Appendix 6
Risk Grading Matrix
Instructions for use:
1. Define the risk(s) explicitly in terms of effect of the risk on achieving an objective
2. Use the descriptors below to determine the consequence score (s) for the potential
outcome of the risk occurring) .
3. Use the descriptors to determine the likelihood score(s) for the adverse outcome
occurring .
4. Calculate the risk score the risk multiplying the consequence by the likelihood = risk
score.
5. Identify the level at which the risk will be managed in the organisation, based on the
risk matrix and escalation detailed below
6. Include the risk in the risk register at the appropriate level.
RISK SCORE MATRIX DEFINITIONS (based on NPSA risk matrix model)
Table 1 Severity/Consequence scores
Choose the most appropriate domain for the identified risk from the left hand side of the
table Then work along the columns in same row to assess the severity of the risk on the
scale of 1 to 5 to determine the consequence score, which is the number given at the top of
the column.
Severity/Consequence score (severity levels) and examples of descriptors
1 2 3 4 5
Domains Negligable Minor Moderate Major Catastrophic
Minimal injury Minor injury or Moderate injury Major injury leading Incident leading to
requiring illness, requiring requiring to long-term death
no/minimal minor intervention professional incapacity/disability
intervention or intervention Multiple permanent
treatment. Requiring time off Requiring time off injuries or
work for >3 days Requiring time off work for >14 days irreversible health
No time off work work for 4-14 days effects
Increase in length Increase in length of
Impact on the safety of
of hospital stay by Increase in length hospital stay by >15 An event which
patients, staff or public
1-3 days of hospital stay by days impacts on a large
(physical/psychological
4-15 days number of patients
harm)
Mismanagement of
RIDDOR/agency patient care with
reportable incident long-term effects
An event which
impacts on a small
number of patients
Peripheral Overall treatment Treatment or Non-compliance Totally
element of or service service has with national unacceptable level
treatment or suboptimal significantly standards with or quality of
service reduced significant risk to treatment/service
suboptimal Formal complaint effectiveness patients if
(stage 1) unresolved Gross failure of
Informal Formal complaint patient safety if
complaint/inquiry Local resolution (stage 2) complaint Multiple complaints/ findings not acted
Quality/complaints/audit
independent review on
Single failure to Local resolution
meet internal (with potential to go Low performance Inquest/ombudsman
standards to independent rating inquiry
review)
Minor implications Critical report Gross failure to
for patient safety if Repeated failure to meet national
unresolved meet internal standards
standards
Reduced
performance rating Major patient safety
if unresolved implications if
findings are not
acted on
Short-term low Low staffing level Late delivery of key Uncertain delivery Non-delivery of key
staffing level that that reduces the objective/ service of key objective/service
temporarily service quality due to lack of staff objective/service due to lack of staff
reduces service due to lack of staff
quality (< 1 day) Unsafe staffing Ongoing unsafe
level or Unsafe staffing level staffing levels or
competence (>1 or competence (>5 competence
Human resources/
day) days)
organisational
Loss of several key
development/staffing/
Low staff morale Loss of key staff staff
competence
Poor staff Very low staff No staff attending
attendance for morale mandatory training
mandatory/key /key training on an
training No staff attending ongoing basis
mandatory/ key
training
No or minimal Breech of statutory Single breech in Enforcement action Multiple breeches in
impact or breech legislation statutory duty statutory duty
of guidance/ Multiple breeches in
statutory duty Reduced Challenging statutory duty Prosecution
performance rating external
if unresolved recommendations/ Improvement Complete systems
Statutory duty/
improvement notice notices change required
inspections
Low performance Zero performance
rating rating
Critical report Severely critical
report
Rumours Local media Local media National media National media
coverage – coverage – coverage with <3 coverage with >3
Potential for short-term long-term reduction days service well days service well
public concern reduction in public in public confidence below reasonable below reasonable
confidence public expectation public expectation.
Adverse publicity/
MP concerned
reputation
Elements of public (questions in the
expectation not House)
being met
Total loss of public
confidence
Insignificant cost <5 per cent over 5–10 per cent over Non-compliance Incident leading >25
increase/ project budget project budget with national 10–25 per cent over
schedule per cent over project budget
slippage Schedule slippage Schedule slippage project budget
Business objectives/
Schedule slippage
projects
Schedule slippage
Key objectives not
Key objectives not met
met
Small loss Risk Loss of 0.1–0.25 Loss of 0.25–0.5 Uncertain delivery Non-delivery of key
of claim remote per cent of budget per cent of budget of key objective/ Loss of
objective/Loss of >1 per cent of
Claim less than Claim(s) between 0.5–1.0 per cent of budget
£10,000 £10,000 and budget
£100,000 Failure to meet
Finance including
Claim(s) between specification/
claims
£100,000 and £1 slippage
million
Loss of contract /
Purchasers failing payment by results
to pay on time
Claim(s) >£1 million
Loss/interruption Loss/interruption Loss/interruption of Loss/interruption of Permanent loss of
of >1 hour of >8 hours >1 day >1 week service or facility
Service/business
interruption
Minimal or no Minor impact on Moderate impact on Major impact on Catastrophic impact
Environmental impact
impact on the environment environment environment on environment
environment
Table 2 Likelihood score (L) What is the likelihood of the consequence occurring?
Select the most appropriate likelihood.
Likelihood score 1 2 3 4 5
Descriptor Rare Unlikely Possible Likely Almost certain
This will probably Do not expect it to Might happen or Will probably Will undoubtedly
Frequency
never happen/recur happen/recur but it recur occasionally happen/recur but it happen/recur,possibly
How often might
(i.e. 1 in 100 years) is possible it may do (i.e. 1 in 1 year) is not a persisting frequently (i.e. 1 in 4
it/does it happen
so (i.e. 1 in 10 issue (i.e. 1 in 1 days)
years) month)
Table 3 Risk Score = consequence x likelihood ( C x L )
Likelihood
Consequence 1 2 3 4 5
and score Almost
Rare Unlikely Possible Likely
certain
5 Catastrophic 5 10 15 20 25
4 Major 4 8 12 16 20
3 Moderate 3 6 9 12 15
2 Minor 2 4 6 8 10
1 Negligible 1 2 3 4 5
NB the risk scores are not intended to be a precise mathematical measure of risk.