Annual Report and Accounts - The Great Western Hospital

• the key controls to mitigate against those risks,
• the assurances on those controls, and
• any gaps in assurances.
An internal audit undertaken in January 2012 granted the Trust substantial (green) assurance on the
design and implementation of the board assurance framework.
14.4.5 Significant Risks
There are a number of risks identified in the board assurance framework and risk register. Examples
of significant risks identified during 2011/12, together with the actions that have been taken to
mitigate them as summarised as follows: -
Risk
Directorate's
forecasts deteriorate
resulting in a deficit.
Activity above
proposed contract
levels
Potential for quality
of care to be
compromised during
transition phase of
transfer of WCHS
Failure to achieve
compliance with new
NHSLA Level 2
Acute Standards
How risk was mitigated
• Project management board to monitor delivery of savings;
• Monthly monitoring of actions by the Executive Committee;
• Monthly reporting to the Finance and Investment Committee;
• Risk framework agreed with Commissioners;
• Appropriate contract values agreed with Commissioners.
• A project transition team created;
• Governance arrangements strengthened;
• A Transition Director of Community Services appointed.
• Agreement with Wiltshire PCT to fund any deficit associated with reductions in
NHSLA Levels for 1 year
• Agreement with NHSLA for an extension to the normal assessment cycle.
No significant gaps in controls or assurances were identified during 2011/12. Where minor gaps in
control were identified, these were acted upon within prescribed timescales.
New risks for 2012/13 will be identified through the annual plan process and will be added to the
Assurance Framework. Major future risks, including significant clinical risks for 2012/13 have been
identified and include the following: -
TABLE - Future risks
Risk
Establishment of
Clinical
Commissioning
Groups with different
approaches within
Swindon and
Wiltshire with risk of
differential pathways
Actions to manage and mitigate, including how outcomes will be
assessed
• Stakeholder engagement
• Trust working with Wiltshire Council to develop partnership
• Attendance at Community Change Programme Group (QIPP) in Swindon chaired
by GP commissioning lead
• Attendance at QIPP Board in Wiltshire, which clinical input
• Partnership working with NHS Swindon and NHS Wiltshire to develop joint
contract performance arrangements with input from Trust Clinicians and GPs
• Monthly GP forum being used to as a vehicle to discuss future plans
• Stakeholder engagement/consultation of the Trust 5 year Strategy enabling
alignment of Trust plans with Commissioning intentions.
Page 165 of 211