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Traffic Lights: A practical risk management system for community early intervention in psychosis teams

Mohammed Ashir (North East London Foundation Trust, Walthamstow, UK)
Karl Marlowe (Tower Hamlets Early Intervention Service (THEIS), Queen Mary University, London and The City University Mental Health NHS Trust, London, UK)

Clinical Governance: An International Journal

ISSN: 1477-7274

Article publication date: 7 August 2009



The current risk management system for community mental health patients in England is based around the Care Programme Approach (CPA). This system is not responsive to changes in risk for community patients. This paper aims to introduce a practical system to manage risk that has been developed for an Early Intervention Service in East London on the basis of need.


Coding of red, amber and green is associated with specific criteria agreed by all disciplines in the team. The change of a code leads to a rapid change in risk level and management. An agreed clinical and non‐clinical action plan leads to a whole team response. The limitation of use is dependent on the size of the case load and the number of clinical staff attending a daily clinical briefing.


Zoning according to the traffic lights system could complement the CPA system and support a clinical governance structure utilising a whole team response.

Research limitations/implications

The risk management system described has not been tested empirically. Currently it has been used in early intervention mental health teams but will need to be adapted for other teams with bigger case loads.


This practical risk management system is aligned with the statuary CPA requirements. A dynamic and flexible management of risk is central to early intervention in psychosis teams but the risk management system described can suit any community mental health team and fits well with the distributed responsibility model of functionalised teams according to new ways of working.



Ashir, M. and Marlowe, K. (2009), "Traffic Lights: A practical risk management system for community early intervention in psychosis teams", Clinical Governance: An International Journal, Vol. 14 No. 3, pp. 226-235.



Emerald Group Publishing Limited

Copyright © 2009, Emerald Group Publishing Limited