PCCC Risk Register January 2017

Group: Primary Care

Ownership Officer: Angela Bright Chair: Gillian Adams
Commissioning Committee

Risk
Risk scores
Score

Likelihoo
Risk Ref.

Overall
Impact
Risk Description Existing Actions Monitoring Owner and Oversight
Next steps

d
RISK CCG unable to meet revenue 4 • Full engagement with NHSE to • PCCC 2 8 • Complete due diligence Ian Potter/Ruth
consequences of ETTF premises ensure guidance is cascaded • Performance and exercises with practices Waddington
developments previously approved appropriately development /FP supported in principle by
through PCCC • Due dilligence processes being • Task Group NHSE
CAUSE Financial pressures considered and fully adhered to in • Procurement and
IMPACT Inability to deliver order to ensure value for money Investment Committee
PCCC1

priorities articulated in the Strategic schemes both from capital and • NHSE
Estates Plan; lack of financial revenue perspective
resource where one or more
recommendations are not approved

RISK Threat to sustainability of GP 4 • CCG supporting practices to • PCCC 4 16 • Engagement with NHSE Ian Potter/Ruth
workforce in terms of existing consider alternative ways of • GP Workforce group and LMC to ensure Waddington
capacity and morale, retention and ensuring clinical provision eg ANP, • Federations are accessibility to the
succession planning’ ECP, federated working currently looking at national recruiting
CAUSE national recruitment issues • Local incentive schemes for resilience returning doctors pilot
and an inability for some practices practices to access eg 'Golden •Establishment of robust
PCCC2

to meet the financial demands of GP Hello', CCG Struggling Practices process to support
applicants Fund identification of practice
IMPACT reduced access to GPs; •Clear understanding of GP issues and subsequent
impact upon clinical quality and Forward View guidance and active resolution
patient safety participation in LLR collaborative •Full engagement with
programmes as appropriate LLR approach to
implementation of GPFV
RISK Co-commissioning budget is 4 • Establishing montly monitoring. • PCCC 3 12 • Reprofiling of the Ian Potter/Ruth
overspent at the end of the financial • Quarterly F&P budgets Waddington and
year Andrew Roberts
CAUSE Failure to forecast and
PCCC3

administer the budgets correctly

IMPACT There will be an overspend

RISK The CCG does not secure
enough interest through a local
process to secure provision of
urgent caretaking arrangements as
required
CAUSE pressures in general practice
which could impact their ability to
take on additional contracting
arrangements
IMPACT reduced pool of providers
PCCC4
5 • CCG ensuring each practice has • PCCC 3 15 • Review practice Ian Potter/Ruth
its own business continuity plan • GP risk log which is sustainability through: Waddington
• Engagement with federations to held by PCCC Practice Appraisals
understand their capacity to •Performance and GP Resilience Programme
support development /FP
• Lessons from recent • Link to risk ref: PCCC9
procurement and mobilisation of
caretaking provision to be
captured, to ensure smoother
more timely process for any future

available to offer quality primary requirements.

medical care services • Discussions at PCCC regarding GP
risk log to identify specific
practices where concerns
regarding future sustainbility of
service provision to allow for
earlier intevention and support
and planning.

RISK The relationship with 3 • Locality Development • PCCC 2 6 • Ongoing Ian Potter/Ruth
stakeholders to ensure successful co- • Federation Meetings •Q&P Waddington
commissioning is not maintained • PPG Newsletter • Health Watch
CAUSE lack of clear communication • Practice appraisals/ PE Input
and guidance • CQC and others from LMC and
PCCC5

IMPACT reduced ability to deliver Health Watch

fully delegated function under co-
commissioning arrangements
 RISK Practices in the CCG are placed 5 • Established data triangulation • PCCC 2 10 • Ongoing, reviewed Ian Potter/Ruth
in to CQC Special Measures undertaken for those practices •NHSE quarterly Waddington
following an inspection where issues come to light •CQC
CAUSE practice level issues •Practices included on GP risk log
resulting in an inability to which is refreshed monthly and
demonstrate that services are being shared with NHSE
delivered to satisfactory standards •Quarterly updates to PCCC
PCCC6

across all CQC domains

IMPACT potential contract
termination, remedial action as a
minimum, requirement to manage
press interest and patient
expectations as a result

RISK Reduction in necessary 5 • NHSE requested to attend future • PCCC 2 10 • Ongoing Caroline
information sharing to maintain PCCC public meetings •NHSE Trevithick/Ruth
quality and safety Waddington
CAUSE lack of attendance from
PCCC7

NHSE
IMPACT compromised ability to
resolve significant events,
safeguarding and contractual issues
c
RISK Delayed mobilisation of GP 3 • NHSE requested to attend future • PCCC 3 9 • Ascertain further clarity Ruth Waddington
Resilience Programme by NHS PCCC public meetings •NHSE from NHSE re support
England • CCG considering local leadership available to practices and
PCCC8

CAUSE of the process in collaboration funding attached, and

IMPACT delay in practices receiving with NHSE to mitigate risk of whether CCG can access
rapid intervention; increased further delays the funds to drive the
reliance on CCG to pursue solutions programme forward

RISK Mobilisation of caretaking
arrangements is unsucessful or
incomplete in timescale
CAUSE Delays in apointing
caretaking provider, and issues
arising from subsequent due
PCCC9
5 Lessons learned form recent
mobilisation to be captured to
inform internal contingency
planning to ensure team prepared
for any future exercise.
• PCCC 2 10 • PCCC to receive a paper Ruth Waddington
in July reviewing lessons
learned from recent
caretaking exercise.

diligence.
IMPACT primary care services
unavailable to registered patients,
and associated impact elsewhere in
the system for local practices and
secondary (urgent) care.