Risk management systems in healthcare

Healthcare is recognised as a complex high risk industry that demands effective management of the risks presented. A total of 260 NHS Trusts were surveyed to identify the risk management arrangements in place. The results were analysed alongside three different sources of nationally published data (CQC, Monitor and NHSLA) to determine if certain organisational or system characteristics existed that would either predetermine risk performance or predispose the Trust to a higher or lower level of performance. The results successfully dispelled a number of preconceptions relating to the size and status of the Trust in determining the performance achieved. However what was evident was the influence that the Trust’s culture and commitment to risk has on the safety and quality of services delivered. A second finding was the significant influence of central policy in the arrangements that organisations had in place from the presentation and content of risk strategy documents, criteria considered and executive leadership. The constraints of a national policy applied locally potentially limits the effectiveness of the processes in managing risk. It was concluded that whilst central policy may help in standardising how risk is managed current arrangements focus arrangements to narrowly. As a result the role of central policy makers should be to set principles that draw on and translate best practice from other high risk industries and encourage local health leaders to flex the approach to reflect local needs and priorities. This local flex should aim to integrate with other corporate programmes to ensure that risk is embedded in all decision making and the risk of the safety and quality of patients is considered alongside risks that may be perceived to be a higher priority such as operational targets and financial balance.