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Organisational turnaround from special measures

How we embedded a risk management culture to improve governance practices for a Clinical Commissioning Group in special measures.

The challenge

A Clinical Commissioning Group (CCG) was put into special measures by NHS England and we were called in to complete a governance review in collaboration with the Good Governance Institute.

Our focus was on the way risk management was being handled by the CCG and the poor ‘risk culture’ that was contributing to inefficient risk management. We were tasked with conducting a review of risk systems and processes and developing a detailed action plan that would help the CCG implement best practice in risk management and improve the organisational risk culture.

Our approach

The project involved:

Reviewing documents and policies including risk management frameworks and guidance, meeting minutes, agendas and cover sheets, training modules and risk registers. This review allowed our team to determine the effectiveness of the policies and procedures, the quality of risks and the effectiveness of the risk management process.

Conducting one to one interviews with risk leads throughout the organisation, as well as the governance team. These interviews allowed our team to get an idea of how risk management was perceived by those most involved in the process.

Observing meetings where risk was an agenda item. These observations allowed our team to gain further insight into the way risk was discussed and around the general attitude towards risk management in more formal settings.  

Throughout the review, we provided continuous feedback and supported the CCG beginning to implement more effective processes.

After the review was completed, we delivered a detailed summary with our findings, recommendations and a proposed action plan for areas requiring development.

The outcome

  • Following the delivery of the findings, SCW worked with the CCG to implement a number of the recommended actions, including the implementation of a ‘risk champion’ programme, to embed risk management within the CCG. 

  • As part of this programme, members of staff from each directorate were nominated to promote risk management and provide support within their directorates. These people were given specialised training and support, including a bespoke risk champions workshop delivered by SCW. 

  • Follow up with the CCG has indicated that they have now implemented many of the recommendations and proposed actions and that the overall risk culture has improved significantly.

Janet Young, Governance & Risk Manager, Bedfordshire Clinical Commissioning Group told us:

'Our work with SCW aimed to review and benchmark our risk management arrangements and identify areas for change. As a result of SCW’s expertise and guidance, we have a much deeper understanding of how our risk management processes should be consistently applied, the expected behaviours from those in leadership roles and the skills and expertise required to implement good risk management practice.'

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