Managing and Assessing Risk

1. Managing and Assessing Risk In Health and Social Care

2. Activity 1 • Spend a few minutes developing a definition of risk taking. Focus on a very general definition which could be applied in any setting • Then spend few minutes attempting to define risk management

3. Definitions of risk • ‘The possibility that a given course of action will not achieve the desired outcome but instead some undesirable situation will develop’ Aleszewski and Manthorpe (1991) • Risk is closely linked to dangerousness, resulting in harm Parsloe (1999)

4. Definition continued • A clinical error to be at variance from intended treatment, care, therapeutic intervention or diagnostic result; there may be an untoward outcome or not’ • Wilson and Tingle (1999) • The level of uncertainty associated with a particular activity, location, service or individual where harmful consequences might occur.. * Saunders 1999

5. Types of Risk • Environmental • People • Financial • Reputation

6. Components of Risk taking

7. Risk management • The identification and analysis of risk combined with explicit plans to control or manage this risk. This includes action or measures to prevent or decrease the likelihood of harmful or negative consequences. • Saunders 1999

8. Origins of Risk management • Pressures for efficiency • Increased expectation of service users and families • Readiness by services users and families to seek legal redress • Increase in litigious payment • Growth of patient organisations • Mimicking US culture

9. Origins of risk management (policy) • Working for Patients (1989) • The New NHS: Modern, Dependable (1997) • Changes in legal profession funding • Health and Safety legislation • Community Care Charters • A First Class Service (1998)

10. Activity 2 • Think about your own service and discuss where there are service users engaged in activities which might be considered a risk. Think about the positive things the service user gains from the activity and also think about some negative.

11. Responsibilities as manager • Know the risks involved in your area of work • Know the procedures that staff are expected to follow • Ensure that safety equipment is available • Take action on faults or potential hazards • Ensure that there are comprehensive risk assessment procedures

12. Risk Management Strategy • Complaints procedure • Training and development plans • Disciplinary procedures • User and advocacy groups • Grievance policy • Quality assurance groups • Incident reporting systems

13. Key Questions • What is the nature of the risk being assessed? • Who is saying it is a risk? • Who is it a risk for? • Whose responsibility is it to manage the risk? • What legal, practice or moral framework will inform decision making?

14. References • Martin, V. And Henderson, E. (2001) Managing in Health and Social Care. Routledge. London • Kemshall, H and Pritchard, J (1996) Good Practice in Risk Assessment and Risk Management. Kingsley Publishing. London • Sale, D. (2005) Understanding Clinical Governance and Quality Assurance. Palgrave. London • Saunders, M. (1999) Managing Risk in Services for People with Learning Disabilities. APLD. Nottingham