Risk Assessments & Risk Matrix

Those of you who know HCPG appreciate that we do not purport to be Health and Safety experts, but we are often asked for an overview on this subject: With the aim of facilitating a better understanding of the process. This then assists you when you then work with experts in this field. Therefore, as requested, an overview in the form of a blog.

If challenged in the event of an actual incident, do your risk assessments support and assist you in evidencing you meet the professional standards and regulations?

Do you know when a RIDDOR report is needed? (Reporting of Injuries, Diseases and Dangerous Occurrences Regulations 2013.) ¹

Does your risk matrix visually illustrate that the changes you have made due to your initial risk assessment have had an impact?

Do you review these assessments on a documented frequency or every time there is an incident? Can you illustrate service changes and shared learnings evolving from any incidents?

There are key aspects which are crucial to consider when looking at how safe is your business and there are many documents to assist this. ²

“For HCPC registered professions: – The overarching HCPC Standards of Conduct, Performance and Ethics ³

Standard 6 for all stipulates all registrants must: –

6. Manage risk: Identify and minimise risk

Each profession has more specific detail e.g., HCPC Standards of Proficiency for Physiotherapists ⁴

Standard 15 stipulates that Physiotherapists must: –

15. Understand the need to establish and maintain a safe practice environment with subpoints 15.1, 15.3,15.4 and 15.5 being particularly important in this area currently being discussed. e.g. 15.4 be able to work safely, including being able to select appropriate hazard control and risk management, reduction, or elimination techniques in a safe manner and in accordance with health and safety legislation.

For physiotherapists: CSP Quality Assurance Standards. ⁵

Standard 2 includes statement:

2.4 There is a systematic, proactive, and responsive approach to risk management that follows the organisation’s overall strategy. Subpoint 4 within this standard specifies the need and actions necessary regarding risk assessments.

For osteopaths, in Standard C Safety and Quality in Practice ⁶ in C5 it states: –
C5. You must ensure that your practice is safe, clean, and hygienic, and complies with health and safety legislation.

For chiropractors Principle A of The Code ⁷ stipulates that chiropractors must out the health interests of their patients first: –
A6: treat patients in a hygienic and safe environment.

When doing risk assessments, remember:-

1 -Use a standard template for consistency and professionalism.
2 -Keep it simple whenever you can. Good risk assessments should include: –

• Description of the hazard/risk
• What is the likelihood of an injury?
• What could be the severity of the injury?
• What is the initial score on the matrix and colour?
• What changes have been made to decrease the risk?
• What is the final score and colour on the risk matrix, ideally this will be reduced considerably, if not ensure there is good, documented evidence to illustrate why this process needs to continue. Does it need to continue?

3 – When will the assessment be routinely reviewed in the event of no incident occurring?

Overview of a risk matrix.
They can vary due to context, but the principles are the same. The illustration below resonates with healthcare and noting a 3-day injury provides an early warning to monitor further; if this continues and exceeds 7 days. It then becomes a RIDDOR1 incident. 

Severity – the seriousness of the potential injury or illness?
Remember. Changing the severity is often deemed reasonably unpracticable therefore focus first on the likelihood.

Likelihood – how likely is the incident to happen?

Using the Matrix.
If we consider an example.
Walking an unsteady patient outside as part of their rehabilitation. It could be deemed not reasonably practicable to cushion whole paths to facilitate walking on different surfaces.

Risk assessment:
Risk of Falling during outside rehabilitation session.
Assessing using a risk matrix without any changes being made.
Severity: Falling to ground = over 3-day injury
Likelihood: Probable
Tracking severity down vertically and likelihood horizontally where do they meet?
Score and colour = Red 12

Think what could you change to decrease the risk?

• Providing a hand or an aid initially to support, could mean the likelihood can be decreased.
• Using an aid could do the same.

Assessing using a risk matrix with any changes being made.
Severity: Falling to ground unchanged = over 3-day injury
Likelihood: Highly unlikely
Tracking severity down vertically and likelihood horizontally where do they meet?
Score and colour = Green 3

The changes made as part of the risk assessment have clearly had an impact on the hazard. The aim is to move as far as possible from the red and into the green.