Risk Title

Risk Description

Aging estate

NHS Grampian's estate is aging with an increasing backlog of maintenance, specifically with regard to ventilation (and summers may be getting warmer).  There is a risk of structural building failures, for example falling masonry, ceiling collapse and/or ventilation system failures, leading to denial of facilities with potential closure of buildings & clinical safety impacts.

Cyber risk

There is an increasing exposure to Cyber risk as criminal gangs become more active in this area and our plans for the future become increasingly reliant upon technology.  This may cause loss of service, ransom attack, and general disruption to our systems including heavy financial penalties.  Our plans may fail if we are unable to provide the level of digital capability needed, leading to financial loss, reputation impact, SG involvement.

Ongoing availability of adequate PPE

If the ongoing availability of adequate PPE cannot be guaranteed we may find that we fail to meet safety standards, leading to possible negative media coverage, potential failure to meet safety standards, and the likelihood of adverse events (including an increasing volume of complaints)

Temporary accommodation

There may be limited availability of temporary accommodation to allow upgrade/refurbishment of existing facilities, or services may be unwilling to relocate temporarily.   It may not be possible to re develop key assets because they are in continual use.  Plans to improve infrastructure may fail, development may take longer.

Threat to the delivery of both critical and protected services

Pressures from the prolonged pandemic and having to continually work in a reactive state (staff deployment, continually reviewing processes and reprioritisation, short-term/fixed term resource) is impacting on the ability to focus on strategic planning for the future. 

Caring for adult patients in ward corridors across  ARI (ED Capacity and Escalation Plan)

Due to the continuing pressures exerted by the Covid pandemic upon our healthcare system, it has been necessary to implement a derogation allowing (amongst others) the care for patents in corridors within ARI and community hospitals.  This is a complex risk that may lead to a number of harmful events as well as the introduction of opportunity that might help ease pressures upon our healthcare system.

Clarity of NHSG's plans

NHSG's plan may not be clear to all, we may not have communicated it well meaning that staff and external stakeholders do not grasp what we are trying to achieve.  Staff may become demoralised, external stakeholders may lose confidence.

Possible impact of healthcare uncertainties 2021/22

Because of the complexity of the current healthcare landscape and the uncertainty of its duration there may be requirements to repeatedly re-visit emergency planning arrangements and business continuity arrangements.  This may reduce the capacity to manage healthcare demand and the development of future strategic plans, with corresponding confidence in leadership falling

Transformation program 2021/22

The intense focus on the current emergency situation may leave insufficient capacity for the long term transformation, which could led to a failure to deliver a sustained strategic approach leading to a failure to deliver the required transformation to meet the healthcare needs of our population in a safe & sustained manner

Future pandemics

There may be future waves of Covid 19 or other virus that could lead to a more severe outcome than the current variant, this may overrun our abilities to cope with increased hospitalisation.   We may be forced to turn patients away, there may be a partial collapse of our system.

Unusually severe seasonal capacity pressures

If the underlying core capacity is insufficient to meet demand, additionally limited by current modifications and pressures due to Covid 19 pandemic, as well as uncertainties due to additional demand during winter 2021, NHSG may not have sufficient capacity to deliver planned & unplanned healthcare against current demand, further displacing planned healthcare.

Health & Care provision in Grampian

Due to difficulties recruiting staff, or an aging workforce, or the pressures of operating in uncertain commercial conditions, Independent Health & Care providers may seek to return their contracts leading to added pressures upon our HSCPs as they are forced to take over management of these facilities.

Staff shortages may continue

Difficulty in recruiting, combined with aging workforce, may lead to increasing numbers of staff shortages.  If these staffing gaps continue our existing personnel may be forced to work beyond safe limits or turn patients away.  We may start to suffer increasingly bad press, staff may leave or retire early, the problem could become 'self-replicating'

Health debt

Over the pandemic waiting lists have grown into what has become known as the Healthcare debt, available resources may not be able to reduce waiting lists to acceptable levels as fast as the public require, increasing public dissatisfaction, reputation damage, SG intervention.

Targeting resources

Because NHSG operates under continually tight financial pressures and cannot afford to undertake all developments that are requested we may spend resources sub optimally.  Leadership may not have a solid grasp of stakeholder needs (as opposed to 'wants') and may focus resources on areas of lesser need.  Investment may fail and stakeholder satisfaction may deteriorate.