A business critical briefing from HSJ’s Risk Management conference

Key themes

  • The effect of the current economic climate on good governance and risk management in the NHS
  • The importance of effective working relationships
  • Learning from NHS Litigation Authority level 3
  • The importance of the global trigger tool approach

Action points

  • Take a proactive approach to risk management to reduce claims.
  • Encourage all staff to consult the NHS Litigation Authority’s recent guidance.
  • Offer patients an apology when something goes wrong.
  • Give risk a high profile at board level by conducting executive patient safety walk rounds, sending patients’ stories to the board regularly, and ensuring adverse incidents and the learning from them are owned by directors.
  • Encourage effective partnerships between frontline staff, patients, governors and board members, as well as with external organisations.
  • Embed business continuity planning.

Key questions and answers

Q Is the commitment to risk management sustainable in the current climate?

  • There are misconceptions about patient safety. Doing the safe thing is cheaper. There is significant evidence that patient safety saves money. Good leadership should drive the safety culture, which will be reflected on energy costs scenarios. This requires sustained focus.

Q Are we too reactive to risks in the NHS?

  • Despite the concerns displayed by the media and the public that there are too many managers in the NHS, management costs represent 4 per cent of the budget. This makes it difficult for the NHS to be proactive, but this culture is changing.

Q What tips can you give us for explaining to the board that incident reporting is not necessarily the best system?

  • Show them that questions about safety cannot be wholly answered by talking about an incident. Show them the alternative with the global trigger tool approach. If staff see something happen after they report an incident, they will be more likely to act on this and be engaged. If the organisation does not react to reporting, the number of incidents will decrease because reporting will slow down.

Q What is the role of a governor in a foundation trust?

  • Governors are there to challenge the board on all aspects of governance and risk management, e.g. to challenge the score of an item on the risk register.

Q How can patients contribute to safety?

  • Empower patients to ask questions. An effective way of getting patients involved is to ask them to look at handwriting when a prescription is given to them. This has reduced medication errors by 20 per cent in South Manchester Foundation Trust. In healthcare, the common denominator is the patient. Patient feedback and patient choice are equally important in allowing patients to contribute to safety.

Sarada Chunduri-Shoesmith is integrated governance facilitator in NHS Camden’s public health department. 

Risk Management