Strategic Risk Register IJB Jan 25

Argyll and Bute Council · 29 January 2025
Back to Argyll and Bute HSCP Integration Joint Board (IJB) — 29 January 2025 and its agenda

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Appendix 1
Argyll & Bute HSCP - Strategic Risk Register - December 2024
SSR Ref Description Of Risk Consequence Likelihood Impact Risk Rating
/Score
Mitigations/
Control Measures 2024/25
Likelihood Impact Risk Rating
/Score
Proposed New
Control Measures
Risk
Owner(s)
1
Medium Term Financial Sustainability - risk of
financial failure arising from costs and demand
outstripping funding. This could be as a result of
demand, cost pressures, inflation, failure to deliver
savings or as a result of the level of delegated
resource to the IJB from Scottish Government and /
or partners being insufficient to deliver on strategic
objectives.
Inability to deliver on the Strategic Plan, reduction in
performance, progress not being made in respect of
national priorities and targets, reputational damage
to IJB and partners and the requirement to
implement service changes or reductions that don't
line with strategy. Possibility of intervention in
management of HSCP.
4- Likely 5 - Extreme VERY HIGH
20
o Financial information reported to Finance & Policy Cttee and IJB
for current year and the 3 year budget outlook
o Review of funding allocations and settlements from government
and partners and engagement with sector networks
oFinance & Policy Committee scrutiny of financial performance,
risk management, savings programme and financial planning
oDelivery of Savings, project management approach to monitor
and record progress
oFinancial governance, integrated financial reporting, financial risk
register, operational and strategic reporting along with modelling
of cost pressures.
oIndependent external audit of accounting and financial planning
and reporting process of partners and HSCP
oEngagement with budget holders, SIO's and finance teams to
improve financial forecasting.
oUse of general reserves to protect services and enable longer
term approach.
4- Likely 5- Extreme VERY HIGH 20 o Detailed plans for use of reserves and refresh of
Transformation Programme, available resources now
being allocated to cover overspending
o Engagement with NRAC modelling team and allocations
o External audit highlighting risk to IJB, NHSH and A&B
Council
o HSCP inclusion in NHSH enhanced expenditure control
processes being implemented
o Risk increasing due to potential impact of Employer NI
increase and overspending in the current year.
oOn going engagement with both partners as the budget
process develops
Chief Finance Officer /
Chief Officer / SLT
↑
2
Going Concern Status - Risk of financial failure
within a 1 year time horizon due to overspending of
service budgets, inflation and cost pressures or
reductions in funding
Inability to deliver on the Strategic Plan, reduction in
performance, progress not being made in respect of
national priorities and targets, reputational damage
to IJB and partners and the requirement to
implement service changes or reductions that don't
align with the strategic objectives. Possibility of
external  intervention in management.
4- Likely 5 - Extreme VERY HIGH
20
Mitigations are as above. Budget for 2024/25 has a significant gap,
however the HSCP has reserves in place which will able it to fund
the anticipated budget gap arising during the year.
3 - Possible 5- Extreme HIGH 15 Level of reserves and non-recurring funding currently in
place mitigate but these are reducing - a revised
assessment is required depending upon the Scottish
Government budget in December 2024, the position of
both partners and progress with savings delivery.
Chief Finance Officer /
Chief Officer / SLT
↑
3
Delivery of Strategic Objectives -
Inability to design and deliver transformational
change could lead to a failure to deliver on strategic
outcomes and the Strategic Plan. The pace of
change to re-design services doesn't keep up with
the demographic pressures.
Inability to engage with the workforce and
communities on the need for change could lead to
reputational damage and the increased fragility of
health and social care services and poorer health
outcomes for local people.
4- Likely 4- Major HIGH 16 ○Locality Planning Groups with agreed terms of reference and
engagement strategy guidelines
○Delivery of the annual Savings Plan with EQIAs produced to
highlight impacts
○Medium term budget planning integrated with strategic planning
○Performance reporting - management information and
transparent reporting to IJB
○Communications and engagement strategies
○SLT reporting structure and links with partner organisations,
including Chief Officer representation on partner senior
management teams
○Engagement with staff representatives
○Clearly articulated  impact on Quality and Performance in all
service redesign plans
4- Likely 4 - Major HIGH 16 o New Strategic Plan and Commissioning Strategy
consulted widely upon
o Review of transformation programme structure and
increased resourcing of key projects
o Financial and staffing constraints putting ability of HSCP
to deliver on strategic objectives at increasing risk
o Service redcutions being considered which will impact on
delivery of strategic objectives - consideration being given
to increasing to 'very high'
Chief Officer / SLT
↑
4
Demographic Changes - failure to
implement strategies and actions to address future
demographic challenges of declining population,
reduced working age population and an increase in
older people. Failure to accurately forecast the
impact on services including shifting the balance of
care and implementing new models of care and / or
ensuring there is sufficient capacity.
This could lead to service failure to meet needs of
service users and deliver against the Strategic Plan
objectives.
5-Almost Certain 4 - Major VERY HIGH
20
○Strategic Plan and role of Strategic Planning Group
○Incorporation of demographic forecasts into Strategic Planning
and Locality Planning
○Locality Planning Groups to inform service re-designs in each
locality in line with needs of the population
OStrategic Workforce Planning Group established to share data
and good practice and develop 3 year workforce plans
○Demand pressures for services incorporated into budget process
○National awareness of demographic changes been driver for
change in the way services are delivered
○Ongoing engagement with Community Planning Partners and
joint planning
4- Likely 4- Major HIGH 16 ○Resourcing and commencement of prevention agenda
and co-production work
○Planning for future workforce demographic changes in
Workforce Plan
O Updated Adult Health Strategic Needs Assessment
OReview of Transformation and change programme and
re-commencement of transformation activities
OUpdated population modelling and indication of
increasing demand for Older Adult Services and review of
care home provision
Chief Officer / SLT
↑
5
Governance and Leadership - IJB arrangements are
not conducive to effective working and lead to poor
decision making and lack of strategic direction and
inability to have appropriate risk management,
contingency and resilience processes in place to
reposnd appropriately to emergencies and changing
circumstances.
Service and reputational damage, lack of confidence
in the IJB and inability to deliver on strategic
objectives in a consistent manner.
4- Likely 4 - Major HIGH 16 ○Appropriate representation on the IJB.
○Programme of development sessions for IJB members.
○Integration Scheme reviewed March 2021, Strategic Plan,
Standing Orders and Code of Conduct.
○Effective sub-committee structure in place
○Internal Audit review of governance arrangements and
recommendations implemented.
○External Audit review of governance and annual governance
statement
ORegular engagement with Standards Officer and regulatory
bodies
OFull engagement of Board in development of Strategic Plan and
Commissioning Strategy
4- Likely 4- Major HIGH 16 O Development of continuous improvement to achieve an
holistic approach to the overall Governance of the IJB and
regular review of performance
O Implementation of governance improvement actions
and audit recommendations
O Strategic Plan approved and in place
O Resilience and contingency planning now incorporated
within SLT rather than as a separate group and
contingency plans in place
O Current gaps in management structure a concern in
respect of capacity to effect strategic development,
change and transformation
Chief Officer
↑
Gross Risk Residual Risk

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6
Partnership Working - service delivery failure due
to inadequate
relationships with partners including the Council
and Health Board and commissioned service
providers including NHS GG&C and the third sector.
May lead to duplication of effort, poor relationships
and the inability to effectively negotiate the IJB's
position. The partnership may be viewed as failing
or not achieving objectives, leading to reputational
damage and loss of confidence in IJB. Could also
result in a reduction or loss of services to the
community and failure to exploit opportunities for
joint working, innovation and efficiencies.
4 -Likely 4 - Major HIGH 16 ○Integration Scheme reviewed outlining roles and responsibilities
○Independent scrutiny arrangements in place and work of internal
audit, including assurance mapping.
○Representation on IJB from partners, community representatives
and third sector representatives.
○Clear channels of communication and information sharing
protocols in place
○Directions are issued to partners in line with strategic direction
and operational delivery of services.
○Strategic Planning work with Commissioned Service providers
and new Commissioning Strategy
○Third Sector representation on the IJB & commitment to co-
production
4- Likely 4- Major HIGH 16 OApproval of Commissioning Strategy following
consultation with partners
OResourcing and Commencement of Prevention and Co-
Production work and activities and integration of these
within Transformation programme
ORe-establishment of regular meetings with GGCHB
OImproved engagement mechanisms and establishment
of prevention and co-production workstreams
OImproved engagement with RSLs and the Housing Crisis
agenda.
ODiscussions with partners over funding becoming
increasingly challenging and change management
processes within HSCP and partners present a risk to
working relationships, Employers NI increase presents an
additional risk.
Chief Officer
↑
7
Infrastructure and Assets -
Assets are owned by the Council and Health Board.
Risk that these do not meet the current and future
requirements due to underinvestment in
maintenance, equipment and ICT or that assets are
not being used or managed efficiently and
effectively.
Risk assets not being maintained / replaced or being
otherwise appropriate to support the IJB's strategic
outcomes and do not enable efficient, safe and
effective service delivery. Properties will fail to meet
standards required by regulators and fail to deliver
on carbon reduction commitments. Equipment will
become unreliable with additional downtime and
ICT infrastructure will not support Digital
Transformation ambitions or may add to cyber
security risks. Increasing risk of failure which could
result in facilities or equipment being unavailable.
5-Almost Certain 4 - Major VERY HIGH
20
O Progressing co-location options with Argyll & Bute Council
O Represented on Council and NHS Highland Asset Management
Boards
O Partnership working to reflect joint planning approach with
membership of both partner asset groups
○ Appointment of new senior management post to increase
capacity
O securing of additional external resource for investment in Tiree
and in carbon reduction.
o Establishment of Infrastructure Transformation Board
5-Almost Certain 4 - Major VERY HIGH 20 oHSCP Digital / IT strategy now complete to enable TEC /
remote working
oDevelopment of a strategic approach to the estate and
the identification of priorities for investment and
replacement of infrastructure assets.
oNew Strategic Estates & Sustainability Post and
Infrastructure Transformation Board.
oBudget suggests NHS capital replacement projects will be
halted, costs of projects increasing and insufficient funding
to replace or maintain assets. Limited flexibility to spend
reserves on asset replacement.
oStrategic Assessment work underway to try and get
replacement assets in capital pipeline at Scottish
Government level - now halted.
oFocus to shift to maintenance of existing assets and
rationalisation and do minimum approach. Budget is not
sufficient to address backlog maintenance or essential
asset replacement. Risk increasing.
Chief Officer, Head of
Strategic Planning and
Performance, Head of
Finance
↑
Risk relates to both
local operational and
strategic impacts.
8
Sustainability of commissioned
service providers - financial and operational
sustainability of care at home and care home
commissioned service providers deteriorates as a
result of financial and workforce pressures.
Market failure would lead to disruption of service,
the implementation of contingency plans, increased
costs and an adverse impact on individuals and their
families. Would also impact on the ability of the IJB
to deliver on the planned shift in the balance of
care.
5 - Almost
Certain
5 -Extreme VERY HIGH
25
○Commissioning team supplier relationship and market
management, including contract management and review
processes and solvency checks as part of contract management
○Additional funding for providers to facilitate the implementation
of wage increases and Fair Work Practices
○Engagement with national work supporting the National
Contracting
OContingency planning in localities for care at home. Care Home
and Care at Home Assurance Group for Argyll and Bute to identify
and manage local and short term risks.
OStrategically the Care Home Programme Board will assist
planning ahead with forecasting demand.
○Engagement with national workforce planning and local training
providers around promotion of care professions.
5 - Almost
Certain
4- Major VERY HIGH 20 ○ Continuing work with providers in partnership and
quarterly provider forums for care homes and care at
home
O Ongoing engagement nationally with financial
sustainability plans and flexible approach to local support
where necessary
O Implementation of Strategic Commissioning Plan based
on Joint Strategic Needs Assessment
O Ability to respond effectively to issues as they arise (eg
KCC, Cowal Care @ Home)
O Engagement with key providers and project planning to
address issues as they arise.
O Regular management escalation where issues arise
O Effective use of additional winter planning funding to try
and improve sustainability of providers
O Positive internal audit review provides assurance risk is
being managed appropriately.
O contingency planning where there are specific issues
O Work with Hub North to progress strategic assessment
work.
O Increased challenge in commissioning and processing of
payments
O Potential service reductions could increase this risk
further especially if NI increase is not funded
Chief Finance Officer /
Chief Officer / SLT
↑
9
Equalities - services are not delivered
in a way that addresses inequality or takes into
account the needs of those with protected
characteristics.
Service users are put at unnecessary risk of harm
and people with poorer life chances may have their
health and wellbeing impacted. Groups with
protected characteristics may be perceived to be
impacted unfairly.
4 - Likely 3- Moderate HIGH 12 ○Equalities Outcomes Framework in place
○Equalities impact considered as part of IJB decision making and
service change.
○Communication with service users as part of implementation of
service change using engagement and communication strategies.
○Adjustments to implementation plans are actioned where
appropriate to mitigate any potential negative impact.
○Service changes not implemented where this would constitute
unlawful discrimination.
4 - Likely 3 - Moderate HIGH 12 o EQIA process are improving but provider sustainability
issues have a significant impact on those with protected
characteristics
Review of Equality outcomes in line with policy
o requirement to make savings may result in increasing
adverse impacts
Chief Officer
↑

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10
Scottish Government Policies - risk of further
legislative, policy developments or change which
impacts on the IJBs ability to deliver on the current
Strategic Plan.
Inability to deliver SG policies alongside the
Strategic Plan and IJB's agreed objectives and the
impact of additional unfunded cost pressures.
5 - Almost
Certain
4 - Major VERY HIGH
20
○Horizon scanning for policy developments through partners and
SMT network groups
○Regular liaison with senior officers in the Scottish Government
and through Cosla Groups
○Respond to Scottish Government information requests on impact
of future policies
○Early impact assessment locally for national policies, including
any impact in budget outlook
○Implement and adopt innovative ways of implementing policies
○Role of Elected Members and IJB members to influence Scottish
Government decision making through political routes
4- Likely 4 - Major HIGH 16 o Engagement in sector developments and networks
relating to the implementation of the National Care
Service and Single Authority Model proposals
oEngagement with government officials including visits to
area and meetings to discuss local impacts of NCS
oRespond to requests for evidence from parliamentary
committees
oPositive relationships with key partners, civil servants and
politicians
oWork on-going re implementation of Staffing Act
oPerceived disconnect between policy landscape, available
resources and sustainability, highlighted by Audit Scotland
oNCS now on hold and SAM models under consideration
Chief Officer, Heads of
Service
↑
11
Workforce Recruitment and Retention - inability to
recruit and retain the required workforce because of
local or national workforce shortages. This may
result in increased costs, increased risk or reduced
service. Applies to commissioned services as well as
direct provision.
Service users needs for particular disciplines or in
particular areas may not be met if workforce is not
in place. Some sites and services at risk of closure
due to persistent staffing shortages.
5 - Almost
Certain
5 - Extreme VERY HIGH
25
○Joint and integrated Workforce Plan
○Strategic Workforce Planning Group to ensure overall visibility of
recruitment, retention and development challenges across HSCP
○#abplace2b campaign framework for attracting people into area.
OService re-designs to plan for changes to services in line with
workforce capacity
O Modern Apprentices to reduce average age of workforce
O Support commissioned service providers with recruitment and
retention, for example supporting implementation of Living Wage
and pay rate increases.
O Links with Open University assisting recruitment of students for
social work and nursing
O Programme for delivering SVQs for social care
5 - Almost
Certain
4 - Major VERY HIGH 20 ○Strategic Workforce Planning group to implement
Workforce Strategy
○Heads of Service and Managers engaged in workforce
planning and sevice pressure group meeting regularly
○Promote ABC and NHSH as employers of choice and
ensure all vacancies promoted using abplace2b.com.
OWork to reduce reliance on locum and agency staff
OEnsure on-going support for CPD
OProgressing options to address housing shortages and
progress key worker housing in partnership with Housing
Associations, Shelter Scotland and Argyll & Bute Council
SLT / Head of People,
Planning and Reward /
People Partner 
↔
12
Communications and Engagement
with Communities - risk of inadequate
arrangements in place to communicate with
stakeholders, communities and partners.
Could result in failure to gain community support
for service changes and ineffective partnership
working with communities. Reputational damage
from failure to adequately consult and engage.
Could result in failure to deliver planned change.
5 - Almost
Certain
4- Major VERY HIGH
20
○Communication and Engagement Strategies
delivered but require to monitor practice through assurance
frameworks.
○Openness and transparency of publicly available information
○Communications events and information widely available to
engage stakeholders in conversations about service changes and
the need for change.
○Engagement with politicians to ensure the Argyll and Bute
position is shared and understood.
○Locality Planning Groups and other forums are used to
communicate with communities and explore new ways of getting
the IJB message across
○Communication plans developed as part of implementation of
service changes
4- Likely 4- Major HIGH 16 ○Support local ownership of communications and
engagement
○Roll out of social media use at a local level
○Review of Communications and Engagement Strategy
and framework.
O Deliver communication and engagement plans within
guidelines. Ensure conforms to SG guidance "Planning with
People" and standards for community engagement.
OEffective engagement on strategic plan, commissioning
strategy and co-production work.
OSupport from Health Improvement Scotland and staff
training and awareness raising
OImproved budget consultation process launched in 2024
OLocality planning groups under review
Associate Director
Public Health,
Communications
team, Heads of Service
↑
13
Workforce Shift - risk that there is not appropriate
engagement with staff groups, particularly over the
need for service changes and the requirement to
work in a different way. There may be professional
concerns about inter-disciplinary working and
cultural barriers will prevent effective integration.
Would result in poor morale and the failure to gain
staff support for the workforce shift and culture
change required. Resistance from the staff group
would in turn limit the flexibility required to deploy
the workforce in line with changed models of care,
full integration will not be achieved and teams will
be disjointed. Ultimately impacting on the service
provided to communities.
4 - Likely 4 - Major HIGH 16 ○Joint Partnership Forum and Staff side Liaison facilitate
communications and information flow between management to
staff side and Trade Unions
○Communications plan for each service change project, including
staff as stakeholders
○Support from staff side partnership to support staff with new
ways of working with an integrated partnership approach.
○Compliance with terms and conditions of employment for both
staff groups
○Individual staff development plans and training programmes
○Workforce Planning
○Staff surveys used to inform targeted improvement work with
individual teams
○Strengthened communication and cascade of information from
Chief Officer
4- Likely 4- Major HIGH 16 OClarity over role and function of teams working in our
communities.OD support will be offered to Area Managers
to support teams.
OOngoing work of the culture and staff wellbeing
workstreams
OImplementation of the Workforce strategic plan
OImprove management of redeployment
Ostaff side involvement in SLT meetings and
Transformation Board
OPlanning for reductions in working week for NHS
employed staff underway
ORequirement for change likely to put upward pressure on
this risk
Chief Officer
↔
14
Safety of Services - inability to maintain the safety
of services due to demographic changes, increasing
need and complexity and the ability to recruit staff
for direct employment and for delivery partners
May result in harm to service users or patients, the
failure to provide appropriate care and reputational
damage to the IJB and partners.
4-Likely 5 - Extreme VERY HIGH
20
○Clinical and Care Governance Committee and professional
leadership
○Risk Management Strategy recently updated and operational risk
management arrangements
○Recruitment, retention and training of staff
○Triggers for service re-designs including ensuring clinical safety is
not compromised
○Prioritisation of need frameworks in place to determine need for
access to services
○Develop and implement contingency arrangements for localities
and services, Improved clinical and care governance at service
level
4-Likely 4- Major HIGH 16 O Increased focus on training and development of staff
and improved flexibility
O Increased engagement with commissioned service
providers
O New Contingency, Risk and Resilience group
Oimproved Health & Safety Training and governance
arrangements
Onew focus on establishment setting and risk
management to comply with Staffing Act requirements
Professional Leads /
Chief Social Work
Officer
↑

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15
Waiting Times -failure to meet waiting times
targets and treatment times guarantees for
treatment in specialities in NHS GG&C and outreach
clinics in Argyll and Bute. Waiting times have
increased due to Covid-19 response and disruption
and pressures within the Health system continue.
Poor level of service for patients, the potential to
have to travel further for appointments, and is not
in line with the anticipatory and preventative
approach to care.
4-Likely 4 - Major HIGH 16 ○ Continued engagement with NHS GG&C to agree a strategic
jointly planned approach to outreach services
○ Monitoring and reporting of waiting times
○ Development of new delivery models such as specialist nurses,
tele-consultation and direct or follow up referral to primary care or
AHP professionals
O Plans for use of Waiting List and winter planning funding
4- Likely 4- Major HIGH 16 OInclusion in NHS Highland Remobilisation plan to request
additional funding to redesign services and address
backlog. Initiatives include increasing virtual
clinics/services, digital and appointment modernisation,
enhanced role of AHPs and waiting times initiatives
additional clinics.
OUse and expansion of Near Me and Outreach Clinics.
OEvidence of continuing disruption to services and staffing
shortages throughout local and national healthcare system
continuing to make it challenging to address increased
waiting times. This is a serious national issue at present.
Pass through of funding required.
Heads of Service
↔
16
Support Services - risk that support services do not
adequately support front line service delivery.
Inability to integrate support services which are not
fully delegated to the IJB. Continued reliance on two
systems, processes and approaches may lead to
confusion and ongoing inefficiency. Risk that
partners will not support changes to current
arrangements.
Could adversely affect services experienced by
patients and service users if support services cannot
fully support front line services. Wasteful
duplication and inefficient use of resource and
impacts on partners if payments and assessments
not processed efficiently. Also increased risk of legal
challenge.
5 - Almost
Certain
4- Major VERY HIGH
20
OCo-location of staff
OSome IT systems integrated and further plans to review this and
to facilitate access to joint systems
ORollout of MS Teams - IT services and remote working are much
improved as a result
OCommittee support arrangements in place
OContinuous improvement in support service provision
5 - Almost
Certain
4- Major VERY HIGH 20 OReplacement programmes for new systems Social work
(eclipse), Hospital Telecoms, and portal (link systems)
funded and in place.
ODevelopment of corporate services agreement with
partners
O Work to improve recruitment processes on-going
O Implementation of staffing act presents an additional
pressure on support services
O Dedicated HR support at SLT removed, presents
increased risk to management of change across HSCP
Chief Officer, Heads of
Service
↑
17
New General Medical Services
Contract - risk that the HSCP are not in a position to
support the implementation of the new GP contract
as a result of availability of funding and capacity for
the HSCP to deliver services transferred from GPs.
Higher risk of implementation across remote and
rural areas.
Could adversely affect services experienced by
patients as gaps in service may arise. Potential for
negative impact on relationships with Primary Care
practitioners.
4-Likely 4 - Major HIGH 16 ○Ongoing collaboration between the HSCP and Primary Care to
support practices
○Primary Care Modernisation Board with priorities established and
Programme Manager in place
○Regular updates on progress to Transformation Board and the IJB,
constructive progress being made pharmacotherapy,
physiotherapy and mental health workstreams
3-Possible 4- Major HIGH 12 ○Head of Primary Care in place to add management
capacity.
OFunding for Primary Care improvement reduced
substantially by Scottish Government and acknowledged
that the contract cannot be delivered in full within existing
resourcing.
Associate Medical
Director / Head of
Primary Care
↔
18
Culture - risk that perception of negative culture
results in increased difficulties in recruiting and
retraining staff, staff wellbeing and wider reputation
of the HSCP.
Adverse impact on reputation and ability to recruit.
Also impacts on service delivery if teams are
unhappy or short staffed as a consequence
4-Likely 5 - Extreme VERY HIGH
20
o Wellbeing groups and workforce strategy group in place
o Whistleblowing process in operation
o extensive roll out of courageous conversations training
4- Likely 3 - Moderate HIGH 12 oSome indications of improving culture from staff surveys
oContinuing high levels of pressure on staff across many
working environments
Chief Officer, Heads of
Service
↑
19
Statutory/Mandatory Training - risk that
patient / service user harm could result
directly from, or be attributed to, a failure to
comply with statutory and mandatory training
requirements. This could result in harm to an
individual or group of service users,
members of staff and could result in financial
claims and reputational damage.
Adverse effect on quality and safety of care and
service delivery.
-Potential to result in Adverse Events with harm to
service users and staff which could result in civil
claims being made with a risk of high financial cost.
-Potential for enforcement action being taken
against the HSCP by the HSE with severe financial
and reputational consequence
5-Almost certain 5- Extreme VERY HIGH
25
- Stat/Man training policy in place.
-Training programmes in place via on-line training and face to face
-Induction programme
3-Possible 5- Extreme HIGH 15 • Head of Service/senior managers to compile service
improvement plans with local delivery based on individual
service position. Plans in place for online training and for
face to face training.
• Heads of Service to ensure there is a regular forum for
reviewing the plan, ensuring implementation and
escalating barriers.
• All staff to receive a communication from the Chief
Officer on responsibilities for undertaking mandatory
training.
• Managers to ensure that they are up to date with their
own training.
• Managers to monitor compliance, support staff to access
computers and have time to bring their mandatory
training up to date.
• Managers to support staff who are falling behind with
their compliance with mandatory training and follow up
until the training has been completed.
• The Health & Safety Committee and Strategic Leadership
Team to review, compliance is improving.
Chief Officer
↔
20
Climate Change - risk that the HSCP will
not achieve the climate change
decarbonisation and emissions targets set
for it. This is likely to result in reputational
damage at both a community and political
level as well as a financial cost.
-Perception that the HSCP is not fully
committed to delivering on the Scottish
Government Climate Change targets as a
result of lack of capital and revenue funding
or management capacity to prioritise this
work.
4-Likely 3- Moderate HIGH 12 oOn-going engagement and participation with A&B council, NHS
Highland and Scottish Government partners in respect of all
health and care areas producing CO2 emissions including
procurement decisions, estate, travel and transport. Services
provided by the HSCP. -
Access to funding revenue and capital to undertake CO2 reduction
projects e.g. zero emission NHS fleet by 2025
4-Likely 3- Moderate HIGH 12 oSecured funding for carbon reduction consultancy but no
capital available in 2024/25 and targets being pushed back
nationally.
oDevelopment of capital and revenue investment plans in
HSCP, Argyll and Bute Council and NHS Highland .
oLocal projects underway, climate change report
submitted and potential for case study
oNew Estates and Sustainability manager now in post and
some HSCP funds available for investment but SG reducing
capital resource.
oShort term direct impacts limited
Head of Finance &
Senior Manager -
Estates &
Sustainability
↑
21
Socio-Economic Situation & Increasing
Poverty and Deprivation - multiple risks
relating to the current socio economic
situation. Risk is driven by direct and indirect
implications of high inflation, expected
increase in poverty, increasing interest rates
and tightening public funding position.
Linked to impact of lockdowns on mental
and physical health. Risk that the health and
wellbeing will deteriorate and the HSCP will
be unable to respond appropriately to
increased service demand.
Consequences may include:
-increased staff and non-staff costs
reducing real terms values of budget and
reserves.
-potential for strike action within HSCP,
partners and in other services and
industries.
-additional service demand arising from cost
of living crisis, increased poverty levels,
increased pressure on mental health
services may be a particular pressure.
-shortages of supplies and services which
could include supplies of drugs and other
critical supplies and care provision.
4-Likely 5 - Extreme VERY HIGH
20
o recognition that this is a national socio-economic issues and local
mitigations and influence is limited
o resilience and contingency planning
o remobilisation of services
o involvement in sector discussions in respect of strike exemptions
o may need to consider prioritisation of services and resources
4-Likely 5 - Extreme VERY HIGH 20 o HSCP planning sensitive to issues facing local
communities
o awareness of pressures and careful financial and service
planning to mitigate impact particularly on most
vulnerable
o initial evidence of increase in cases requiring expensive
residential care packages which could result in severe cost
pressures.
ocontinuing to work with key partners and community
planning to help mitigate the impact.
o largely outwith the control of the HSCP
0removal of fuel allowance, service reductions and
sustainability of 3rd sector increasing this risk to
communities further.
Chief Officer & SLT
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#
Risk Matrix
Risk Rare    (1) Unlikely     (2) Possible     (3) Likely    (4) Almost Certain 
(5)
Extreme     (5) MEDIUM 5 HIGH 10 HIGH 15 VERY HIGH 20 VERY HIGH 25
Major 
(4) MEDIUM 4 MEDIUM 8 HIGH 12 HIGH 16 VERY HIGH 20
Moderate 
(3) LOW 3 MEDIUM 6 MEDIUM 9 HIGH 12 HIGH 15
Minor 
(2) LOW 2 LOW 4 MEDIUM 6 MEDIUM 8 HIGH 10
Insignificant 
(1) LOW 1 LOW 2 LOW 3 MEDIUM 4 MEDIUM 5
Table 1 Assessment of likelihood
Score Description
1 Rare
2 Unlikely
3 Possible
4 Likely
5 Almost Certain
Table 2 Assessment of Impact
Descriptor Insignificant Minor Moderate Major Extreme
Score 1 2 3 4 5
Patient
Experience
Reduced quality of
patient experience /
clinical outcome not
directly related to
delivery of clinical
care.
Unsatisfactory
patient experience
/ clinical outcome
directly related to
care provision –
readily resolvable.
Unsatisfactory
patient experience /
clinical outcome,
short term effects –
expect recovery
<1wk.
Unsatisfactory
patient experience /
clinical outcome:
long term effects –
expect recovery -
>1wk.
Unsatisfactory
patient experience /
clinical outcome:
continued ongoing
long term effects.
Injury (physical
and
psychological)
to patient /
visitor / staff.
Adverse event
leading to minor
injury not requiring
first aid
Minor injury or
illness, first aid
treatment required
Agency reportable,
e.g. Police (violent
and aggressive acts)
Significant injury
requiring medical
treatment and/or
counselling.
Major injuries/long
term incapacity or
disability (loss of
limb) requiring
medical treatment
and/or counselling.
Incident leading to
death or major
permanent
incapacity.
Complaints/
Claims
Locally resolved
verbal complaint
Justified written
complaint
peripheral to
clinical care.
Below excess claim.
Justified complaint
involving lack of
appropriate care.
Claim above excess
level. Multiple
justified complaints.
Multiple claims or
single major claim.
Complex justified
complaint.
Staffing and
Competence
Short term low
staffing level
temporarily reduces
service quality (<
than 1 day). Short
term low staffing
level (> 1 day),
where there is no
disruption to patient
care.
Ongoing low
staffing level
reduces service
quality. Minor
error due to
ineffective
training/
implementation of
training.
Late delivery of key
objective / service
due to lack of staff.
Moderate error due
to ineffective
training/implementati
on of training.
Ongoing problems
with staffing levels.
Uncertain delivery of
key objective /
service due to lack of
staff.  Major error
due to ineffective
training/implementati
on of training.
Non-delivery of key
objective / service
due to lack of staff.
Loss of key staff.
Critical error due to
ineffective
training/implementati
on of training.
Financial
(including
damage/ loss/
fraud)
Negligible
organisational/
personal financial
loss (< £1k) (NB.
Please adjust for
context)
Minor
organisational/per
sonal financial
loss (£1-10k).
Significant
organisational
/personal financial
loss (£10-100k).
Major organisational/
personal financial
loss (£100k - £1m).
Severe
organisational/
personal financial
loss (>£1m).
Adverse
Publicity /
Reputation
Rumours, no media
coverage. Little
effect on staff
morale
Local media
coverage – short
term. Some public
embarrassment.
Minor effect on
staff morale /
public attitudes.
Local media – long-
term adverse
publicity. Significant
effect on staff morale
and public perception
of the organisation
National media /
adverse publicity,
less than 3 days.
Public confidence in
the organisation
undermined. Use of
services affected
National /
International media /
adverse publicity,
more than 3 days.
MSP / MP concern
(Questions in
Parliament). Court
Enforcement. Public
Enquiry/ FAI.
Strong possibility that this could happen again
This is expected to frequently happen again – more likely to re-occur than not
LIKELIHOOD
IMPACT
Chance of Occurrence
Can’t believe this event would happen again – will only happen in exceptional
circumstances
Not expected to happen again, but definite potential exists
Has happened before on occasions – reasonable chance of re-occurring