Evaluation of risk management practices: data analysis of NHS England hospitals

Abstract

Risk management practices are applied in the National Health Service (NHS) England hospitals to reduce harm rates and to ensure safety. This study evaluates current risk management practices in the NHS England hospitals through highlighting non-compliance issues within the practice and through explaining board level risk priorities. All data were collected for selected (N=34) NHS England hospitals. Data were gathered from the NHS Litigation Authority (NHSLA) reports to reveal risk management problems and from Board Assurance Frameworks (BAF) to define top risks. Results from an external authority of the NHSLA show that local induction of staff is a major non-compliance issue for risk management practice with more than half of the hospitals having difficulties. Following that supervision of medical staff in training is the second highly observed deficiency. Results from hospitals’ board level demonstrate that top risks in hospitals were regarding quality and performance issues. Additionally, most of the board level defined top risks were categorized as organizational and clinical-related risks. Within these, workforce issues and non-compliance with requirements are highlighted as top risks for organizational-related risks while Accident and Emergency (A&E) targets and treatment delays are prioritized as part of clinical-related risks. Financial deficit is also frequently defined at board level as a top risk for financial-related risks. Both the NHSLA and hospital board level assessments show that workforce related issues are still a major concern in hospital risk management practices. It is therefore a slight influence of an external authority (NHSLA) has been recognized on prioritization of board level defined risks.