enforcement
bodies such as civil and criminal court to meet their legal requirements. However, the employees
are accountable to their employer to follow the assigned duties whereas registered practitioners
are accountable to regulatory bodies such as NHS to comply with terms and standards of practice
and treating patients. Accountability and delegation of power is done to secure the right of the
patient and save their time or money. Accountability has allows each registered professionals to
perform their duties and justify their action to the respective authorities if not, penalise in case of
breach. If there employee does any misconduct then employer is authorised to enforce the
contract law and can make liable for breach of duty.
Accountability covers core areas of health sector and clearly define the roles and
responsibilities to effectively review the working system of health and safety care. It promotes
better communication, enhance the professional skill, ensure safety and security, respect the
dignity and integrity of the patient (Mekonnen, 2018). There are certain legal and ethical
principles that are made to exercise effective decision in relation to clinical skills and

professional practitioners. The first and most crucial principle is autonomy which means every
individual is free to make their own judgements. The another ethical principle is dealing with the
Beneficence, it means care must be ensure to the patient and avoid the risk of any harm. The
third and one of the most ethical responsibility of medical practitioner is Non- Maleficence,
exercise their duties for the betterment of their client. The fourth and last ethical principle is
dealing with justice which means equal ,fair and reasonable care must be ensured to the patient
to prevent them form disease (Peate, 2019). In order to implement these principles , it is
important for the legal practitioner is to serve the best effort for the beneficial of their patient and
minimise the error while exercising their legal and ethical duties. These principles further
includes various aspect such consent and proper communication among the patient and medical
practitioner to understand their problems and diagnose them properly to avoid any kind of harm
to their body or health. The staff members of the NHS has a legal duty to maintain the
confidentiality of information shared by the patient from the medical practitioners. The Legal
Capacity (Scotland) Act of 1991 enables the parents to give their consent on behalf of their child
if they are below 16 years. The NMC Code of 2008 has guided the professional partitioner
through training and various development programme to gain clinical knowledge and medical
practice to make effective treatment of their patients.
2. The record keeping is important for gathering vital information and statistical data to make
effective management of the health care system (Pilcher, 2018). It promotes customised
accounting system to maintain all the records of the patient and medication to demonstrate
various aspect of various areas of health system. It is a backbone of UK health care system as it
helps to ascertain the financial estimation to provide effective medical assistance to the patient.
Accurate accountancy encourage the systematic organisation of work and avoid or money of the
people. It a fundamental aspect that helps in making effective decisions to sustain growth and
development of heath sector. Accounting helps to maintain legal documents which are
admissible in court and important for medical administration. Accountability reduce the chances
of uncertainty and clinical negligence that were continuously rising earlier (Ruane, 2019). The
NMC provides the guidance for accurate records of all the information that are important to
maintain professional accountability in order to preserve the trust and right of the patient.

CONCLUSION
From this above report, it has been concluded that medical professional are bound to
comply with the code of professional conduct to secure the right of the patient. The accounting
help the professionals to govern the activities and answer the authorities that are actually
responsible to regulate the health activities. Accounting is a complex process and covers wide
areas of practice in health sector. The medical professional are comply to follow the legal and
ethical principles to fairly treat their patient. The legislative framework has been made to avoid
risk in health sector and encourage the professionals to maintain the standards while making
treatment of their patient. The health service provider is answerable to their action for oneself
and also towards others. However, the concept of accounting is varied and unique. It ensure
effective mechanism to administer the work and activities performed by the various
professionals.

REFERENCES
Books and Journals
Ballantyne, A., 2019. Adjusting the focus: a public health ethics approach to data
research. Bioethics, 33(3), pp.357-366.
Bowman, D., Huxtable, R., Razai, M. and Gallagher, A., 2021. Towards ethical preparedness:
Regulators’ responses to ethical issues during the COVID-19 pandemic. Nursing
ethics, 28(6), pp.837-839.
Ellis, P. and Ellis, H., 2021. Ethical and legal concepts: responsibility, accountability and
liability. Journal of Kidney Care, 6(5), pp.239-242.
Enombu, J.A. and Adhikari, P., 2022. Clinicians’ informal acquisition of accounting literacy in
UK clinical commissioning groups. Public Money & Management, pp.1-7.
Fortunato, A., Grainger, D.W. and Abou-El-Enein, M., 2018. Enhancing patient-level clinical
data access to promote evidence-based practice and incentivize therapeutic
innovation. Advanced Drug Delivery Reviews, 136, pp.97-104.
Kaur, A. and Lodhia, S.K., 2019. Sustainability accounting, accountability and reporting in the
public sector: An overview and suggestions for future research. Meditari Accountancy
Research.
Mekonnen, D.R., 2018. The Principle of Complementarity and the Challenge of Ensuring
Accountability for Crimes Against Humanity in Eritrea. Available at SSRN 3209946.
Montreuil, M., Martineau, J.T. and Racine, E., 2019. Exploring ethical issues related to patient
engagement in healthcare: Patient, clinician and researcher’s perspectives. Journal of
bioethical inquiry, 16(2), pp.237-248.
Peate, I., 2019. NHS screening programmes. British Journal of Healthcare Assistants, 13(8),
pp.378-381.
Pilcher, R., 2018. Conclusion and globalising accounting, accountability and governance.
In Public Sector Accounting, Accountability and Governance (pp. 143-157). Routledge.
Ruane, S., 2019. Access to data and NHS privatisation: reducing public accountability. In Data
in Society (pp. 171-182). Policy Press.
Smitherman Jr, H.C., Baker, R.S. and Wilson, M.R., 2019. Socially accountable academic health
centers: pursuing a quadripartite mission. Academic Medicine, 94(2), pp.176-181.
Stuteville, R., 2022. Competing Accountability Frameworks and the Role of Interdisciplinary
Practice for Publicly Funded Scientists and Scientists within Government. Soundings:
An Interdisciplinary Journal, 105(1), pp.84-107.
Zimmerman, D.H., 2019. Record-keeping and the intake process in a public welfare agency.
In On record (pp. 289-321). Routledge.
Online
Health Equity in England: The Marmot Review 10 Years On, 2020 [Online] Available
through:<https://www.health.org.uk/publications/reports/the-marmot-review-10-years-on>
NHS