The QED Group

Solutions to Accreditation ChallengesRisk Management and Contract Management

The QED Group

Carolyn Searle

The QED Group

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The QED Group

The QED Group

• An alliance of like minded professionals

• Long history of working with MLs• Consultants– Kim Wilson – Peter Spence– Tarun Philip– Marissa Jank– Carolyn Searle

The QED GroupRisk Management & Contract Management

• How MLs can extend the benefits of robust risk and contract management to beyond just Accreditation Standards.

• The Presenters– Kim Wilson– Marissa Jank

The QED Group

Success strategies for implementing risk management

in Medicare Locals

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1. Strategy

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Strategy

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2. Structure

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Risk Management FrameworkStrategicRisk

Operational Risk

Program/Project Risk

1. Identified as an adjunct to Strategic Plan

2. Assessed by Board3. Reviewed by Risk

Sub-Committee (ARC) of the Board when they meet.

4. Reviewed by the Board as a whole on an annual basis as part of planning process

1. Identified by key executive/senior managers

2. Managed in the course of business operations – part of KPIs for managers

3. Board and/or Risk Sub-Committee receives regular reports on High/Extreme risks and mitigation actions.

1. Identified as part of business case/proposal

2. Assessed by Program/Project Manager

3. High/Extreme risks should be reported to Board, Risk Sub-Committee or senior Executive

4. Risks Retired as program/project ceases.

The QED Group

Sample Risk Matrix Insignificant Minor Moderate Major Catastrophic

Almost Certain

Low Medium High Extreme Extreme

Likely

Low Medium High High Extreme

Possible

Low Medium Medium High Extreme

Unlikely

Low Low Medium Medium High

Low

Low Low Medium Medium Medium

Likelihood

Cons

eque

nce

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Risk Assessment Process – Likelihood

Rare: The event will only occur in exceptional circumstances or as a result of a combination of unusual events

Unlikely: The event may occur at some time but not likely to occur in the foreseeable future

Possible: The event may occur within the foreseeable future or medium term

Likely: The event will probably occur in most circumstances Almost Certain: The event will occur in most circumstances

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Risk Assessment Process – ConsequenceInsignificant Minor Medium Major Catastrophic

Legal and Regulatory Compliance

Insignificant legal regulatory or internal policy failure

Minor legal, regulatory failure (able to be resolved with no penalty)

Limited legal, regulatory failure - reportable incident to regulator.

Major regulatory, legal or internal policy failure. Visit by regulators in relation to non-compliance.

Significant legal regulatory or policy failure – substantial criminal, financial penalties.

Reputational No harm done to organisation’s reputation. Complaints resolved by Team manager or member of staff.

Minor adverse publicity in particular locations. Minor complaints about products and/or services.

Increased attention from local media and/or heightened concern by local community. Significant complaints about services.

Significant or consistent adverse national media/public attention (local). Major complaints by stakeholders.

Serious adverse public or media publicity (local, state and national level). Loss of confidence by stakeholders and media/public.

Workplace Health and Safety

No injury, near miss.

Isolated event, minor injury requiring only first aid treatment

One or two employees requiring medical treatment or lost injury time.

An event resulting in:• permanent injury/ illness or hospitalisation(single employee• medical treatment (>3 employees)

An event resulting in death or permanent injury/ illness or hospitalisation of multiple employees.

Financial Minor loss resulting in only minimal impact to local area budget.

Loss that impacts on a single service but does not threaten that service’s overall budget.

Loss of less than$500,000, includes losses of < $500,000 that threaten the overall budget of a single service.

Loss between $500,000 to $2M

Loss greater than $2M.

The QED Group

Risk Assessment Process – ConsequenceInsignificant Minor Medium Major Catastrophic

Operational Negligible short term disruption to non-essential services.

Short term disruption to services, can be contained within existing contingencies.

Short term disruption to services, exceeds contingencies, resulting in additional resource and /or budget requirements.

Substantial disruption to multiple services resulting in short to medium term loss of business continuity, resulting in the need to conduct re-planning and re-estimating.

Substantial disruption to multiple services, threatening the survival or long term business continuity of the organisation.

Political and economic

Political and economic events without noticeable consequences.

Political and economic events with minor consequences.

Political and economic events that may cause disruption of programs and/or changes to budget.

Political and economic events leading to reduction in flexible funding and activities, and changes in operating requirements that need reallocation of resources.

Political and economic events leading to core and flexible funding removed or significantly reduced threatening business continuity.

Strategic Negligible impact on achieving strategic objectives.

Minor impact on achieving strategic objectives that are easily remedied.

Major impact on achieving strategic objectives that require allocation of extra resource.

One or more strategic objectives are under significant threat of not being achieved.

One or more strategic objectives cannot be achieved.

Clinical A preventable event resulting in no injury.

A preventable event resulting in minor injury requiring only first aid treatment.

A preventable event resulting in increased treatment, but not hospitalisation.

A preventable event resulting in:• temporary loss of physical function• requiring hospital admission• surgical intervention, or• transfer to a higher acuity facility.

A preventable event resulting in:• permanent disabling physical and/or• psychological injury, or• death

The QED Group

3. Sponsorship

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4. Stories

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5. Simplicity

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The QED Group

ML Contract Management

Are you following your organisation’s set processes?

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Schedule 4 .1 – Subcontracting

• Demonstrating contestable tendering • strategic sourcing• Seeking the correct information from applicants• effective bid analysis• Fair and transparent award of services to providers

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Schedule 4 .1 – Subcontracting

• Demonstrating effective implementation of contracts• Cross reference with the ML Deed to ensure that you do

not create any inconsistences between the two documents

• Formation of contracts• Scope of work or services• Fee and payment structure• Performance management of service provider• Deliverables• Persons responsible• General conditions

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Schedule 4 .1 – Subcontracting

• Section 4.1.7 – Schedule 4 requirements:– Typically included in the general conditions of

contract– Recommend AMLA template contracts and then

adapt to meet ML organisational specific requirements

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Section 4.2 Subcontracting - Contract management

• DoH reporting– Can also meet section 4.2 of Schedule 4

requirements– Align contract performance with ML reporting

requirements to DOH for your relevant program– Align deliverable with your own DoH deliverables– Dates that suit your reporting

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Subcontracting - Contract management

• General issues from service providers– General conditions • Liability• Insurance• Payment terms• Intellectual property• Variation processes and approvals• Dispute Resolutions

– Scope of work

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Subcontracting - Contract management

• Variations– Negotiating with an authorised person– Record all variations and changes in a systematic

format– Cross reference with ML Deed to ensure that you

do not create any inconsistences between the two documents

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For more information, please contact

• Tarun Philip(02) 9925 4022tarun@kwelasolutions.com

• Kim Wilson(02) 9925 4021Kim@kwelasolutions.com