A model approach advocated

This paper gives a brief overview of a four-stage risk model, specifically researched and designed by me in partnership with Loughborough University’s Centre for Hazard & Risk Management, for use within the NHS to identify, prioritise and manage risks within a managerial system. Since the model’s original development in 2001, it has been successfully used in a number of Trusts, as it overcomes the major problems associated with the NHS “5 x 5 criticality grid”. The aforementioned grid produces unreliable risk scores, due to the problems associated with managers attempting to predict the percentage probability that an incident would occur from a less than perfect management system. The model overcomes this problem by employing a series of “utility functions”. These provide a fully auditable, robust and repeatable trail for the assessment and scoring of risk. This resulting score is then transferred into the standard NHS 5x 5 grid for direct inclusion into a Trust’s risk register. As part of their mandatory governance responsibilities, boards of NHS organisations need to conduct a review of the effectiveness of their managerial systems of internal control. Compliance with NHS Litigation Authority standards, together with other processes and systems, gives assurance to all stakeholders that a Trust’s managerial systems are meeting the national codes of practice as a minimum. The system of internal control should be based on an ongoing risk management process, and monitoring system, via a multiprofessional team. Estatecode1 clearly states that failure to follow such an approach could lead to corporate and/or personal liability. From the aforementioned it is clear that there is a need for managers to begin to identify, in a transparent, auditable manner, the risks that are being generated within their spheres of activity, and to advise their Trust’s senior managers and others of the identity and scale of their findings. They should also formulate detailed risk treatment plans giving options, manpower and cost implications, and timeframes, for the control and/or reduction of the risks. National codes of practice provide a framework for Trusts to assess their managerial systems against, and to identify those areas of weakness that could produce unacceptable levels of risk to the organisation, staff and patients. However, they can only provide a very high level of assessment. For a greater degree of appraisal a more in-depth and meaningful analysis must be undertaken.

Risk model methodology

This model is designed to assist managers to compare their existing managerial actions against those recommended within national codes of practice. The model is split into four stages, which promote a disciplined approach. Listed below, and each briefly discussed, these are: