Executive Overview
A risk register only delivers value when everyone understands it and updates it. This guide walks through designing a register that clinicians and administrative staff can use together to track digital and operational risks, meet DCB0160 expectations, and keep improvements on track.
Clarify the Purpose and Scope
- Purpose: provide a single view of risks linked to digital systems, clinical workflows, and supporting processes.
- Scope: cover patient safety, data protection, operational disruption, and compliance obligations (DCB0160, DSPT, DTAC, CQC).
- Audience: Clinical Safety Officer (CSO), practice manager, reception supervisors, nurses, GPs, PCN leads.
Agree these points before you start so contributors know what belongs in the register.
Design a Register That Works for Everyone
Use a table or spreadsheet with the following columns:
| Column | Why it matters | Tips |
|---|---|---|
| Risk ID | Makes referencing easy in meetings and reports | Use sequential numbers (R001, R002...) |
| Risk title | Provides a quick plain-language summary | e.g. “Online consultation red flags missed outside triage hours” |
| Description | Explains what could happen and the potential impact | Avoid jargon; describe the patient or staff consequence |
| Category | Groups risks (clinical safety, data, operations, supplier, people) | Helps teams focus on similar themes |
| Likelihood (1-5) | Shows how often the risk might occur | Agree a simple scale on the cover sheet |
| Impact (1-5) | Shows severity if the risk occurs | Link impact levels to patient or service outcomes |
| Current controls | Lists what is already in place to manage the risk | Reference policies, training, system settings |
| Additional actions | Records mitigation tasks that still need to happen | Assign target dates and owners |
| Owner | Names the person accountable for monitoring the risk | Include deputies if the owner is away |
| Review date | Sets when the risk will be discussed next | Update after each review |
| Status | Highlights priority (green, amber, red) | Use conditional formatting or symbols |
Add a cover sheet with definitions, scoring guide, and escalation process so new staff can understand it quickly.
Populate and Maintain the Register
- Initial population: gather risks from existing documents (hazard logs, incident reviews, supplier agreements, DSPT action plans).
- Workshop: bring together representatives from reception, nursing, GPs, and management to validate entries and identify gaps.
- Link to DCB0160: map each clinical technology risk to its corresponding hazard log entry and safety controls.
- Set review cadence: discuss top risks at monthly safety huddles and full register quarterly, escalating red items to partners or PCN leads.
- Update consistently: log new risks when incidents occur, during change planning, or after supplier updates.
Store the register in your safety file with version control and access permissions for all relevant staff.
Use the Register During Meetings
- Start safety huddles or governance sessions by reviewing red and amber risks.
- Document decisions directly in the register (for example, update status, add actions, revise scores).
- Agree owners and deadlines for new actions before the meeting ends.
- Highlight resolved risks and celebrate progress to keep morale high.
Connect the Register to Other Processes
- Incident management: when incidents are logged, check whether a related risk exists; update likelihood/impact or add a new entry.
- Change control: review the register before approving system changes to anticipate knock-on effects.
- Supplier management: share priority risks with vendors during regular reviews and capture their responses.
- Training and comms: use the register to prioritise refresher sessions or patient messaging.
Scenario: Ashfield Health Partnership
Ashfield rebuilt its risk register with the columns above and scheduled a monthly 20-minute review. Reception supervisors add risks related to patient messaging and booking flows, while the CSO covers clinical system hazards. The team now spots trends—such as recurring login issues after updates—earlier and can show the PCN how risks are being managed when bidding for funding.
Pitfalls to Avoid
- Too much detail: lengthy risk statements deter updates; keep descriptions short, with links to more detail elsewhere.
- Unclear responsibility: every risk needs a named owner or it will stagnate.
- Static registers: if you only touch the document before inspections, it will be out of date and untrusted.
- Technical jargon: ensure admin teams and clinicians can understand every entry.
Action Checklist
- Agree the purpose, scope, and audience for the register.
- Build the template with shared definitions and scoring guidance.
- Populate initial risks from hazard logs, incidents, and change plans.
- Schedule regular reviews and update the register live during meetings.
- Store the register in the safety file with controlled access and version history.
Resources to Bookmark
- NHS England – Clinical Safety Standards (DCB0160/DCB0129)
- NHS England – Digital Primary Care Good Practice Guidelines
- Data Security and Protection Toolkit
Key Takeaways
A simple, shared risk register enables clinical and administrative teams to speak the same language about risk, track actions, and evidence compliance. Keep the format clear, update it regularly, and integrate it with your wider safety processes to maintain momentum.