Report highlights ‘extreme’ risks within the health system

IN its most recent corporate risk register, the Western Health Trust reported that seven aspects of the local health care system either face or represent an ‘extreme’ risk.

According to the public document, presented at the latest meeting of the Trust’s board, local patient outcomes are currently being compromised by serious challenges to emergency departments, endoscopy services, children and young people’s mental health services, and the transfer of babies, children and adults between hospitals.

Other, less patient-oriented risks were also classified as ‘extreme’, including fire risks, the potential impact of a cyber security incident, and the toll on services as a result of industrial action in relation to pay, safe staffing and travel rates.

A corporate risk register is a list kept by an organisation to identify, assess and lay out measures to mitigate current problems and potential threats.

According to the Northern Ireland Health and Social Care Trust, ‘top risks’ – such as the seven currently red-flagged by the Western Trust – represent the most immediate safety, financial, service and reputational dangers to a trust.

However, when asked how concerned senior management was by this, a Western Trust spokesperson suggested the public, rather than being alarmed, should be reassured that by identifying and ranking risks, local medical and administrative staff are more able to understand and address challenges.

“Western Health and Social Care Trust maintains a Corporate Risk Register and Assurance Framework (CRR&AF) to manage and monitor the most significant risks that could impact the objectives of the organisation. Each risk is scored based on its likelihood and consequence, and controls are put in place to manage these risks,” they said.

“This process helps in prioritising risks and ensuring that necessary actions are taken to reduce their potential impact and likelihood.”

They then explained the factors that are taken into account when deciding which grade of risk to apply to a particular scenario.

“When a risk is labelled as ‘extreme’, it does not necessarily mean that the risk will be realised. Instead, it indicates that the risk has a high potential consequence and likelihood if it were to occur.

“The purpose of identifying such risks is to ensure they are closely monitored and managed with appropriate mitigation strategies.

“By following this structured approach to risk management, the Western Trust can reassure the public that we are actively working to prevent these risks from materialising and are prepared to respond appropriately if they do.”

Returning to the contents of the register, in its summation of the issues plaguing emergency departments, a Western Trust official wrote, “If emergency department physical capacity and staffing levels are not sufficient to meet the demands of patient numbers and acuity, there will be increased likelihood of significant patient harm, risk to staff wellbeing and damage to trust reputation as a direct result.”

As a result of a the lack of endoscopy capacity, the register acknowledges that two-week red flag waits have been being breached – which is the most urgent cancer referral a suspected cancer patient can receive.

“The lack of timeliness for endoscopy will lead to delayed diagnosis of cancer and poor outcome for these patients,” reads the author’s assessment.