risk register complete 5Feb2016 - Risks List - 17/04/2016 1 / 31 Total Review (All) Count of Score WS# Keyword Title Mitigation Progress Owner Control Probabilit y Impact Score Status Total 04 Decant - all 0 Unforeseen Changes in Law - Health and Safety. Potential changes in legislation or new methods. (4.17) No mitigation possible 0 RSB Decant Delivery Group 1 1 1 Open 1 Incoming Trust-supplied services (not Stats) are not completed in line with the programme. Includes BMS, IT & Security final connection points (4.44) Good programme management assumptions clear in phase 4 contract programme RSB Decant Delivery Group 1 1 1 Open 1 Failure to implement agreed decant plan Regular update to 3T’s Programme Board. Regular meeting to update operations team, Executives and Chief’s. Ongoing discussions with individual divisions and services. Operational staff now engaged and a range of solutions are being worked through for the "orphans" although some double decating will now be necessary. Site Logistics Group set up to manage these issues. DP DDG 3 5 15 Open 1 Lack of infrastructure capacity in TKT to cope with additional loads associated with CTYD. LOR to undertake review and report back. Review consequences & options. Permanent solution included within NRB scope. RSB Decant Delivery Group 1 4 4 Open 1 Failure to maintain all services whilst they are decanted is a business continuity risk Regular update to 3T’s programme Board. Regular meeting to update Operations Team, Executives and Chief’s. Ops Team involved in Decant Delivery Group to ensure minimal/no impact on business Mitigation includes detailed operational commissioning plans to be developed. DP Decant Delivery Group 3 4 12 Open 1 04 Decant - all Total 5 5 07 Decant C RSCH FRONT CAR PARK 0 Construction delayed by RPAs inspection and/or non availability of BSUH RPA. Limited specialist resources available. Delay to programme to be compliant (4.20) LOR provided construction programme for FCP, which identifies when RPA access to the site will be required. Trust will then review the proposed plan at each identified point ,identify how long testing would be expected to take and source RPA. RSB Decant Delivery Group 1 2 2 Open 1 Completion of commissioning for radiopharmacy is delayed due to unexpected microbiology results Agree commissioning and performance qualification in advance, and formulate options to outsource elements if licence compromised. To be progressed as part of Delivery Project Team work stream Robert Brown Decant Delivery Group 2 4 8 Open 1 Environment Agency (EA) will not issue licence for radiation safety in accordance with decant designs. Applies to all areas with sealed sources. Note - Handover criteria in LOR contract needs to be confirmed through GMP including allocation of risk. (1.02) Based on other previous projects. Impact can be high cost implications £0-£20,000 and several months delay. Decant Project part of mitigation To be progressed as part of Delivery Project Team work stream Helen Cripps Decant Delivery Group 1 4 4 Open 1 MHRA Sign-off & validation of Aseptic suite. Front Car Park Building may not be able to be used. Note - Handover criteria in LOR contract needs to be confirmed through GMP including allocation of risk. Decant of Nuclear med cannot be achieved Revenue Issue (1.04) Engagement with MHRA To be progressed as part of DeliveryProject Team work stream Helen Cripps Decant Delivery Group 2 4 8 Open 1 Counter Terrorism Security Advisor (CTSA) sign-offs delays Decant project. (3.01) Early engagement, throughout construction phase. To be progressed as part of Delivery Project Team work stream Robert Brown Decant Delivery Group 1 3 3 Open 1 Enabling works disrupt adjacent services (MRI service) through vibration or magnetic interference. Report received for review. South MRI affected and trailer/off- site solution being investigated. Smaller plant solution enables North MRI to be used. On-going discussions with users. Works programmed. Craning of modules complete. Potential risk related to external cladding works and lift instillation. Laura Hodnett Decant Delivery Group 1 4 4 Open 1 Asbestos contamination Barry Building Link - risk of more asbestos than assessed at R&D survey. This cannot be determined by a pre- construction survey until the building is empty. MRI suite after 2000 when use of asbestos products banned. Likelihood very low Survey allowed for in Phase 4 works RSB Decant Delivery Group 2 1 2 Open 1
WS# Ref Title Mitigation Progress Owner Control Probability Impact Cost Score Requires
Attention
21 ICT 28 Continuing alignment with Trust IM&T developments Accept stage D+ design to avoid FBC approval delay Process being managed as part of market testing. Stage D
design accepted
G Steen Programme
Team
4 4 4 16 01/06/2013
26 Workforce
Planning
2 The LTFM and 3Ts FBC assume 3% year-on-year pay cost
efficiencies, and additional capacity at marginal cost (LTFM
assumes 50% of tariff). Risk: the Trust will not be able to
reduce its pay cost base in concert.
Mitigation: an integrated workforce development/CIPs
programme has been approved by the Trust Board, and
some external workforce project funding has been secured.
However investment remains challenging in the context of
‘15/16 financial pressures.
Affordability gap between LTFM and Workforce plans as
projected by bottom up review equates to a significant
revenue gap. New projections will be based on a mix of
bottom up calculations and benchmarking from other high-
performing trusts. External support sourced to undertake
workforce calculations for FBC.External support sourced to
undertake workforce calculations for FBC; and the
mitigation was to use speciality-specific marginal rates to
calculate staffing. Workforce planning post now filled.
Some pressures on timescales remain so this risk increased
Project Ref Title Comments Owner Target Status Total
Workstream
Project name:
Project overview
Project lead
Executive lead
Date completed
Clinician completing QIA
Workforce Impact
Standard
Quality Indicator(s) and
1
Standards (KPIs)
2
3
4
5
Clinical Effectiveness Select
Strong link to best practiceyes
Link to best practice
Some links to best practice
Poor or no links to best practice
Patient Safety
Safe with no risk harm
Generally safeyes
Pockets unsafe
Generally unsafe
Patient experience
A good patient experienceyes
Generally a good experience
Pockets of poor experience
Generally poor experience
Overall risk score
Medical Director
Director of Nursing
QIA Check up Review
00/00/2014
Exec
Lead
Approve
d
Yes
Yes
Check up comments (for minor
points to note)
- Patient Experience - delivery of locally based treatment of patients and provision of comprehensive
treatment regimens - % of patients receiving IMRT and IGRT therapy.
Brighton and Sussex University Hospitals NHS Trust
CIP Assurance Review
Quality Impact Assessment (QIA)
The 3Ts hospital redevelopment programme will deliver marked improvements for patients across a range of health services, replacing all of the
buildings along the front of the RSCH site with two new state-of-the-art facilities. To ensure the continuity of service to patients the redevelopment will
be undertaken in stages. This will allow many services to stay in situ until their new accommodation is complete, although some will have to move to
temporary accommodation. Inpatient accommodation- The 3Ts project will replace and improve the inpatient accommodation offered in the Barry and
Jubilee buildings. Wards in these buildings are too cramped, with only 5% of patients having individual rooms. There are too few toilets and bathrooms
and a dire lack of storage for important equipment. The layout of the wards, necessitated by the building design, hampers effective nursing.
Anna BarnesDuane Passman
Stephen Drage
KPI level
Patient Experience and Outcomes - % of patients receiving first radiotherapy treatment within 31-
days (national target), and within 14 days for urgent patients e.g. head & neck cancers as per best
practice.Patient Experience and Outcomes - % of patient receiving subsequent radiotherapy treatment within
31-days (national target), and within 14 days for urgent patients e.g. head & neck cancers as per best
practice.
Operational efficiency - increased throughput and productivity and increased capacity at Sussex
Cancer Centre - utilisation rates - number of fractions delivered at Sussex Cancer Centre
Mitigation to address risk, where score is above 1
Operational efficiency - reduction in cancellations due to unplanned downtime
Supporting evidence
0
See 3Ts bibliography which contains over 300 references to best practice and evidences the benefits within the
Management Case (for instance the data on quicker recovery rates due to improved sleep quality, reduced patient
moves and improved staff morale). The attached risks from the risk register show the read across to the 3Ts risk
register which contains appropriate mitigations if some of these benefits do not materialise.
Supporting evidence
1
There have been discussions within course of the QIA about the impact of 3Ts on nursing practices because of the
ergonomically designed wards and the associated efficiencies. However, 1 factor has given rise to concern within the
monetised efficiencies: the impact of single rooms on patient safety (specifically risk of falls) because of reduced
observations (which has meant that any monetised efficiencies been removed). This risk has been mitigated by the
design of the single rooms with the provision of handrails from the bed to the en-suite bathrooms. Moreover,
examples of nursing in single rooms elsewhere do not substantiate these fears. However we recognise that there is
more work to do within the modernisation programme to familiarise staff with the new ward environment.
Supporting evidence
1
The 3Ts development will provide a much improved patient experience in all areas of the development. We have
made a small allowance of 633 square metres of floor area for private patient facilities within the new development
(representing 0.68% of the total planned floor area), but not bed capacity. However there could be an increase in
demand for private facilities generated by the increase in single rooms with en-suite across the development. There is
scope to meet this demand which will be considered a) if there is sufficient capacity at the time and b) of no NHS
patients are clinically disadvantaged. Clinical need will therefore continue to dictate which patients are admitted and
will override financial considerations. Any money generated from private patients would be reinvested to directly
benefit NHS patients.
1`
See above that clinical need must remain the chief reason for admission.
Review and sign-off
Sign off Approve Date
Insert eSignature and Name
Insert eSignature and Name
Are project actions as per original plan and no additional Quality, Safety or Was this QIA re-
Comment
Please see attached templates with signatures and the letter.
Check up date
Has original QIA been reviewed and score still reflective of original Exec Lead Approval Date
Quality Impact Assessment
Project referenceN/A Clinical Lead
Project title3Ts Financial Lead
Project Manager / Programme ManagerDuane Passman (Director of 3Ts) Business Support
Likelihood 1 - Almost never; 2 - Unlikley; 3 - Likely; 4 - Highly likely; 5 - Almost certain.
Controls in place (Mitigating actions)Impact
(1 - 5)
Likelihood
(1 - 5)
Overall Rating (Impact x
Likelihood)
Flexibility of design so building can be adapted for appropriate use over time
3 2 6
Negotation of contract with hard FM provider
4 3 12
Demand management strategies across health economy in partnership with commissioners
2 3 6
Flexibility of design so building can be adapted for appropriate use over time
3 4 12
Contingency to be included and sensitivities within financial model.
2 3 6
Robust business plan in conjunction with commissioners.
2 3 6
Robust business plan in conjunction with commissioners & LTFM modelling.
2 5 10
Date
Date
Date
Incorrect estimated cost of maintenance/Deterioration of building fabric or M&E caused by inadequate maintenance regime. Additional cost for the Trust. (risk register ref 10/9 & 11/12)
Stephen Drage
Paresh Patel
Mark Frake
Description of Scheme
The 3Ts hospital redevelopment programme will deliver marked improvements for patients across a range of health services, replacing all of the buildings along the front of the RSCH site with two new state-of-the-art facilities. To ensure the continuity of service to patients the redevelopment will be undertaken in stages. This will allow many services to stay in situ until
their new accommodation is complete, although some will have to move to temporary accommodation.Inpatient accommodation- The 3Ts project will replace and improve the inpatient accommodation offered in the Barry and Jubilee buildings. Wards in these buildings are too cramped, with only 5% of patients having individual rooms. There are too few toilets and
bathrooms and a dire lack of storage for important equipment. The layout of the wards, necessitated by the building design, hampers effective nursing.
- Patient Experience - delivery of locally based treatment of patients and provision of comprehensive treatment regimens - % of patients receiving IMRT and IGRT therapy.
- Patient Experience and Outcomes - % of patients receiving first radiotherapy treatment within 31-days (national target), and within 14 days for urgent patients e.g. head & neck cancers as per best practice.
- Patient Experience and Outcomes - % of patient receiving subsequent radiotherapy treatment within 31-days (national target), and within 14 days for urgent patients e.g. head & neck cancers as per best practice.
- Operational efficiency - increased throughput and productivity and increased capacity at Sussex Cancer Centre - utilisation rates - number of fractions delivered at Sussex Cancer Centre
- Operational efficiency - % reduction in cancellations due to unplanned downtime
Description of Area of Concern / Risk
Trust changing brief, operational policies, departmental policies through the process. Statutory requirements change brief. NHS changes over the 10 years. ( risk register ref 10/13)
Approved by Director of Nursing Sherree Fagge
3Ts building being too small (If CIPs don’t deliver LOS reductions and growth is above 0.5% NE and 1% Elective then 3Ts will require additional capacity). Bed model seems to be based on 100%
delivery of all assumptions (risk register ref 11/20)
Response to flexibility policy not accepted. (Adapting services & building - future-proofing) Additional cost and redesign (risk register ref 10/16)
Changes in the volume of demand for client services: Increased cost / inefficient use of resources. Change to FBC assumption (risk register ref 11/9)
Unexpected changes in medical technology (Unexpected changes in medical technology may lead to a need to rescale or reconfigure the provision of services) (risk register ref 11/10)
Volume and case mix of activity estimated incorrectly to support services (the level of activity assumed in workforce and service planning is significantly greater than that used in the
assumptions) (risk register ref 11/17)
Quality Impact Assessment Summary
- The development of 3Ts supports the needs of the local and regional patients.
- The new facility has got strong links to best practice and will provide treatments of the highest quality to our patients
- The service will be located in a safe working environment that carries minimal risk of harm to patients, their carers, visitors and staff.
- The unit will be operated in line with the existing policies and procedures and will be supported by experienced and competent staff.
- The unit will offer a good patient experience and deliver good patient outcomes.
- The benefits of the project will be assessed with measurable outcomes.
Approved by Clinical Director/Clinical Lead Stephen Drage
24 Trust do not vacate all of site in a timely manner as part of the
decant leads to delay to start of construction, cost of inflation,
increased duration of decant and associated costs. (Main issue
is nuclear med). Additional transition costs (Revenue) (Note
closed on Trust PPT - now an issue, remains here for
contingency)
Joint risk mitigation meetings. ( Site Logistics
Group).Mitigation includes liaison with Trust operational
staff to ensure any further delays are prevented, and there
is clear accountability regarding who has the authority to
cease decant construction
Partial site handover is being planned in order to
control impact. Query impact to be reduced in
February 2016.
DP
Pro
gra
mm
e
Bo
ard 5 5 25 Open 1
10
De
sig
n P
roce
ss 1 94 Risk of aspergillus to immuno compromised patients
exacerbated by the impact of construction on the RSCH site.
Impact on decant programme caused by delay whilst mitigations
are identified.
Review of evidence from other construction sites and
further testing as work on site progresses.
Liaison with Infection Control for appropriate
mitigation measures. Also include a joint
(Trust/PSCP) review of all associated construction
risks, reviewing all potential hazards with agreed
mitigations, for sign-off by all parties. Policy
awating ratification in November 2015.Risk
reduced following discussions. Joint Statement has
been included in contract between LOR and
BSUH re mitigations.
Duane Passman
Pro
gra
mm
e B
oa
rd 4 5 20 Open 1
11
Tru
st B
usin
ess
Co
ntin
uity 23 Failure to pay contractor on time Mitigation includes setting up a purchase order, and ring
fenicng 3Ts budget for use exclusively by 3Ts
0 DP
Pro
gra
mm
e B
oa
rd,
Pro
ject T
ea
m, L
oca
l
He
alth
Eco
no
my
Bo
ard
LH
E a
tte
nd
an
ce 4 5 20 Open 1
14
De
sig
n P
roce
ss M
ain
Sch
em
e
2 55 There is a risk that stakeholders within the Trust are unsatisfied
with the construction, demolition, excavation and any other
method statements applicable causing significant delay to
construction.
Identify and manage key stakeholders - clear
authorisation
Mitigation includes early identification of key stakeholders
and formal sign off of method statements.
Various meetings held with clinical ops staff to
identify and progress mitigation strategies. Clear
authorisation for works on site, or any requests to
cease work on site is also imperative. Preparatory
work is underway on the identification of these
issues and detailed work is about to start in the
development of the risk and method statements;
Site Logistics Group has been set up to work
through these issues in more detail.
DP
MS
DG 4 5 20 Open 1
16
P2
1+
GT
hp
s 8 Stage 3 Approvals and Contracts not implemented in time
leading to delayed design deliverables
P21 Stage 3 contracts to be finalised asap and design
team instructions issued. Trust to formally confirm
budget in writing whilst paperwork is put in place
0 Trust 0 4 5 20 Open 1
11
Tru
st B
usin
ess
Co
ntin
uity 19 Site electrical Infra-structure is inadequate Infrastructure requirements now identified and
replacement timescales. NRB wil provide additional
capacity for electrical loads.
Allowance made in the Trust’s Operational Capital
programme for 2014/15 which was approved by
TBoD on 31/03/14 with additional monies coming
from 3Ts to cover off the Courtyard electrical
loading requirements. Plans for a revised British
Gas solution for energy provisions is being brought
into line with 3Ts Energy Centre plans to ensure a
smooth transition through the work phases.
DP
Pro
gra
mm
e B
oa
rd 4 4 16 Open 1
12
Ma
in
Sch
em
e
Ca
pita
l
6 Failure to sign up partner Trusts / Medical School /CCG to the
brief
Work with Partners - Medical School and CCGs Negotiations with BSMS close to fruition re
financial settlement for the cost of this space.
DP
Re
se
arc
h &
Ed
uca
tio
n G
rou
p 4 4 16 Open 1
12
Ma
in S
ch
em
e
Ca
pita
l
30 Prudential Borrowings used as procurement route instead of
Public Dividend Capital could add £15.6m to CIPs programme
over next 10 years and have an adverse effect on Trust’s
liquidity position e.g. loan with 40 year repayment term would
create an overdraft of £44m by 2022/23
Ensure borrowing is under best possible terms for BSUH Discussions with DH have focused on the
availability of Public Dividend Capital as a
preference. Final mix of PDC/PBL will be a key
aspect of FBC approval. Conditions of approval
letter describe this in more detail and are under
negotiation.
DP
Pro
gra
mm
e B
oa
rd 4 4 16 Open 1
14
De
sig
n
Pro
ce
ss M
ain
Sch
em
e 2 53 Interfaces/impacts from other projects on site during Decant -
Trust/PFI/utilities contractors / capital works (LOR, Willmott
Dixon infrastructure, Children's hospital, audiology) - Leads to
delay. (piling and ground anchors, leads to interference on other
projects and start claims)
Interface planning tool required to track complexities
ocross the site.
Initial meeting held with Estates team across
BSUH to begin to track interdependencies.
Development control plan in existence and
regulary updated.
DP 0 4 4 16 Open 1
14
De
sig
n
Pro
ce
ss
Ma
in
Sch
em
e 2 12 80 temporary car parking spaces will need to be provided during
the construction period away from the RSCH site. Discussions
with the council have yet to yield a satisfactory outcome for this
issue.
The council are now engaged in working with us to
secure a resolution including possible off site parking.DP
to continue discussions as SG has now left BSUH.
DP in discussions with B&HCC re relocation of
SMH tennis courts and provision of additional
parking there.
DP
Pro
gra
mm
e B
oa
rd 4 4 16 Open 1
21
IC
T 28 Continuing alignment with Trust IM&T developments Accept stage D+ design to avoid FBC approval delay Process being managed as part of market testing.
Stage D design accepted
G Steen
Pro
gra
mm
e
Te
am 4 4 16 Open 1
26
Wo
rkfo
rce
Pla
nn
ing 2 The LTFM and 3Ts FBC assume 3% year-on-year pay cost
efficiencies, and additional capacity at marginal cost (LTFM
assumes 50% of tariff). Risk: the Trust will not be able to reduce
its pay cost base in concert.
Mitigation: an integrated workforce development/CIPs
programme has been approved by the Trust Board, and
some external workforce project funding has been
secured. However investment remains challenging in the
context of ‘15/16 financial pressures.
Affordability gap between LTFM and Workforce
plans as projected by bottom up review equates to
a significant revenue gap. New projections will be
based on a mix of bottom up calculations and
benchmarking from other high-performing trusts.
External support sourced to undertake workforce
calculations for FBC.External support sourced to
undertake workforce calculations for FBC; and the
mitigation was to use speciality-specific marginal
rates to calculate staffing. Workforce planning post
now filled. Some pressures on timescales remain
so this risk increased
Helen Weatherill/ Spencer
Prosser HM
B 4 4 16 Open 1
04
De
ca
nt -
all 6 Failure to implement agreed decant plan Regular update to 3T’s Programme Board.
Regular meeting to update operations team, Executives
and Chief’s.
Ongoing discussions with individual divisions and
services.
Operational staff now engaged and a range of
solutions are being worked through for the
"orphans" although some double decating will now
be necessary. Site Logistics Group set up to
manage these issues.
DP
DD
G 3 5 15 Open 1
11
Tru
st B
usin
ess C
on
tin
uity 22 Commissioners cannot afford scheme (changes in the size and
allocation of resources for health care) which undermines FBC
Mitigating this risk would include a regular
updates/commissioning interface to confirm costs and
affordability as the scheme progresses. There is also a
need to ensure that the scheme kept to its brief and that
there are robust plans in place to ensure that BSUH's
efficiency programme delivers its savings and to see if
more savings can be delivered above those already
identified.
Commissioning support requires further
discussions and negotiations via Commissioner
Oversight Forum and National Programme Board.
Downside scenarios have been outlined within
FBC and now require further modelling.
DP
Pro
gra
mm
e B
oa
rd, P
roje
ct
Te
am
, L
oca
l H
ea
lth
Eco
no
my B
oa
rd L
HE
atte
nd
an
ce 3 5 15 Open 1
11
Tru
st
Bu
sin
ess
Co
ntin
uity 13 Unclear requirements from NHS England a for instance changes
to NHS Outcomes Framework.
Gain certainty from CCG and partner organisations e.g.
NHS England Area Team.
Ongoing dialogue with CCGS. Commissioner
Oversight Forum has been established as well as
National Programme Board.
DP
Pro
gra
m
me
Bo
ard
5 3 15 Open 1
12
Ma
in S
ch
em
e
Ca
pita
l
1 Support with transitional costs is withdrawn Transitional costs have been agreed with commissioners
to be funded by 2% top slice. Invoice has been raised for
2014/2015 and monies received
Ongoing support with transitional costs requires
confirmation as part of FBC approval process
DP/SP
Co
mm
issio
ne
r
Ove
rsig
ht F
oru
m a
nd
Na
tio
na
l P
rog
ram
me
Te
am
.
3 5 15 Open 1
14
De
sig
n P
roce
ss M
ain
Sch
em
e 2 10 Vibration disruption to linacs during construction of stage 1 Investigations have been undertaken to determine
impact.WSP report has been reviewed and the
methodology has been outlined for Trust to decide on
relocation or additional measures. Review what the
agreed level is (statutory limits)
Workshop held 10th April, Notes issued April 14th
Trust subsequently providedwith Royal London
acoustic solution details, with the following
response (and current holding position) received:
As discussed at our meeting on 10th April 2015,
we will be undertaking the recommendations of the
3 reports produced by WSP: Assessment of
Potential Vibration Impacts on Sensitive Equipment
within the LINAC Bunkers, Barry Building and the
Front Car Park Modular Units, which also
references BS5228.
By following the recommendations from the well-
researched reports and using modern, well
maintained noise-efficient and silenced plant, we
are confident that the noise and vibration can be
controlled and maintained at acceptable levels.
We would not anticipate utilising the level of
acoustic shielding used at Royal London Hospital,
which is not included in the current cost plan.
Comms plan required to communicate mitigation
strategy with staff.
DP
MS
DG 3 5 15 Open 1
14
De
sig
n
Pro
ce
ss
Ma
in
Sch
em
e 2 28 Sign off not achieved to programme dates. 1:50 non-standard
rooms. Additional comments provided after programme sign off
date. Leads to increased time and cost of design and
construction.
Clear programme management On programme DP
MS
DG 3 5 15 Open 1
16
P2
1+
GT
hp
s 7 Proposal for BREEAM Very good not accepted by planners Clear statement required pre agreement to be sought
from planners as part of early consultation process
0 Trust 0 3 5 15 Open 11
6
P2
1 +
GT
h ps 11 Statutory approvals not received Early identification of Statutory bodies that need to
provide approval required
0 Trust 0 3 5 15 Open 1
16
P2
1+
GT
hp
s 26 Design team unable to meet the required timescales to deliver
ntbec and gmp.
Ensure reources identified, deliverables and programme
defined and budgets confirmed and agreed to meet key
deadlines
closed at GMP submission Galiford Try 0 3 5 15 Open 1
16
P2
1 +
GT
h ps 30 Programme benefits from using modular construction do not
materialise
Meet with suppliers to validate programme assumptions
and seek references
0 Trust 0 3 5 15 Open 1
16
P2
1 +
GT
h ps 52 Design not coordinated at GMP; post GMP design development Design management required and contingency closed at GMP, allocations included in Stage 4
GMP
Galiford Try 0 3 5 15 Open 1
16
P2
1 +
GT
h ps 51 Poor ground conditions during construction discovered resulting
in additional foundation works
SI to be undertaken in areas of ground works 0 Trust 0 3 5 15 Open 1
16
P2
1 +
GT
h ps 76 Errors in GMP Pricing - incl work packages / BQ erros Engagement of specialist health PQS for BQs. 0 Galiford Try 0 3 5 15 Open 1
16
P2
1+
GT
hp
s 66 Estimated project budget is insufficient to provide required levels
of new accommodation
Develop design to the budget and manage expectations
without compromising clinical effectiveness of final design
0 Trust 0 3 5 15 Open 1
16
P2
1+
GT
hp
s 73 Preferred design exceeds budget at GMP Ongoing cost planning and review; ongoing VE 0 Trust 0 3 5 15 Open 1
16
P2
1+
GT
hp
s 83 The Trust and PSCP Commercial teams fail to integrate Ensure engagement and understanding of common goals
and critical success factors and take open book approach
0 Trust 0 3 5 15 Open 1
04
De
ca
nt -
all 9 Failure to maintain all services whilst they are decanted is a
business continuity risk
Regular update to 3T’s programme Board.
Regular meeting to update Operations Team, Executives
and Chief’s.
Ops Team involved in Decant Delivery Group to ensure
minimal/no impact on business continuity.
Mitigation includes detailed operational
commissioning plans to be developed.
DP
De
ca
nt
De
live
ry
Gro
up 3 4 12 Open 1
08
De
ca
nt
D&
E 5
45
&P
CA
BIN 6 Increase in design and works cost because of lack of drawn up
SOA
SoA issued and 1:100 GA produced, so risk now more
about change in brief.
0 RSB
De
ca
nt
De
live
ry
Gro
up 3 4 12 Open 1
10
De
sig
n
Pro
ce
ss
1 16 Response to flexibility policy not accepted. (Adapting services &
building - future-proofing) Additional cost and redesign (1.06)
0 On programme. LOR to respond to BSUH. 0 0 3 4 12 Open 1
10
De
sig
n
Pro
ce
s
s 1 20 Warrantees to the adjacent SPV for the children's' hospital,. Negotiation with Kajima Information on ground anchors has been provided DP
Pro
gra
mm
e
Bo
ard 3 4 12 Open 1
10
De
sig
n
Pro
ce
ss 1 10 The Employer instructs the cessation of construction activities
that are being carried out within the noise, vibration and dust
levels defined in the Works Information.
Check control measures allowed for in GMP (some
booths move into the annex).
Review report from WSP on ENT building - adjust values
if necessary
On programme DP
Pro
gra
mm
e
Bo
ard 4 3 12 Open 1
10
De
sig
n
Pro
ce
ss 1 11 A statutory authority and/or utility provider does not work within
the times shown on the Accepted Programme
Trust to consider letting an enabling works contract
separately and early
Check Stat Auth works in Main Scheme, timescales and
who will be placing orders. PR to liaise with LO'R.
On programme DP/PR
Pro
gra
mm
e
Bo
ard 3 4 12 Open 1
11
Tru
st
Bu
sin
es s
Co
ntin
ui
ty 12 Incorrect estimated cost of maintenance Contingency to be included Maintenance costs in FBC benchmarked within
expected range of peer group.
DP 0 4 3 12 Open 1
11
Tru
st
Bu
sin
ess
Co
ntin
uity 14 Reconfiguration of local Health Economy/ CCGs priorities and
impact of required efficiencies
Ensure strategic fit with emerging commissioner priorities. Dialogue with commissioners and TDA is positive.
Mitigations to the construction programme are
being worked through and discussed with
commissioners.
DP
LH
C S
EG 3 4 12 Open 1
11
Tru
st
Bu
sin
es s
Co
ntin
ui
ty 16 Adverse impact of needs of other CCG funded projects Build in contingency. Liaison with other projects BSUH fully engaged in whole health economy
planning.
DP 0 3 4 12 Open 1
11
Tru
st
Bu
sin
ess
Co
ntin
uity 11 Changes in commissioning intentions re activity/repatriation. Dialogue across the Sussex Cancer Network & with
commissioners
Risk increased because of national changes to
clinical networks which may affect the service
configuration
DP
Pro
gra
m
me
Bo
ard 3 4 12 Open 1
11
Tru
st
Bu
sin
ess
Co
ntin
uity 15 Adverse impact of needs of other Trust projects such as site
reconfiguration or Clinical Strategy.
Build in contingency and sensitivity within financial model Programme management strategies have been
adopted across 3Ts & Estates /Facilities
DP
Pro
gra
m
me
Ma
na
ge
m
en
t
4 3 12 Open 1
12
Ma
in
Sch
em
e
Ca
pita
l
16 Response to flexibility policy not accepted. (Adapting services &
building - future-proofing) Additional cost and redesign (1.06)
0 0 DP
Pro
gra
mm
e
Bo
ard 3 4 12 Open 1
12
Ma
in
Sch
em e
Ca
pita
l
4 Capital Costs / Equipment Draw up accurate equipment list on agreed 1:50s Additional procurement resource now available DP
Pro
gra
mm
e
Te
am 3 4 12 Open 1
12
Ma
in
Sch
em
e C
ap
ita
l
8 Associated or adjacent projects insufficiently 'joined up' Ensure Trust provides overview strategy and control and
co-ordination across projects
Increased complexity of diverse capital projects
across RSCH reflected by this rating. Portfolio
management being discussed via work being
undertaken by J Nerney.
DP
De
ve
lop
me
nt o
f
Inte
rim
Str
ate
gy 3 4 12 Open 1
12
Ma
in S
ch
em
e
Ca
pita
l
9 Estimated income from income generating schemes is incorrect Contingency to be included and sensitivities within
financial model. Appropriate marking required
FBC activity modelling is in process. DP
Pro
gra
mm
e B
oa
rd,
Pro
ject T
ea
m, L
oca
l
He
alth
Eco
no
my B
oa
rd
LH
E a
tte
nd
an
ce 3 4 12 Open 1
12
Ma
in
Sch
em
e
Ca
pita
l
13 Change in requirements of the NHS trust. The NHS trust may
require changes to the design, leading to additional design and
construction costs. FBC delay or reduced efficiency.
Keep change register and issues log fully up to date. Robust change policy in place for design process DP
Pro
gra
mm
e B
oa
rd 3 4 12 Open 1
14
De
sig
n
Pro
ce
ss
Ma
in
Sch
em
e 2 7 Failure to translate operational policies into design Robust FBC process incl design briefs & generation of
ADB sheets in conjunction with users
User involvement via 1:200 and 1:50 processes
required to mitigate this risk.
DP
Pro
gra
mm
e T
ea
m 4 3 12 Open 1
14
De
sig
n
Pro
ce
ss
Ma
in
Sch
em
e 2 19 Status and risk of future changes with Building Regs and
Building Control. (3.23)
Determine what building regs will apply and when the
building regs application is submitted
LOR to advise DP
MS
DG 4 3 12 Open 1
14
De
sig
n
Pro
ce
ss
Ma
in
Sch
em
e 2 8 Failure to design to brief (3.02) Manage Architects and end users. Ensure design
requirements are explicit within brief
Robust change process in place (stage D/stageE
processes).
Gary Speirs
MS
DG 3 4 12 Open 1
14
De
sig
n
Pro
ce
ss
Ma
in
Sch
em
e 2 40 Construction Inflation increasing beyond estimation in FBC after
the initial 2 years. Excludes VAT. Leads to increased cost
outside GMP.
INFLATION RISK IS ACCOUNTED FOR OUTSIDE THE
RISK REGSITER
After initial 2 years - agree packages fixed for another 2
years. Or review at stages
Construction inflation fixed for Stage 1. Stages 2
and 3 subject to a review process.
DP
MS
DG 4 3 12 Open 1
21
IC
T 29 Inadequate funds for IM&T requirements Inadequate funds for
IM&T density requirements
the mitigation includes identifying the IM&T requirements
throughout each planning stage and iteration
0 G Steen
Pro
gra
mm
e
Te
am 4 3 12 Open 1
24
Sta
ke
ho
lde
r
su
pp
ort 20 Impact of contruction. There is a risk that stakeholders outside
the Trust are unsatisfied with the construction, demolition,
excavation and any other methodologies applicable for the
delivery of the works as described in the Method Statements,
Identify and manage key stakeholders including local
residents. Clear lines of communication with local
residents and other key stakeholders. Adherence to
CEMP
0 R Beard 0 3 4 12 Open 1
24
Sta
ke
ho
lde
r
su
pp
o rt 5 Planning submission and interplay with local stakeholders re
traffic
Increased liaison with B&HCC 0 DP 0 3 4 12 Open 1
26
Wo
rkfo
rce
Pla
nn
ing 4 Operational policies for 3Ts may not have been developed in
sufficient detail to enable workforce implications to be
identified.The impact of new physical designs of workforce
requirements/costs (eg. significant increase in
spacing/distances, and in particular proportion of single inpatient
rooms) may have been underestimated.
Robust FBC process incl design briefs & generation of
ADB sheets in conjunction with users.There are ongoing
discussions about Trust-wide Workforce Plans (closing
the LTFM/Workforce Plan CIPs gap, three-year rolling
CIPs plans for workforce which will be summarised in a
single PID
PB discussion regarding difficulty in progressing
this workstream raised this risk
Gary Speirs
Pro
gra
mm
e T
ea
m 4 3 12 Open 1
26
Wo
rkfo
rce
Pla
nn
ing 5 3Ts significantly increases capacity in some of the harder-to-
recruit specialties (eg. general- and neuro-Critical Care). The
Trust-wide Recruitment & Retention and workforce development
strategies may not bridge this gap (sufficiently, or in time) eg
difficulty in recruiting to assistant practitioner role as specified
within 3Ts workforce plans
Role redesign may be required the Trust’s education commissioning requirements
for the academic year 2013/2014 have been
submitted. This includes increases in commission
numbers for both Diagnostic and Therapeutic
Radiography and also for entrants on to the
Scientist Training Programme in Medical Physics.
The Trust has also set out a plan to reinstate
secondment commissions for the nursing and
midwifery programmes at the University of
Brighton.PT discussion regarding difficulty in
funding this workstream raised this risk
0 0 4 3 12 Open 1
32
Ma
in
Sch
em
e
Eq
uip
m
en
t
1 Access routes and weight loadings for large equipment. Under review with LoR and key equipment suppliers to
quantify.
0 DV/JM 0 3 4 12 Open 1
32
Ma
in
Sch
em
e
Eq
uip
me
nt
2 Time and resource limitation Look to identify when additional resource is likely to be
needed, and how this could be effectively commissioned
and financed. Escalate as necessary. Outsource to MTS if
necessary.
Staff now in place so risk reduced. DV 0 3 4 12 Open 1
32
Ma
in
Sch
em
e
Eq
uip
me
nt
6 Delay to equipment delivery (Group 2, 3) and installation (Group
3, 4). Minor quantity of transferred kit. Caused by Trust delays.
Leads to programme delays in construction and / or operational
commissioning
Set up monitoring processes to track progress with
selection, ordering and delivery of equipment.
0 0 0 3 4 12 Open 1
34
Ma
in
Sch
em
e P
21
De
live
ry 1 Third party insurance claims (Public Liability) on adjacent
properties (Children's hospital, neighbours) caused by
construction. Cost may be covered with insurance apart from the
excess amount.
Design Temporary works and perm works. Monitor
throughout, minimise movement. LOR have confirmed
this is insured. £10k excess each party. £25k excess for
works. Surveys to adjacent properties carried out in
advance
Movement monittoring measures in place and risk
control measures have been introduced. Will need
regular review.
PSCP
PS
CP 4 3 12 Open 1
16
P2
1+
GT
hp
s 2 Reputational damage (internally and externally) through poor
communication, lack of benefits realisation, not meeting
programme
Benefits realisation being reviewed through FBC process
and risk and benefits meeting to be arranged.
Programme critical to 3T's project + reputation,
deliverables need active management and expectations
need to be managed.
0 Trust 0 3 4 12 Open 11
6
P2
1 +
GT
h ps Stakeholder list to be reviewed to ensure completeness 0 Trust 0 3 4 12 Open 1
16
P2
1+
GT
hp
s 53 Part L Building reg compliance - as part of obtaining renewable
contribution to the 10% Part L requirement - design requires
connection to site wide strategy - risk of not obtaining Part L
approval due to this failure
Design assumes connection to Trust plant therefore Part
L not achievable without reliance on Trust plant. Steam,
IT and Water are being picked up from the Trust. Model
and initial calculations completed and Part L and
BREEAM Very good acheivable with LED Lighting
provision?
0 Trust 0 3 4 12 Open 1
16
P2
1 +
GT
h ps 56 Delay to input from preferred suppliers impacts on design of
interfaces
MTX, Generator etc 0 Trust 0 3 4 12 Open 1
16
P2
1+
GT
hp
s 71 Sub-contractor Insolvency Assessments of financial stability of s/c's 0 Galiford Try 0 3 4 12 Open 1
16
P2
1+
GT
hp
s 77 Variations to P21+ contract may not be approved or agreed Ensure appropriate governance in place and clarity of
scope and brief so that variation are clear. Work together
to clearly define changes in scope and impact.
0 Trust 0 3 4 12 Open 1
16
P2
1+
GT
hp
s 59 Discovery of unknown artifacts of archaelogical importance No survey required for this site. No history of this on the
site and site area partiual used during Trust's Phase 1
development in the 1990's
0 Galiford Try 0 3 4 12 Open 1
16
P2
1 +
GT
h ps 57 Risk of the current infrastructure not complying with current
regulations - building regs, HBN's/HTM’s
RDS and layouts developed and reviewed and
derogations discussed
0 Trust 0 3 4 12 Open 1
16
P2
1+
GT
hp
s 58 Discovery of unknown asbestos and Knott Weed as works
proceed, and subsequent management
PSCP to include allowance in GMP based on
Management surveys - assumptions. This risk is for
s 61 Additional building remedial works required Cost plan will assume structure is in fit condition, local
surveys required to confirm scope
0 Trust 0 3 4 12 Open 1
16
P2
1 +
GT
h ps 81 P21+ Stage 4 not in place in timely manner; leaving project on
hold
P21+ Standard Framework contracts used 0 Galiford Try 0 3 4 12 Open 1
16
P2
1 +
GT
h ps 80 P21+ Stage 3 not in place in timely manner; leaving project on
hold
P21+ Standard Framework contracts used 0 Trust 0 3 4 12 Open 1
16
P2
1+
GT
hp
s 85 Planning conditions result in additional works / scope to the
project resulting in additional cost
Close liaison with Planners to understand potential
conditions and their impact and accommodate in the
design
0 Trust 0 3 4 12 Open 1
16
P2
1 +
GT
h ps 92 Costs of discharging planning conditions exceed allowances Enagage with LPA to identify requirements early and
make suitable allowances
0 Trust 0 3 4 12 Open 1
35
De
ca
nt
PS
CP
(LO
R)
2 45 That there may be unforeseen interface / scope gaps within the
design flowing from the Phase 3 stand down and remobilisation
process.
LOR Design Manager to manage design process and
identify all potential design development issues.
0 LOR
De
ca
nt
De
live
ry
Gro
up 4 3 12 Open 1
35
De
ca
nt
PS
CP
(LO
R)
2 49 That there may be additional cost implications flowing from
detailed design development at Phase 4.
LOR Design Manager to manage design process and
identify all potential design development issues.
0 LOR
De
ca
nt
De
live
ry
Gro
up 4 3 12 Open 1
08
De
ca
nt
D&
E 5
45
&P
CA
BIN 8 Risk of aspergillus to immuno compromised patients
exacerbated by the impact of construction on the RSCH site.
Impact on decant programme caused by delay whilst mitigations
are identified.
Review of evidence from other construction sites and
further testing as work on site progresses.
Liaison with Infection Control for appropriate
mitigation measures.
Duane Passman
De
ca
nt
De
live
ry
Gro
up 2 5 10 Open 1
11
Tru
st B
usin
ess C
on
tin
uity 17 Volume and case mix of activity estimated incorrectly to support
services
Robust business plan in conjunction with commissioners
& LTFM modelling has taken place.
Robust business plan in conjunction with
commissioners & LTFM modelling has taken
place.
DP
Pro
gra
mm
e B
oa
rd, P
roje
ct
Te
am
, L
oca
l H
ea
lth
Eco
no
my B
oa
rd L
HE
atte
nd
an
ce 2 5 10 Open 1
11
Tru
st
Bu
sin
ess
Co
ntin
uity 21 Commissioning process halted by major incident Make pre-arrangements with surrounding / London Trusts
to cover any Major Incident if our operational capacity is
compromised due to commissioning process.
0 DP
De
sig
n
Te
am 2 5 10 Open 1
11
Tru
st B
usin
ess C
on
tin
uity 18 Overall Affordability- revenue. BSUH has to make savings of
£173m (including Pathology and EPR) between 2013/14 and
2021/22 and 3Ts added £15.6m to this (down from £30m).
There is therefore an overall risk on affordability.
Enabled growth as envisaged by LTFM will reduce
affordability gap. 3Ts will facilitate this growth and
repatriation.
Level of savings required remains challenging.
'Do nothing' option has been worked up, which has
quantified the impact of 3Ts on activity/income
post costruction. The FBC does demonstrate that
the scheme is affordable and makes a minimal
difference to the CIPs (in part because of a lower
DV assessement and a favourable projected
impairment). In the longer term the scheme will
positively impact on the Trust balance sheet.
DP
Pro
gra
mm
e B
oa
rd 2 5 10 Open 1
12
Ma
in
Sch
em
e
Ca
pita
l
29 HMT requirement to significantly reduce size and scope of
scheme
Provide full justification of building size and scope to HMT Full justification of building size and scope
provided to TDA. Approval of OBC has reduced
the likelihood.
DP
Pro
gra
m
me
Bo
ard 2 5 10 Open 1
12
Ma
in
Sch
em
e
Ca
pita
l
27 Introduction of Private Finance 2 (PF2) Delays may be less than previous PFI (circa 18 months
rather than 3-4 years)
PF2 shows marginal financial benefit which is off
set by time delays (which reduce the clinical
benefits as they are delayed). However PFI still not
affordable.
DP
Pro
gra
mm
e
Bo
ard 2 5 10 Open 1
14
De
sig
n P
roce
ss M
ain
Sch
em
e 2 9 Asbestos and contamination - unknown extent of asbestos and
contamination in existing buildings. (No allowance made in GMP
for removal). Asbestos surveys are costed and programmed in
the GMP. LOR cannot have access to these areas until Trust
handover the building.
In Nov 14 - asbestos surveys update carried out and
passed to LOR
Contingency now in place via costed risk register.
Not able to mitigate fully until building handed
over, likely September 2015 stage 1 and 2018
stage 2.
Asbestos and contamination - unknown extent of
asbestos and contamination in existing buildings.
(No allowance made in GMP for removal).
Asbestos surveys update carried out and passed to
LOR. LOR cannot have access to these areas
until Trust handover the building. Methods
statements from LOR required.
DP
MS
DG 5 2 10 Open 1
14
De
sig
n
Pro
ce
ss M
ain
Sch
em
e 2 23 Construction delayed by RPAs inspection and/or non availability
of BSUH RPA. Limited specialist resources available. Delay to
programme to be compliant (4.20)
LOR will provide construction programme, which
identifies when RPA access to the site will be required.
Trust will then review the proposed plan at each identified
point ,identify how long testing would be expected to take
and source RPA
Learning from decant projects will be key. Gary Speirs
MS
DG 2 5 10 Open 1
16
P2
1 +
GT
h ps 3 GMP is not within delegated approval limits Early cost plan to identify cost pressures and manage
scheme within defined budgets
closed at GMP submission Trust 0 2 5 10 Open 1
16
P2
1+
GT
hp
s 5 Additional approvals are required by Trust Board which would
delay approval
Project Director to report regularly to Trust Board and
highlight any movement from current approvals
closed at GMP approval Trust 0 2 5 10 Open 1
16
P2
1 +
GT
h ps 4 GMP not approved by 3Ts Programme Board Engagement with Project Board through GMP
development
closed at GMP submission Trust 0 2 5 10 Open 1
16
P2
1 +
GT
h ps 12 Scope of project changes and difficult to fix brief Design team to work closely with project team to reflect
user requirements
0 Trust 0 2 5 10 Open 1
16
P2
1+
GT
hp
s 14 Trust stakeholders not carried along with the project
developemnt process, resulting dissent and need for late
revision in scope, and/or project not meeting required outcomes
Key stakeholders to be identified and engaged 0 Trust 0 2 5 10 Open 1
16
P2
1+
GT
hp
s 15 final design and layouts not functional for activity Care to be taken to ensure designs meet staff needs and
derogations are understood and do not compromise
accomodation requirements
0 Trust 0 2 5 10 Open 1
16
P2
1+
GT
hp
s 21 End User disappointment with accomodation Stakeholder involvement in developing designs 0 Trust 0 2 5 10 Open 1
16
P2
1+
GT
hp
s 36 Client side site management and interface is not adequately
defined and agreed leading to coordination and management
issues
Local Trust representatives to be identified and involved
in method statement and site coordination
0 Trust 0 2 5 10 Open 1
16
P2
1+
GT
hp
s 39 Temporary works not adequately defined Temporary work to be designed accordingly 0 Galiford Try 0 2 5 10 Open 1
16
P2
1+
GT
hp
s 72 PSCP insolvency Trust to carry out checks prior to appointment 0 Trust 0 2 5 10 Open 1
16
P2
1+
GT
hp
s 74 Changes in revenue assumptions and tariff results in an the
proposed capital expenditure being unaffordable
Changes in income assumptions to be managed within
the affordability envelope
0 Trust 0 2 5 10 Open 1
16
P2
1 +
GT
h ps 64 Cutting cables for existing services to other parts of the hospital Surveys and risk / method statements undertaken closed at GMP submission Galiford Try 0 2 5 10 Open 1
10
De
sig
n P
roce
ss
1 2 Discovery of any contamination, soft ground, services,
LOR to undertake a full vetting process of tenderers
during the market testing process. LOR project team to
manage, monitor and control performance on site.
0 LOR
De
ca
nt
De
live
ry
Gro
up 2 4 8 Open 1
35
De
ca
nt
PS
CP
(L
OR
) 2 46 That Trust supplied equipment 'Group 2,3,4' is not available in
accordance with the timescales shown on the agreed
programme.
Item to be present on Trust internal risk register. Trust
Project Manager
Risk increased at risk review meeting 28/09/15-
equipment schedule delayed
Trust
De
ca
nt
De
live
ry
Gro
up 2 4 8 Open 1
10
De
sig
n
Pro
ce
s
s 1 12 Adverse weather conditions is above that anticipated (less than 1
in 10). Leads to delay
0 On programme DP
Pro
gra
mm
e
Bo
ard 2 3 6 Open 1
10
De
sig
n P
roce
ss
1 7 Fire Strategy interface for TKT needs to be integrated with
design and operational parameters for TKT incorporating the
addition of the Helideck, Trauma Lift and flues. Additional work
required to meet revised fire strategy
Investigate jointly with design team and Trust fire officer
Go back to fire brigade to remind them that they will be
approving strategy - ensure they understand the extent of
their involvement (recover wreckage)
On programme DP
Pro
gra
mm
e B
oa
rd 2 3 6 Open 1
10
De
sig
n P
roce
ss
1 31 Noise & vibration in demolition - There may be additional control
measures required over and above that currently included to
maintain operation of departments in stage 1 building during
stage 3 construction (linacs bunkers). Leads to design, testing
and construction. CHECK DUPLICATE EARLIER LINACS
WSP report has been reviewed and the methodology has
been outlined for Trust to decide on relocation or
additional measures. Review what the agreed level is
(statutory limits)
Duplicate of 14/10 DP
Pro
gra
mm
e B
oa
rd 3 2 6 Open 1
10
De
sig
n
Pro
ce
ss 1 1 The Employer does not enter into the Section 278 legal
agreement with the council to allow the works to progress in
accordance with the Accepted Programme.
Engage early in the process - follow up July 2015 and
discuss at next Main Scheme delivery group. Get it right
first time. Programme the works and funding of the works
before GMP
Workshop to take place 06/06/15 DP
Pro
gra
mm
e B
oa
rd 3 2 6 Open 1
10
De
sig
n
Pro
ce
ss 1 3 Asbestos is discovered within the Site, including any asbestos
shown
on existing asbestos registers.
Nuclear med - known asbestos and some has been
removed (July 2015)
Intrusive surveys have been carried out. When carry out
demolition - take samples and pass to LOR
Risk reduced at GMP risk review meeting DP
Pro
gra
mm
e
Bo
ard 3 2 6 Open 1
10
De
sig
n P
roce
ss 1 34 Trust operational restrictions defined in the contract are changed
as a result of variation in Trust requirements impact on design,
construction methodology, programme, delay to programme and
possible change to design.
Ensure in GMP and contract that methodology is specific
inc access and changeovers. Operational restrictions to
be kept under constant review - project meetings. Ensure
strong staff engagement / communications in place. Gain
support from CEO and Ops Team. Contract to set out
clear escalation process and key contact - communicate
with key duty holders
Has been escalated via Datix to BSUH Board to
ensure that construction/programme staff and
operational/clinical staff interface is seemless.
DP
Pro
gra
mm
e B
oa
rd 3 2 6 Open 1
11
Tru
st
Bu
sin
es s
Co
ntin
ui
ty 7 Legislative/regulatory change: non-NHS specific Communication with authorities for early warning None known. DP 0 2 3 6 Open 1
11
Tru
st
Bu
sin
es s
Co
ntin
ui
ty 8 Changes in taxation Communication with authorities for early warning None known. DP 0 2 3 6 Open 1
11
Tru
st B
usin
ess C
on
tin
uity 9 Changes in the volume of demand for client services Contingency to be included and sensitivities within
financial model. OBC refresh has incorporated this
modelling
In the FBC timeframe DP
Pro
gra
mm
e B
oa
rd, P
roje
ct
Te
am
, L
oca
l H
ea
lth
Eco
no
my
Bo
ard
LH
E a
tte
nd
an
ce 2 3 6 Open 1
11
Tru
st B
usin
ess C
on
tin
uity 10 Unexpected changes in medical technology Robust business plan in conjunction with commissioners In the FBC timeframe DP
Pro
gra
mm
e B
oa
rd, P
roje
ct
Te
am
, L
oca
l H
ea
lth
Eco
no
my
Bo
ard
LH
E a
tte
nd
an
ce 2 3 6 Open 1
11
Tru
st
Bu
sin
es s
Co
ntin
ui
ty 20 3Ts building being too small Demand management strategies across health economy 0 DP 0 2 3 6 Open 1
11
Tru
st
Bu
sin
ess
Co
ntin
uity 6 Increased costs and revenue risks associated with fragmented
temporary Estate
Build in transition contingency.
Develop detailed decant plans. Including purchase of St
Mary's Hall
Transition costs included in revenue projections
Decant plans underway to being implemented.
Transition costs included in revenue projections.
DP
De
ca
nt
De
live
ry
Gro
up 3 2 6 Open 1
14
De
sig
n
Pro
ce
ss
Ma
in
Sch
em
e 2 4 Failure to incorporate Control of Infection best practice Robust FBC process incl design briefs & generation of
ADB sheets in conjunction with users
Close liaison with BSUH Infection control team is
ongoing.
DP
Pro
gra
mm
e T
ea
m 2 3 6 Open 1
14
De
sig
n P
roce
ss
Ma
in S
ch
em
e 2 16 Project specific requirements may impact on the ability to meet
statutory requirements. Conflict between brief & standards. Trust
adapt their brief & impacts on design.
Statutory Regulations and/or legal requirements may change
causing the Trust to adapt their brief & impacts on design and
construction. Additional costs
Review changes to Fire Regs / Fire Engineered solution LOR are proving compliance statement to BSUH to
review in September 2014
DP
De
sig
n T
ea
m 3 2 6 Open 1
14
De
sig
n P
roce
ss M
ain
Sch
em
e 2 22 Following the wind tunnel test and VE study, further Helideck
design may alter location / height / treatments / services. If
design changes significantly it will need to go back to Planning
for the Helideck. Potentially additional design and construction
cost and programme
RISK IMPACTED - design has been amended and it now looks
different. Need to go back to the Planners. Decision has been
made on accom from 14 to 15.
Take revised design to Planning (aesthetics of Helideck)
Trust to confirm wind tunnel test to go ahead
Design has now been a amended and now looks
different. Planners to be notified. Decision to be
made on accommodation / water tanks on roof -
currently getting prices.
DP
MS
DG 3 2 6 Open 1
14
De
sig
n
Pro
ce
ss M
ain
Sch
em
e 2 37 The condition of the Thomas Kemp Tower (TKT) existing
structure is not as the existing
drawings or the surveys carried out by the Contractor before the
17/07/15. included in the site informaiton
Carry out Gap analysis on structural tests while
undertaking refurb works in level 10 (Cardiac) TKT and
during any other projects in 15,6,14,13 TKT.
risk reopened with more defined wording at
contract signing workshop
DP
MS
DG 2 3 6 Open 1
14
De
sig
n
Pro
ce
ss M
ain
Sch
em
e 2 18 Failure to meet deadlines and quality of specification/URS for
Nuclear medicine / aseptic unit for Main Scheme stage 1. Risk
continues through design, construction and up to handover for
compliance and sign-off by MHRA / EA (RPA). Post-GMP delay
to programme.
Process in place for design, agree with the TRUST. On programme DP
De
sig
n T
ea
m 2 3 6 Open 1
14
De
sig
n P
roce
ss
Ma
in S
ch
em
e 2 57 The Employer does not shut down hospital areas or services to
allow the Contractor to make connections with existing buildings
and services. This will include connections of Stage 2 and 3
works to plant and equipment that is being used in the Stage 1
building. Shutdowns to be indentified on the Accepted
Programme.
According to logistics programme Risk opened at contract signing workshop DP
MS
DG 2 3 6 Open 1
14
De
sig
n P
roce
ss M
ain
Sch
em
e 2 61 Planning permission relating to a value engineering item is not
given in a timely manner
or at all. These are the omission of cladding to the underside of
the helideck, the car park ramp being retained at the steeper
gradient constructed in Stage
1.
(Explanatory note: such value engineering item does not comply
with the planning
permission given at the Contract Date, but the tendered total of
the Prices includes a
reduction on account of such item. The Employer will apply for
planning permission for
such value engineering item, but the risk of the planning
permission remains with the employer
Utilisation of planning tracker to mitigate Risk opened at contract signing workshop DP
MS
DG 2 3 6 Open 1
18
En
g
ag
e
me
nt
Sta
ff 5 Loss of Programme Director / Manager Monitor workload and create contingency plan, potential
cross-skilling, succession planning
DP now working full time on 3Ts as per Gateway
review
SP
Exe
c
Te
a m 2 3 6 Open 1
21
IC
T 17 Nuclear medicine required isotope monitoring software to be
installed in decant location but this is not funded by 3Ts
Dept needs to seek agreement regarding who will fund
this requirement
Works complete. Risk is now on decision
regarding funding
Gary Steen 0 2 3 6 Open 1
21
IC
T 22 Integration of direct works contractors such as IM&T and AV Programme and project managers to ensure that IM&T
elements are fully considered in plans, requirements and
any change
0 Gary Steen 0 3 2 6 Open 1
24
Sta
ke
ho
ld
er
su
pp
ort 7 Introduction of Planning Gain Supplement Continuing regular dialogue with city planners and
research. Include contingency during planning process
Optimism bias within OBC allowed for this cost DP
LH
E c
hie
f
exe
cs
gro
up 2 3 6 Open 1
24
Sta
ke
ho
lde
r
su
pp
o rt 10 Location of consolidation centre (1.05) Proactive liaison with B&HCC about likely location Risk reopened as has been raised at HLG DP/ LOR 0 2 3 6 Open 1
24
Sta
ke
ho
lde
r su
pp
ort 12 The Employer does not obtain permissions and/or consents from
3rd parties, which are the Employers responsibility to provide, to
allow the works to progress in accordance
with the Accepted Programme. This includes permissions such
as crane over sailing licenses, licence to install under or fix to the
PFI operated children's hospital, wayleaves, connection of CHP
engine to feed back to the DNO (Distribution
Network Operator) network.
Identify in the programme the milestones for the TRUST.
Consider using Party Wall route to gain cooperation.
Ground movement monitoring.
Ground anchor design solution agreement with CAPL
Legal discussions Re: PFI with T&T and BSUH in July
2015. LOR to extract drawings to issue to Kajima
0 0 0 2 3 6 Open 1
32
Ma
in
Sch
em
e
Eq
uip
me
nt
4 Equipment is based on BoQ Rev. (doc ref required ) F03.
Awaiting aligned equipment schedule. Could lead to
additional/changed equipment added post contract. Impact could
be additional costs and programme (depending on timing / and
type of change)
Check equipment schedules during contract signing - use
document reference in contract.
Continuous process of review.
0 DV/LOR
Pro
gra
mm
e
Te
am 3 2 6 Open 1
34
Ma
in
Sch
em
e
P2
1
De
live
ry 20 Scheme impacts on surrounding area to a greater extent than
indicated in the Environmental Impact Assessment targets
(noise, dust, vibration).
HIA and EIA Ongoing communication with local residents will be
maintained
PSCP
PS
CP 3 2 6 Open 1
34
Ma
in
Sch
em
e P
21
De
live
ry 5 Performance of design team may be lower than anticipated.
Caused by performance of individuals, disruption to the team
due to re-starting. Redesign & programme, Reputation impact.
Design coordination post procurement. Potential re-work during /
after construction
QA of designers; lessons learnt on other projects.
Replacement of designers for subsequent stages
risk reviewed. GMP review in July 2015. To be
monitored during construction process.
PSCPP
SC
P 3 2 6 Open 1
34
Ma
in
Sch
em
e
P2
1
De
live
ry 53 There may be a lack of design co-ordination caused by the
partial stage E
QA design and coordinate between services REVIT
model
Risk raised after LOR FBC review. Requires
continual monitoring.
PSCP
PS
CP 3 2 6 Open 1
34
Ma
in S
ch
em
e
P2
1 D
eliv
ery 73 Misalignment of tolerances between works packages. Gap
