Report on High Risks (Quarter 1)
                                       RISK MATRIX                                                      RIS RISK NAME                                     RISK          CQC         RESIDU       RISK  ACTIONS
                                                                                                         K                                              OWNER OUTCOM AL RISK SCOR
                                                                                                       REF                                                                E                        E
                                                                                                       GOV  Ineffective infection control               Director of        8          High         16     • Policy and guidance to be reviewed in light of new national guidance by (tbc) (Lead: tbc)
        5 - Very                                                                                        11    management                               Nursing and                                        • Establishment of audit arrangements to assess compliance with MRSA screening policy by (tba) (Lead: Head of Nursing Older 
                                                                     OPS    FIN         FIN                                                              Clinical 
          High                                                        05     04         03                                                              Standards                                           Adult Services)
                                                                                                                                                                                                          • Peer review of individual cases looking at the RCAs and recommending actions to reduce number of cases (Lead: Director of 
                                                                                                                                                                                                            Nursing and Clinical Standards)
          High                                                          GOV                                                                                                                               • Monitoring of quarterly trajectory and action plan mechanism with PCT (Lead: Director of Nursing and Clinical Standards)
                                                                         11                                                                                                                               • Communication and collaboration plan with GPs to be developed by (tbc) (lead: tbc)
                                                                     GOV    FIN                                                                                                                           • Out of Hours contract with OUH to be agreed and signed (Lead: Head of contracting) Contracts for microbiology services to be 
                                                                      13     07                                                                                                                             agreed and signed (Lead: Head of Contracting)
        Medium                                                                                         GOV  Ineffective medicines management             Medical           9          High         16     • Review of effectiveness of non-medical prescribing within the organisation [Source Local National Inquiry Action Plan] by Dec 12 
                                                                                                        13                                               Director                                           (Lead: Medical Director/Director of Nursing and Clinical Standards)
                                                                                                                                                                                                          • Introduction of new operating procedures in prisons by (tbc) (Lead: tbc)
           Low                                                                                                                                                                                            • Identify the technical solution that will enable Ascribe to be utilised at HMP Bullingdon and C&SH by end June 12 (Lead: 
                                                                                                                                                                                                            Pharmacy Procurement Manager) [Ref: 11/OHFT/19a Internal Audit, Clinical Pharmacy Support Unit - CHO transition 
                                                                                                                                                                                                            Arrangements]
Pro                                                                                                                                                                                                       • Review the contract, and investigate alternative options through CPSU, and cost the savings possible including any early exit 
        1 - Very                                                                                                                                                                                            costs from the contract by end Dec 12 (Lead: Chief Pharmacist) [Ref: 11/OHFT/19a Internal Audit, Clinical Pharmacy Support Unit 
bab                                                                                                                                                                                                         - CHO transition Arrangements]
ility      Low                                                                                                                                                                                            • All purchases of drugs and supplies should be quoted for by CPSU and external providers, and the cheapest option selected and 
                                                                                                                                                                                                            evidenced by 1st April 12 (Lead: Pharmacy Procurement manager) [Ref: 11/OHFT/19a Internal Audit, Clinical Pharmacy Support 
                                                                                                                                                                                                            Unit – CHO transition Arrangements]
                       1 - Very          Low         Medium            High        5 - Very                                                                                                               • All budgets reviewed monthly by budget holder and finance and remedial action for variances identified and recorded by 1st 
                          Low                                                         High                                                                                                                  April 12 (Lead: Chief Pharmacist) [Ref: 11/OHFT/19a Internal Audit, Clinical Pharmacy Support Unit - CHO transition 
                                                                                                                                                                                                            Arrangements]
                                                                                                                                                                                                          • Medicines Management strategy to be updated by Dec 12 [Source Local National Inquiry Action Plan] (lead: Chief Pharmacist) 
                                                                                                                                                                                                            Review of pharmacy input to clinical areas by Oct 12 [Source Local National Inquiry Action Plan] (Lead: Chief Pharmacist)
                                                                                                                                                                                                          • E-learning package for medicines management to be established by (tbc) (Lead: Chief Pharmacist) Training education and 
                                                                                                                                                                                                            support for prescribers to be reviewed by Dec 12 [Source Local National Inquiry Action Plan] (Lead: Chief Pharmacist).
                                                                                                                                                                                                          • Licence review due 2011 (Lead: OPS Commercial Development Manager)
                                                                                                        OPS  Facilities are not fit for purpose and       Chief            8          High         20     • Issue of capital to transfer with community estate to be raised with FTN (Lead : Chief Executive) Business Case for transfer of 
                                                                                                        05    therefore do not support effective        Operating                                           community services estate including due diligence (Lead: Director of Finance) Engagement of Clinical Commissioning Groups 
                                                    Impact                                                    service delivery                            Officer                                           post PCTs to confirm and protect revenue in Buckinghamshire to support Manor House development (Director of Finance)
                                                                                                                                                                                                          • Clear evidence of checks should be reviewed and documented by the Project Board at every stage and every meeting. [Ref 
                                                                                                                                                                                                            Internal Audit 10/OBMH/21 (Lead: Interim Director of Estates)
                                                                                                                                                                                                          • Governance principles should be adhered to at all times, and regular reviews undertaken to ensure any breaches are identified 
                                                                                                                                                                                                            and escalated to the Board of Directors, or its nominated committee. Furthermore, the recording of minutes for all committees 
                                                                                                                                                                                                            and groups should be standardised and consistent. [Ref Internal Audit 10/OBMH/21] (Lead: Interim Director of Estates)
                                                                                                                                                                                                          • All procurement should be reviewed on the project to ensure it is appropriate and correctly authorised, decisions as to why 
                                                                                                                                                                                                            consultants were selected recorded, and to ensure that competition requirements have not been breached [Ref Internal Audit 
                                                                                                                                                                                                            10/OBMH/21] (Lead: Interim Director of Estates)
                                                                                                                                                                                                          • Calculation for single sex breaches to be revised to meet central guidance (Lead: Director of Nursing) Review of suitability of 
                                                                                                                                                                                                            minimum build standards for fencing by (tbc) (Lead: tbc)
                                                                                                        FIN   Non- delivery of cost improvement         Director of        -          High         25     • Business case for the realignment of Improvement and Innovation programme and Cost Improvement/benefit realisation plan 
                                                                                                        03    plans could cause the trust to fail in     Finance                                            (Lead: Head of Strategy and Programmes)
                                                                                                              the delivery of its financial plan which                                                    • Development and approval of 3 year savings plan to meet savings target as part of Annual Plan to be submitted to Monitor's 
                                                                                                              could lead to additional scrutiny and                                                         deadline for Annual Plan (Lead: Head of Strategy and Programmes)
                                                                                                              intervention by Monitor and a 
                                                                                                              shortfall in cash for the trust’s Capital                                                   • Delivery of 11/12 cost improvements by March 12 (Lead: Director of Finance)
                                                                                                              Programme 
                                                                                                                                                                                                          • Executive Board to consider how improvement and transformation resources could be focused on delivering and aligning 
                                                                                                                                                                                                            benefits to form part of the work on next year's Annual Plan and the delivery of CIPs by End February2012 (Lead: CEO)
                                                                                                        FIN   The payment of salaries, allowances,      Director of        -          High         16     • Review of reimbursement criteria to be completed by end April 2012 (Lead: Payroll Manager) [Ref: Internal Audit report 11/OH/5 
                                                                                                        07    variable pay, expenses, deductions is      Human                                              Payroll] Review of sanctions to be enforced against non compliance with Trust payment guidelines (Lead: Payroll Manager) [Ref: 
                                                                                                              not properly managed leading to           Resources                                           Internal Audit report 11/OH/5 Payroll] A resourced plan for full roll out of e-expenses using Trust's project plan methodology to be 
                                                                                                              salary or expenses under/over                                                                 agreed by Sept 2012 (Lead: Payroll Manager) [Ref:Internal Audit report 11/OH/19C
                                                                                                              payments and resulting in pecuniary                                                         • E-expenses - On-going Technological solution required for all HR forms to be scoped and agreed following standardisation of 
                                                                                                              loss and/or staff dissatisfaction                                                             forms (Lead: ESR Programme Manager)
                                                                                                                                                                                                          • Contract for long term solution for payroll to be executed prior to the commencement of the contract (Lead: Payroll Manager) 
                                                                                                                                                                                                            {Ref: Internal Audit reports 11/OH/5 Payroll: 11/OH/10B Payroll provider]
                                                                                                                                                                                                          • Business Case for long term payroll solution to be approved (Lead: ESR Programme Manager) Sept 11
                                                                                                                                                                                                          • Legal advise to be sought to ensure that appointment of interim provider does not go against legal requirements relating to 
                                                                                                                                                                                                            procurement (Director of HR)
                                                                                                                                                                                                          • Appointment of Interim Provider for maximum of 12 months to allow completion of formal tender process (Director of HR) (In 
                                            Author                                                                                                                                                          Place)
                                                                                                                                                                                                          • Payroll long term solution to be in place by Jan 13 (Director of HR)
                                                                                                        FIN   Stated government intent in the           Director of        -          High         20     • Delivery of cost improvement plan by March 2012 (Lead: Director of Finance) Business planning templates to be completed by 
                                                                                                        04    Health and Social Care Bill 2011 to        Finance                                            15th March 2012 (Lead: Divisional/Corporate Directors)
                                                                                                              increase competition in the provision                                                       • Consolidation of business plans into the Annual Plan for presentation to the May Members Council and Board of Directors for 
           Usmaan Rahman, Strategy & Business Planning                                                        of healthcare services could lead to                                                          submission to Monitor by end of May 12 (Lead: Head of Strategy and Programmes)
                                                                                                              loss of existing core business and 
                                            Manager                                                           therefore a loss of contribution to                                                         • Information review and Data warehouse consolidation complete June 12 (tbc) (Lead: Interim Head of Information and Business 
                                                                                                              overhead and fixed costs and loss of                                                          Intelligence)
                                                                                                              margin; new business opportunities 
       Lead Executive Director: Mike McEnaney, Director of                                                    not realised (won) that compliment 
                                                                                                              our core business and add 
                                            Finance                                                           contribution; erosion of competitive 
                                                                                                              edge preventing the trust substituting 
                                                                                                              additional contribution and margin for 
                                                                                                              CIPs;  working without a national tariff 
                                                                                                              and under block contract 
                                                                                                              arrangements the Trust is forced to 
                                                                                                              compete on price in addition to 
                                                                                                              quality and to ensure core business is 
                                                                                                              retained has to reduce price and 
                                                                                                              therefore contribution/margin