Trust Board Febuary 2010 - Sandwell & West Birmingham Hospitals

Risk Register
APPENDIX 7 Version 1 new format November 2009
Sandwell and West Birmingham NHS Trust Clinical Risks for Medium Term Options
J Dunn redesign Director,G GAdd-service
redesign Manager,E Newell Head of Midwifery, P
Bosio Lead Clinician, S Murray Divisional
Manager
SWBTB (2/10) 045 (c)
Risk Area Risk Assessment Risk Owner
Risk Management
Risk Commentary
Post Mitigation Risk Assessment
OPTION Category Description Impact Likelihood Overall Risk Level Organisation Officer Advisor Indicators for Crystallisation Action to Mitigate
Date for
Review Notes Impact Likelihood Overall Risk Level
1g
Lack of appropriate public transport
infrastructure for women living close to
2 3 6 medium Delay in women receiving timely intervention
and cincreased clinical risks asscociated with
Careful planning with local transport networks to
ensure that appropriate transport links in place.
2 3 6 medium
this situation
Positive promotion of service reconfiguration to
Sandwell- delay in accessing antenatal
ensure women are aware of benefits of service.
services
Clear information provided to women (all
languages) regarding planned changes.
2a
OPTION 2= SAME AS FOR OPTION 1
BUT SOME CONSULTANT LED CLINICS
AT SANDWELL
Increased DNAs for hospital appointments
resulting in lack of appropriate antenatal
assessment
2 2 4 low Poor continuity of care. Lack of appropriate
assessent and booking for delivery.
Careful planning with local transport networks to
ensure that appropriate transport links in place.
Positive promotion of service reconfiguration to
ensure women are aware of benefits of service.
Clear information provided to women (all
languages) regarding services available.
Promotion of community based midwifery
services
2 1 2 low
2b
2c
Sandwell women may perceive there is a lack
of choice and delay accessing appropriate
ante natal assesment
Women may arrive at Sandwell in labour and
2 2 4 low Poor continuity of care. Lack of appropriate
assessent and booking for delivery.
2 4 8 medium Women receive delayed or substandard care As above. Ensure A & E dept included in
consultation plans
need urgent transfer to City
2d Increased numbers of birth before arrival 3 3 9 medium Babies delivered in an inappropriate
environment with lack of appropriate suppo
2e
Loss of staff who do not wish to transfer to
City
3 3 9 medium Midwife to birth ratio is reduced. Difficulty in
providing continuity of care. Need to recruit
midwives
2f Inappropriate home births 3 2 6 medium Women refuse to be booked for City Hospital
delivery
as above 2 2 4 low
As above. Ensure local ambulance Trust
engaged in consultation. Ensure robust BBA
policy
Ensure staff fully engaged in consultation
process. Regular staff updates re planning of
any service changes. Introduce rotation
programme so that staff are familiarised with
environment. Maintain transport service
between sites for staff redeployed. Set up early
discussions with HR and staff side
representatives. Establish proactive recruitment
strategy
Consult with users extensively and prepare
patient information which promotes maternity
services at City site. Engage community
midwives in planning in order that they are able
to effectively inform women.
2 2 4 low
2 1 3 low
3 2 6 medium
3 1 3 low
2g
Lack of appropriate public transport
infrastructure for women living close to
Sandwell- delay in accessing antenatal
service
2 2 4 low Delay in women receiving timely intervention
and cincreased clinical risks asscociated with
this situation
Careful planning with local transport networks to
ensure that appropriate transport links in place.
Positive promotion of service reconfiguration to
ensure women are aware of benefits of service.
Clear information provided to women (all
languages) regarding planned changes.
2 3 6 medium
3a
OPTION 3= TRANSFER ALL BIRTHS
AND CONSULTANT LED CARE TO CITY
AND THEN DEVELOP A STAND-ALONE
BIRTH CENTRE IN SANDWELL BUT NOT
ON HOSPITAL SITE
Increased DNAs for hospital appointments
resulting in lack of appropriate antenatal
assessment
2 3 6 medium Women receive delayed or substandard care Ensure wide public consultation and information
campaign to reduce the likehood of this
occuring. Liaiase with Local Ambulance Trust to
promote appropriate pathway/urgent transfers
2 2 4 low
3b
Sandwell women may percieve there is a lack
of choice and delay accessing appropriate
antenatal care
2 2 4 low Poor continuity of care. Lack of appropriate
assessent and booking for delivery.
Careful planning with local transport networks to
ensure that appropriate transport links in place.
Positive promotion of service reconfiguration to
ensure women are aware of benefits of service.
Clear information provided to women (all
languages) regarding services available.
Promotion of community based midwifery
services. Future development of stand alone
MLU in Sandwell.
2 1 3 low
3c
Loss of staff who do not wish to transfer to
City
3 3 9 medium Midwife to birth ratio is reduced. Difficulty in
providing continuity of care. Need to recruit
midwives
Ensure staff fully engaged in consultation
process. Regular staff updates re planning of
any service changes. Introduce rotation
programme so that staff are familiarised with
environment. Maintain transport service
between sites for staff redeployed. Set up early
discussions with HR and staff side
representatives. Establish proactive recruitment
strategy
3 2 6 medium
3d
Women may arrive at Sandwell in labour and 2 3 6 medium Women receive delayed or substandard care As above. Ensure A & E dept included in
2 3 6 medium
need urgent transfer to City
consultation plans
3e inappropriate home births 3 2 6 medium 3 1 3 low
3g
Lack of appropriate public transport
infrastructure for women living close to
Sandwell- delay in accessing antenatal care
2 3 6 medium increased clinical risk to mother and baby As above. Ensure A & E dept included in
consultation plans
4 1 4 low
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Risk Register