Strategic Risk Register IJB Jan 24

Argyll and Bute Council · 31 January 2024
Back to Argyll and Bute HSCP Integration Joint Board (IJB) — 31 January 2024 and its agenda

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Page 1

Strategic Risk Register IJB Jan 24
ARGYLL & BUTE INTEGRATION JOINT BOARD STRATEGIC RISK REGISTER  UPDATED JANUARY 2024
Risk Ref and
xRef to
Strategic
Objectives
Description Of Risk Consequence Likelihood Impact Risk Rating
/Score
Mitigations/
Control Measures 2023/24
Likelihood Impact Risk Rating
/Score
Proposed New
Control Measures
Risk
Owner(s)
SSR01
links to
B,E,F,J
Medium Term Financial Sustainability - risk of
financial failure arising from costs and demand for
services outstripping funding. This could be as a
result of demand, cost pressures and 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 financial performance, risk
management, savings programme and financial planning
oFocus on delivery of Savings, project management approach to
monitor and record progress
oDevelopment of financial 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.
oIncrease in general reserves due to better than expected financial
performance in 2022/23
4- Likely 5- Extreme VERY HIGH 20 o Detailed plans under development for use of reserves
and refresh of Transfromation Programme
o Review of medium term financial plan to be completed
& NRAC funding allocations to be investigated further
oexternal audit reports highlights that this is a risk
oanalysis of December draft busget underway
odevelopment of both short term and long term savings
plans being prioritised
oHSCP inclusion in NHSH enhanced expenditure control
processes being implemented
opotential reallocatation of resource from development of
capital projects
Chief Finance Officer /
Chief Officer / SLT
↑
SSR01 (b) 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 dont
align with the strategic objectives. Possibility of
external  intervention in management.
4- Likely 5 - Extreme VERY HIGH
20
Mitigations are as above. Budget for 2023/24 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 currently in place mitigate but clawback
of funding by partners, spend of reserves and draft
Scottish Budget are all increasing this risk at present.
Chief Financial Officer
/ SLT
↑
SSR02
links to
A,B,C,D,E,F,
G,H,I,J,K
Delivery of Strategic Objectives -
Lack of resources to 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 might not keep up with
the demographic pressures of an ageing population.
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 where appropriate
○Medium term budget planning integrated with strategy
development
○Performance reporƟng - management informaiton and
transparent reporting to IJB
○CommunicaƟons and engagement strategies
○Improved governance for IJB  and commiƩees
○SMT reporƟng structure and links with partner organisaƟons,
including Chief Officer representation on partner senior
management teams
○Engagement with staﬀ representaƟves
○Clearly arƟculated  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 and approved, this re-states and
validates strategic objectives
o Roll out of new Integrated Performance & Reporting
Regime in 2023/24
o Locality Planning Groups
o Review of transformation programme structure and
increased resourcing to projects
Chief Officer / SLT
↑
SSR03
Links to
B,E,G,H,I
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.
This could lead to service failure to meet needs of
service users and deliver against the Strategic Plan
objectives.
4- Likely 4 - Major HIGH 16 ○Strategic Plan and role of Strategic Planning Group
○IncorporaƟon 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
○NaƟonal 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 prevenƟon agenda
and co-production work
○Planning for future workforce demographic changes in
Workforce Plan
OUpdated Adult Health Strategic Needs Assessment
OReview of Transformation and change programme and
re-commencement of transformation activities
OEstablishment of Prevention Transformation Programme
OReview of NRAC formula and updated population
modelling
OIndication of increasing demand for Older Adult Services
during 2023
Chief Officer / SLT
↑
Gross Risk Residual Risk

Page 2

Strategic Risk Register IJB Jan 24
SSR04
links to J
Governance and Leadership - IJB arrangements are
not conducive to effective working and lead to poor
decision making and lack of strategic direction.
Service and reputational damage, lack of confidence
in the IJB and inability to deliver on strategic
objectives in a consistent manner.
3 - Possible 4 - Major HIGH 12 ○Appropriate representaƟon on the IJB.
○Programme of development sessions for IJB members.
○IntegraƟon Scheme reviewed March 2021, Strategic Plan,
Standing Orders and Code of Conduct in place.
○EﬀecƟve sub-commiƩee 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
3 - Possible 3 - Moderate MEDIUM 9 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 Increased stability in senior leadership team
O New Strategic Plan approved and in place
Chief Officer
↔
SSR05
links to G,H
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 ○IntegraƟon Scheme recently reviewed outlining roles and
responsibilities
○Independent scruƟny arrangements in place and work of internal
audit, including assurance mapping.
○RepresentaƟon on IJB from partners, community representaƟves
and third sector representatives.
○Clear channels of communicaƟon and informaƟon sharing
protocols in place
○DirecƟons are issued to partners in line with strategic direcƟon
and operational delivery of services.
○Strategic Planning work with Commissioned Service providers
and new Commissioning Strategy
○Third Sector representaƟon on the IJB & commitment to co-
production
ORegular engagement with key partners
3 - Possible 3 - Moderate MEDIUM 9 ○Alignment of roles and responsibiliƟes through the code
of corporate governance and induction training for new
members of the IJB
OApproval of Commissioning Strategy following extensive
consultation with partners
OShift from annual grant funding to longer term contracts
to facilitate longer term security / planning
OResourcing and Commencement  of Prevention and Co-
Production work and activities and integration of these
within Transformation programme
OReinvigoration of locality planning groups and
engagement with the Local Area Group.
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.
Chief Officer
↑
SSR06
links to E,J
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.
4 - Likely 4 - Major HIGH 16 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.
4- Likely 4 - Major HIGH 16 oHSCP Digital / IT strategy now complete help enable TEC
/ remote working
oDevelopment of a strategic approach to the HSCP estate
and the identification of priorities for investment and
replacement of infrastructure assets.
oNew Strategic Estates & Sustainability Post and
establishment of Infstructure Transfromation Board.
oDecember 23 Budget suggests NHS capital replacement
projects will be halted, costs of projects increasing.
oresourcing of key infrastrucutre projects to link with
strategic and transformation objectives
oStrategic Assessment work underway to try and get
replacement assets in capital pipeline at Scottish
Government level - this work may now require to be
halted.
oRisk increasing due to implications of SG draft budget for
capital investment and business case development. Focus
to shift to maintenance of existing assets and
rationalisation.
Chief Officer, Head of
Strategic Planning and
Performance, Head of
Finance &
Transformation
↑

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Strategic Risk Register IJB Jan 24
SSR07
links to
B,D,E,H
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 relaƟonship and market
management, including contract management and review
processes and solvency checks as part of contract management
○AddiƟonal funding for providers to facilitate the implementaƟon
of wage increases and Fair Work Practices
○Engagement with naƟonal work supporƟng the NaƟonal
Contracting
OContingency planning in localities for care at home during the
pandemic.  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 naƟonal workforce planning and local training
providers around promotion of care professions.
5 - Almost
Certain
4- Major VERY HIGH 20 ○ ConƟnuing work with providers in partnership
O Ongoing engagement nationally with financial
sustainability plans and flexible approach to local support
where necessary
○ ImplementaƟon of Strategic Commissioning Plan based
on Joint Strategic Needs Assessment
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 known
issues
Onew care at home contract being developed in a
consultative way
Heads of Adult Care,
Head of Strategic
Planning and
Performance
↔
SSR08
links to A
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 ○EqualiƟes Outcomes Framework in place
○EqualiƟes impact considered as part of IJB decision making and
service change.
○CommunicaƟon with service users as part of implementaƟon of
service change using engagement and communication strategies.
○Adjustments to implementaƟon plans are acƟoned where
appropriate to mitigate any potential negative impact.
○Service changes not implemented where this would consƟtute
unlawful discrimination.
3 -Possible 3 - Moderate MEDIUM 9 o EQIA process are improving but provider sustainability
issues have a significant impact on those with protected
characteristics
Reciew of Equality outcomes in line with policy
Chief Officer
↔
SSR09
links to
B.C,D,E,F,I,J
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 Scoƫsh Government
and through Cosla Groups
○Respond to Scoƫsh Government informaƟon requests on impact
of future policies
○Early impact assessment locally for naƟonal policies, including
any impact in budget outlook
○Implement and adopt innovaƟve ways of implemenƟng policies
○Role of Elected Members and IJB members to inﬂuence Scoƫsh
Government decision making through political routes
OOn-going monitoring of developments with NCS
4- Likely 3 - Moderate HIGH 12 o Engagement in sector developments and networks
relating to the implementation of the National Care
Service and Single Authority Model proposals
o Engagement continuing through professional networks
to respond to NCS proposals
oSpending Review published in May 22 outlines
prioritisation for Health and Care sector
oEngagement with governement officials including visits
to area and meetings to discuss local impacts of NCS
oRespond to requests for evidence from parliametary
committees
oPositive relationships with key partners, civil servants
and politicians
oWork on-going to consider implementation of Staffing
Act
oPerceived disconnect between policy landscape and
available resources (staff and finance)
Chief Officer, Heads of
Service
↑
SSR10
links to
B,C,E,H,I,J
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.
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 aƩracƟng people into area.
OContingency plans for clinical posts to reduce reliance on locums
OService re-designs to plan for changes to services in line with
workforce capacity
OTargets for new Modern Apprentices to reduce average age of
workforce
○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
O Development and roll out of community team standards
5 - Almost
Certain
4 - Major VERY HIGH 20 ○Strategic Workforce Planning group to implement
Workforce Strategy
○Heads of Service and Managers acƟvely engage in
workforce planning
○Explore further opportuniƟes for Growing our Own
including MAs in NHS
○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
Oidentification of options within current estate in HSCP to
address housing shortages and progress key worker
housing in partnership with Housing Associations, Shelter
Scotland and Argyll & Bute Council.
OInternal audit review
Oindustrial action remains a risk and may impact
negatively on workforce retention and recrutiment
SLT / Head of People,
Planning and Reward /
People Partner 
↔

Page 4

Strategic Risk Register IJB Jan 24
SSR11
links to
B,E,F,J,K
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
○CommunicaƟon and Engagement Strategies
delivered but require to monitor practice through assurance
frameworks.
○Openness and transparency of publicly available informaƟon
○CommunicaƟons events and informaƟon widely available to
engage stakeholders in conversations about service changes and
the need for change.
○Engagement with poliƟcians 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
○CommunicaƟon plans developed as part of implementaƟon of
service changes
4- Likely 4- Major HIGH 16 ○Support local ownership of communicaƟons and
engagement
○ConƟnue roll out of social media use at a local level
○Ongoing review of CommunicaƟons 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.
OLocality Planning groups meeting regularly
OSupport from Health Improvement Scotland and staff
training and awareness raising
Associate Director
Public Health,
Communications team
↑
SSR12
links to
B,E,F,J,K
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.
This 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
○CommunicaƟons 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 condiƟons 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 communicaƟon and cascade of informaƟon 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 involvment in SLT meetings and
Transfromation Board
Chief Officer
↔
SSR13
links to
A,B,H,J
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 CommiƩee and professional
leadership
○Risk Management Strategy recently updated and operaƟonal risk
management arrangements
○On-going recruitment, retenƟon and training of staﬀ
○Triggers for service re-designs including ensuring clinical safety is
not compromised
○PrioriƟsaƟon of need frameworks in place to determine need for
access to services
○Develop and implement conƟngency arrangements for localiƟes
and services
4-Likely 4- Major HIGH 16 ○ Increased focus on training and development of staﬀ
and improved flexibility
○ Increased engagement with commissioned service
providers
○ New ConƟngency, Risk and Resilience group
Oimproved Health & Safety Training and governance
arrangements
Lead Nurse/Chief
Social Worker
↔
SSR14
links to
A,B,H,I
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
already increased due to Covid-19 pandemic 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 ○ ConƟnued engagement with NHS GG&C to agree a strategic
jointly planned approach to outreach services
○ Monitoring and reporƟng of waiƟng Ɵmes
○ 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 is essential to progress.
Heads of Service
↔
SSR15
links to
A,B,C,D,E,F,
G,H,I,J,K
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.
4-Likely 4- Major HIGH 16 ○Co-locaƟon of staﬀ
○Some 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
4- Likely 4- Major HIGH 16 ○Replacement programmes for new systems Social work
(eclipse), Hospital Telecoms, and portal (link systems)
funded and in place.
O Office 365 implementation
○Development 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, particularly HR
Heads of Service
↑

Page 5

Strategic Risk Register IJB Jan 24
SSR16
links to
A,B,C,D,E,F,
G,H,I,J,K
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 collaboraƟon between the HSCP and Primary Care to
support practices
○Primary Care ModernisaƟon Board with prioriƟes established and 
Programme Manager in place
○Regular updates on progress to TransformaƟon Board and the IJB,
constructive progress being made pharmacotherapy,
physiotherapy and mental health workstreams
4- Likely 4- Major HIGH 16 ○Head of Primary Care in place to add management
capacity.
OEngagement with Scottish Government in respect of
funding to enable permanent workforce structures to be
developed and implemented and agreement of some
concessions within Argyll and Bute
OFunding for Primary Care improvement reduced
substantially by Scottish Government, risk therefore
continues to increase at present
Associate Medical
Director
↑
SSR17
links to
A,B,C,D,E,F,
G,H,I,J,K
Contingency and Resilience risks including
responding to winter pressures, service pressures
and emergencies
Adversely affecting service delivery and waiting
times performance, and ability to deliver planned
transformation
4 - Likely 5 - Extreme VERY HIGH
20
oRegular testing of emergency scenarios
oAdditional management post created and improvement
leadership of winter planning.
4- Likely 4- Major HIGH 16 oDigital / IT & Telecoms  infrastructure enhanced
oContingency, Risk and Resilience Management group
established including representation from partners
oon going high demand for services combined with
workforce issues
oSystem under increasing pressure as winter approaches
and evidence of increased delayed discharges locally -
winter plan in place.
All SLT
↑
SSR18
links to
A,B,C,D,E,F,
G,H,I,J,K
Culture - risk that perception of negative culture
results in increased difficulties in recruting and
retraining staff, staff wellbeing and wider
repiutation 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 Guardian Service in operation - independent and confidential
o extensive roll out of courageous conversations training
3 - Possible 3 - Moderate MEDIUM 9 oindications of improving culture Chief Officer
↔
SSR19 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.  Specific plans put 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 communicaƟon 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 CommiƩee and Strategic Leadership
Team will review compliance performance regularly,
compliance is improving as a result.
Chief Officer
↓
SSR20 Vaccine Delivery - Whilst responsibility for
the delivery of the vaccination programme
sits with NHS Highland, there is a risk that
locally the vaccine programme may not be
delivered as quickly as communities and
government wish,
-Reputational damage may arise as a
result of the local management of the
vaccination programme
-communities may not benefit from the
impact of the vaccination programme to the
maximum possible extent
4-Likely 4 - Major HIGH 16 oEngagement with Highland Health Board to ensure that the
vaccination is programme is delivered as quickly and efficiently as
possible
oRecruitment of vaccination staff on a permanent basis
oEffective communication with local communities
3-Possible 3-Possible MEDIUM 9 oPermanent recruitment of vaccination staff
oGood local performance levels to date
Extended messaging on all vaccination programmes for all
ages
Chief Officer
↓
SSR 21 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
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
funds available for investment
Head of Finance /
Senior Managemer
Estates and
Sustainability
↓

Page 6

Strategic Risk Register IJB Jan 24
SSR 22 Socio-Economic Situation - 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.
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 largely outwith the control of the HSCP
Chief Officer & SLT
↔
Deleted from Strategic Risk Register
SSR18
links to
A,B,C,D,E,F,
G,H,I,J,K
Covid-19 and other respiratory illnesses- risks of
further waves of covid and other infections with
more people becoming ill and requiring health care
Adversely affecting service delivery and waiting
times performance, and ability to deliver planned
transformation. Risk would result on further
pressure on available workforce.
5 - Almost
Certain
5 - Extreme VERY HIGH
25
o there is an effective vaccination programme in place.
o experience and project planning of previous mobilisation from
first and second waves
3-Possible 3 - Moderate MEDIUM 9 oRisk perceived to be reducing at present - no current
testing regime - suggested that this risk can be removed as
is covered by Contingency, Risk and Resilience risk.
All SLT
↓