accountability for clinical risk management rests with the Managing Director of Provider Services and the Director of Clinical Performance / Executive Nurse. 2. Organisational risks – Covered by the annual report on risk management and recorded in the Assurance Framework, and Corporate Objectives report. Executive accountability for organisational risks rests ultimately with the Chief Executive. 3. Financial risks - Covered by the annual report on risk management and recorded in the Assurance Framework and Corporate Objectives report. Financial Risks are also reported in Finance Reports to the Board. Executive accountability for financial risk management rests with the Director of Finance and Assurance. 4. Strategic risks (risks which will impact on the achievement of corporate objectives) – Covered by the annual report on risk management and the statement of internal control. These risks are also recorded in the Assurance Framework. Risk assessment forms part of all strategic policy decisions. Risks in all these areas are recorded in directorate risk registers and feed into the corporate risk register. Using the reports detailed above, and regular performance update reports, these risk areas are monitored regularly by: o o o o
The Board The Audit Committee The Risk Management Committee The Quality Board
Risk management awareness and the purpose of assessment and monitoring of risk are embedded in the activity of the organisation at all levels through: o
o
o o
Including risk and residual risk rating in business cases, Board reports/papers relating to all development proposals and all performance reports, corporate and team objectives. The development of Directorate risk registers in all services and sites informed by risk assessments carried out by staff trained and competent to assess both physical and geographical risks posed by location and client group. The development of action plans to address risks identified and monitoring mechanisms to ensure key controls are effective. In line with virtually every PCT commissioner during 2009/10, NHS Medway faced significant financial pressure from an over performing acute provider. Activity anomalies where observed in year through routine performance monitoring. These were escalated to the Board to manage.
Payments for these acute services are based on performance figures and over performance presented a significant financial risk to the organisation. The Board tackled the risk through negotiation and the implementation of a 80