Risk and governance processes review and recommendations

We provided specialist support to an acute trust to accelerate improvement by developing a risk management program to reduce risks, assuring quality by making recommendations, and developing a risk dashboard for executive oversight.

Background​

MLCSU were approached by a North-West Integrated Care Board (ICB) to provide specialist support to an acute trust. The trust had received a ‘Requires Improvement’ notice following a Care Quality Commission (CQC) visit earlier in the year. An improvement plan had been formulated, and the trust required the capacity and capability to accelerate progress in several key areas of improvement. ​

Requirement: To review the risk management process to support the Board Assurance Framework (BAF) ward to board corporate risk register and to provide support with implementing governance systems and processes to aid improvement.​

Action​

An MLCSU workstream lead with specialist expertise undertook a preliminary diagnostic exercise capturing key concerns and identifying improvement recommendations.​​​

An initial 6-week immediate action delivery plan was devised to:​​

– Develop and deliver risk management training to the trust’s corporate risk and governance team, triumvirates and corporate divisions. ​​

– To review divisional risk registers.​

– To work with key trust members to data cleanse the Datix Risk module.​

– Ensure all documentation and guidance is up-to-date and would support a workable process for staff.​

Impact​

Developed a comprehensive Risk Training programme to support the improvement of Trust reporting and management of risk​​

Reduced the number of open risks on the corporate risk register through data cleansing, risk review and identifying actions to mitigate or close risks.​​

Reduced departmental level of risk through review of risk registers and provision of support to identify mitigation actions. ​​

Assurance of quality of the Board Assurance Framework through review against best practice.​​

Made recommendations on improving risk management processes and supporting risk management in Datix. ​​

​Developed a risk dashboard for divisions enabling the flow of information to the executive level to provide clear executive direction and oversight.