OPEN BOARD OF DIRECTORS’                              Open BoD: 31.10.12
                                                                                   Item: 10
                                   31 October 2012

TITLE OF PAPER        Board Risk Profile

TO BE PRESENTED BY    Mick Rodgers, Deputy Chief Executive / Executive Director of Finance, obo
                      Liz Lightbown, Executive Director of Nursing and Integrated Governance

ACTION REQUIRED       Discussion and Approval by the Board

                      To ensure the Board is fully informed of the high level risks that are prevalent
                      within the Trust

                      The risk profile will be presented to the Board on a monthly basis

                      1.1   In-patient care standards
BAF OBJECTIVE No      2.1   Vulnerability to changing commissioning strategies
and TITLE             2.3   QIPP programmes
                      6.3   Reduction in income from SDS

                      Internal Audit Report (December 2010) highlighting concerns in relation to the
                      monitoring of organisational risks and governing internal control
                      Monitor’s recommendations following their review of the Trust’s Annual Plan
                      stage two review 2011

                      BAF links to strategic objectives, corporate (organisational) risk register,
                      directorate risk registers Monitor’s regulatory frameworks

                      Implications of individual risks outlined on risk profile

                      Compliance with Monitor’s Quality Governance Framework.

Author of Report      Tania Baxter
Designation           Head of Integrated Governance
Date of Report        23 October 2012

                                             Page 1 of 5
                                         SUMMARY REPORT

Report to:          Open Board of Directors’

Date:               31 October 2012

Subject:            Board Risk Profile

From:               Mick Rodgers, Deputy Chief Executive / Executive Director of Finance, obo
                    Liz Lightbown, Executive Director of Nursing and Integrated Governance

Prepared by: Tania Baxter, Head of Integrated Governance

1.       Purpose

The attached report is the Board Risk Profile produced using the high level risks currently recorded
on the Trust’s Corporate Risk Register. This report is provided to enable greater awareness and
understanding at Board level of the major risks facing the organisation and for the Board to
challenge the effectiveness of the controls in place to mitigate these risks.

2.       Summary

The corporate risk register records the risks that underlie the strategic, overarching risks that are
captured on the Board Assurance Framework (BAF); the operational risks that the Trust faces on a
day-to-day basis. Risks that cannot be controlled within a single directorate, or that affect more
than one directorate, are recorded on the corporate risk register.

The Board risk profile contains all ‘amber’ and ‘red’ rated risks that are recorded on the corporate
risk register, after controls have been put in place to manage them.

The risks on the risk profile have been scored using the risk rating matrix below.

     Consequence              Rare         Unlikely               Possible    Likely       Almost
                               (1)           (2)                    (3)        (4)         certain

     Negligible      (1)        1              2                     3          4             5
     Minor           (2)        2              4                     6          8             10
     Moderate        (3)        3              6                     9         12             15
     Major           (4)        4              8                    12         16             20
     Catastrophic    (5)        5             10                    15         20             25

There are currently five risks on the corporate risk register that are scored ‘amber’ or ‘red’. These are
detailed on pages 4 and 5.

There have been no changes to the risk scores recorded on the Board Risk Profile since it was last
provided to the Board of Directors. However, the controls and actions against risk 2161 have been

                                                   Page 2 of 5
3.       Next Steps

    The Risk Register Co-ordinator will continue to maintain the corporate risk register on the Trust’s
    The corporate risk register will continue to be presented to the Audit and Assurance Committee
     on a quarterly basis, with the last update reported in October 2012;
    ‘Red’ and ‘amber’ risks from the corporate risk register will be presented to the Board monthly,
     via the risk profile;
    The Executive Directors’ Group (EDG) will review the risk profile prior to Board meetings.

4.       Required Actions

The Board of Directors’ is asked to:

         discuss and approve the Board risk profile;
         agree to continue to receive monthly risk profiles.

5.   Monitoring Arrangements

The corporate risk register will be maintained by the Trust’s Risk Register Co-ordinator. The Board of
Directors’ will receive and monitor high level risks on a monthly basis. EDG and the Audit and
Assurance Committee will receive and review the corporate risk register on a quarterly basis.

6.   Contact Details

For further information, please contact:

         Tania Baxter, Head of Integrated Governance
         226 3279

                                                 Page 3 of 5
                                                                        Board Risk Profile October 2012
Risk     Lead Director            Summary of Risk            Previous    Current   L C   Comparison                Controls in Place                   Management Action            Date
No./                                                          Score       Score            to Last
BAF                                                                                        Report
2116   Director of Finance   Loss of income due to self                                                 SDS Project Group established and           Work ongoing with              Oct 12
BAF:                         directed support (SDS) and                                                 monitoring SDS expenditure.                 commissioners to
6.2    Executive Director    the potential for service                                                  Board Development sessions held to          commission a ‘Core Model’
6.3    of Operational        users to choose care outside                                               consider implications on Trust in short     which could reduce
       Delivery              of SHSC                                                                    to medium term.                             redundancy risks.
                                                                                                        New business being developed through        Management efficiencies        Oct 12
                                                               15          15      3 5                 service responding to demand for            being reviewed to reduce
                                                                                                        provision of support for people in crisis   costs.
                                                                                                        and preventing unwanted out of city         Support planning being         Nov 12
                                                                                                        placements.                                 considered as further
                                                                                                        Spot contracted business being              development opportunity.
                                                                                                        established through using additional
                                                                                                        staff on temporary contracts.
2118   Director of Finance   Inability to deliver required                                              Financial plans for reconfiguration over    Currently reviewing all CIP    Sept-
                             financial savings in 2012/13                                               next 2 years being developed.               plans and working on           Oct 12
BAF:   Executive Director                                                                               CMHT reconfiguration plans being            alternatives for
2.2    of Operational                                                                                   implemented from September 2012.            consideration. Mitigation
2.3    Delivery                                                                                         Board development sessions taken            plan identified up to around
2.4                                                                                                     place regarding future financial rating.    £2.3m with potential to
                                                                                                        Joint QIPP plan agreed with                 reduce FRR to 3 by reducing
                                                                                                        Commissioners.                              planned surplus by £700k,
                                                                                                        Accountability framework in operation.      this would have mitigated
                                                                                                        All Directorates have been asked to         potential shortfall.
                                                                                                        present their detailed CIP plans.            However, need a further
                                                                                                        CIPs for 2012/13 being managed by           £1m -£1.5m due to
                                                                                                        Directors and monitored by Executive        increasing cost overruns.
                                                               16          16      4 4                 Director of Operational Delivery.           These are being reviewed
                                                                                                        Financial reports monitored monthly to      as part of CIP work.
                                                                                                        ensure savings are being realised.          Staffing skill mix to be       Oct 12
                                                                                                                                                    analysed in order to
                                                                                                                                                    increase productivity.
                                                                                                                                                    Reviewing productivity
                                                                                                                                                    MARs being utilised to         Up to
                                                                                                                                                    enable CIPs to be made         Mar 13
                                                                                                                                                    recurrent in 2013/2014.
                                                                                                                                                    Service reconfigurations to    Dec 12
                                                                                                                                                    be monitored on regular
                                                                                                                                                    basis and presented to

                                                                                          Page 4 of 5
Risk     Lead Director           Summary of Risk             Previous   Current   L C   Comparison               Controls in Place                  Management Action              Date
No./                                                          Score      Score            to Last
BAF                                                                                       Report
2120   Executive Director   Potential detriment to quality                                             CMHT reconfiguration plans being          Reconfiguration and              May 12
       of Operational       of patient care as a result of                                             implemented from June 2012.               commissioning plans shared
BAF:   Delivery             changing commissioning                                                     Plans have been impact assessed           and discussed with Clinical
2.2                         strategies and potential                                                   during development.                       Commissioning Group.
2.3                         reduction in workforce.            12         12      3 4                 Contract negotiations and monitoring in
2.4                                                                                                    place with commissioners.
                                                                                                       Regular monitoring of quality metrics.
                                                                                                       Joint QIPP agreed with commissioners.

2121   Executive Director   Reduction in the quality of                                                Acute reconfiguration plans being         Board considered acute           Mar 12
       of Operational       services, due to inadequate                                                developed.                                reconfiguration plans.
BAF:   Delivery             clinical environment and                                                   Client satisfaction surveys being         Reconfiguration and              May 12
2.2                         inadequate assurance                                                       undertaken.                               commissioning plans shared
2.3                         mechanisms.                                                                Quarterly performance meetings with       and discussed with Clinical
2.4                                                                                                    NHS Sheffield.                            Commissioning Group.
                                                                                                       Monthly performance meetings with         Locked Rehab ward being          Mar 13
                                                               12         12      3 4                 Sheffield City Council.                   upgraded in 2012/13.
                                                                                                       Annual PEAT assessment in 5
                                                                                                       New PICU and Intensive Support
                                                                                                       Service (ISS) for Learning Disability
                                                                                                       Service being built.
                                                                                                       Service User Experience Monitoring
                                                                                                       Unit being established
2161   Executive Director   Risk of financial loss due to                                              Project Board established which           Project Manager to ensure        Nov 12
       of Operational       future contracts being                                                     monitors the implementation of Mental     that all service users not yet
BAF:   Delivery             procured on the basis of                                                   Health Clustering.                        clustered are allocated
3.4                         Mental Health Clustering.                                                  Contracts to be run in shadow-form in
       Executive Director                                                                              2012/13, followed by a transitional       Contracts Manager and            Mar 13
       of Nursing and                                                                                  period in 2013/14.                        NHS Sheffield to develop
       Integrated                                                                                      Memorandum of Understanding in place      Service Specifications to
       Governance                                                                                      between SHSC and commissioners.           form basis of contracting
                                                               12         12      4 3                 Robust clinical activity recording to
                                                                                                       inform costings.                          Project Finance Lead to          Dec 12
                                                                                                       Contract Management Group monitors        calculate cluster costs
                                                                                                       contact activity.
                                                                                                       All relevant service users allocated to   Project Manager to               Nov 12
                                                                                                       the correct cluster.                      undertake quality checks of
                                                                                                       Protocol for cluster allocation agreed.   cluster allocation, following
                                                                                                       Training in place for clinicians.         agreement with NHS

Key:   L = Likelihood of risk occurring
       C = Consequence of risk

                                                                                         Page 5 of 5

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