A lack of clarity in role definition can pose a risk to the care of patients in the peri-operative phase. Health care teams are often made up of multi-skilled-nursing-care-providers that are not statutorily registered professionals. This may undermine who is actually responsible and accountable in practice. This delegation dilemma is due to certain market forces, like changes and reforms in health service provision, shortages of doctors and nurses, and ever rising costs. Change and development in practitioners' scope of practice has been encouraged with training to enable practitioners to take on certain specific aspects of health care provision that were traditionally part of a doctor and, or a nurse's role. These changes should be monitored and considered by risk managers or those responsible for clinical governance, as they raise important legal and professional issues. In short, there is confusion over accountability driven by issues of role expansion. The respective professional bodies, both medical and nursing and the Department of Health need to come together and find a consensus of opinion in resolving the confusion over accountability and role delineation.