Ruptura voluntaria

NICE actively considers the risks associated with the achievement of strategic and business objectives. The SMT regularly reviews risk to ensure that appropriate mitigating action is being taken to reduce the risks associated with the achievement of our objectives. The Audit and Risk Committee receives regular assurance on behalf of the Board concerning the identification and management of risks. The main vehicle for this assurance is the risk register but the Audit and Risk Committee also receives reports on significant incidents resulting from unforeseen or unmitigated risks.

The Board receives assurance on these from a number of sources but primarily through the Chief Executive’s regular report. High level risks associated with achieving the 2013-14 business objectives are set out in the Institute’s risk register. These specific operational risks are considered by the Board in the context of the following strategic risks:

Strategic risk Mitigation

1. Changes taking place in the new health and social care system cause the Institute to lose visibility and impact.

As new structures are put in place at national and local levels, although in most cases occupied by current NHS staff, there is a risk that the corporate memory of the detail of what NICE might degrade. And as people move jobs, the personal relationships which are so important in maintaining effective business relationships may be lost. In order to mitigate these risks, we are actively engaging with NHS England and Public Health England, at a

national and a local level, using the partnership agreements we have with in place with them. These agreements set out our respective roles and responsibilities and make clear the commitment of both organisations to use NICE guidance to inform their policy and commissioning functions. NICE executive directors and senior managers meet regularly with their counterparts in NHS England, Public Health England and the other national agencies with which we work, to actively manage our relationships with them. In addition, our Field Team is working directly with their local structures. In addition, we are working with the Care Quality Commission to respond to the standard-setting recommendations in the Francis report.

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Local government is now the primary audience for our public health guidance. We will work to better understand the services and tools it needs to take advantage of public health guidance and the other work from NICE which can use to discharge their service delivery and oversight responsibilities.

All this work is led by the Chief Executive and the Deputy Chief Executive and tracked by the Senior Management Team (SMT) and the Board.

In addition, Non-Executive Directors will continue to connect with their counterparts in other Arms’ Length bodies, to enable relationships to be formed across ALBs, in order to improve consistency and allow for the sharing of ideas and best practise.

2. New programmes added to the Institute’s portfolio strain the available corporate management capacity.

The Institute has grown each year as new programmes have been commissioned from us. We have considerable experience of assessing the resource consequences of additional activity and we do not accept new commissions without being clear about where the funding will come from and that we will be able to deliver the work involved. The concern associated with this risk is that although we are always clear about the direct consequences of new activity, the operational corporate support functions (finance, human resources, IT, facilities, communications) and our governance capacity in the form of the director team may be taken for granted. To mitigate against this, we have a process in place which engages the leaders of the teams involved who are asked to assess the impact on their teams. This is monitored by the SMT.

Existing management capacity is kept under review to sure it is consistent with the recommendations of the Francis Report regarding Workforce Planning and to ensure it can effectively cope with an expanding remit for NICE an extended network of relationships in the new NHS architecture.

The Board is responsible for assessing the impact of programme growth on the director community. It was last reviewed in detail in October 2011 and considered again in March 2013, in advance of the Institute’s transition to becoming a non-departmental public body and it continues to monitor the impact of a broadening range of commissioned work.

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3. We fail to engage sufficiently with social care audiences, including local government compromising the impact of our new social care guidance and standards.

To deal with this, we are engaging actively with social care leadership, involving them in our corporate advisory structures, including the Board, and in the development of individual guidance and standards. We are using the combined resources of our Field Team, and the social care team to promote the value of advice at a local level, with local government and care providers. They are supported by the new social care collaborating centre, a partnership of organisations with extensive knowledge of local government and its social care partners. We have also

established a Social Care External Network, a partnership of over thirty social care organisations, to help shape our engagement with the sector.

We have been working with local government since 2005 when we launched our public health programmes.

Awareness of what NICE can offer local government has been growing slowly since then. With the publication of our first social care guidance and standards, we need to accelerate the process.

Engagement with local government and social care and the support that NICE can give to better integration of health and social care services will feature in the work of the Board throughout 2014/15.

4. Our guidance, standards and

evidence services and the way they are made available are not sensitive enough to changes in the needs of users and so their utility and value for money reduces.

Each of our existing programmes has been carefully developed in conjunction with the people they are designed to support (professionals and patients and service users), and are based on the commission we have received from the Department of Health or NHS England. We are confident at the point of launch that they are fit for purpose. The fact our guidance and other advice are developed by the people who use it, gives us added confidence that it is meeting the needs of the communities from which they come. Nevertheless, we need to ensure that the outputs themselves, the way we present them and the way they are used by our partner organisations remain aligned to the needs of users.

Our partnerships with NHS England and Public Health England will ensure that we are engaged with both the NHS commissioning system and the work of the public health communities. The Field Team provide intelligence on local reaction to our guidance

5. Our position as the preferred provider of guidance and standards is compromised by the development of new analytic capacity in other national agencies in health and social care.

The extent of this risk will only become apparent once the structures and processes in then other main national agencies in health and social care are fully in place. The risk exists because the functions of some of these organisations require access to an interpreted evidence base for a substantial part of their roles and although we can supply much of that, they will inevitably have to create what we can't, or can't immediately offer. Once that capacity for developing evidence-based guidance is in place, setting boundaries around what it does becomes more challenging.

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Our partnership agreements with the national agencies go a considerable way towards mitigating this risk. They set out respective roles and responsibilities and identify the work we do which they will take into account. In addition, the agreements provide the means for uncertainty and disputes to be discussed and resolved. The early experience of this facility is encouraging.

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