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Clinical risk assessment and management of service users

Alexis Bowers (Hertfordshire Partnership NHS Foundation Trust, St Albans, UK)

Clinical Governance: An International Journal

ISSN: 1477-7274

Article publication date: 9 August 2011




The purpose of this study is to improve compliance with clinical risk procedures across a United Kingdom based mental health trust.


A cross‐sectional audit was carried out in April 2010. In total, 70 Risk Assessment Proformas (RAPS) were measured against an agreed “gold‐standard”. The standards were a combination of Department of Health recommendations as well as the current Hertfordshire Partnership NHS Foundation Trust (HPFT) policy on clinical risk assessment.


Only 53 (out of a possible 70) RAPS were completed. The acute and community psychiatric service stream samples on the whole provided more information within their RAPS than other parts of the service. There were overall low levels of documentation regarding service user and carer involvement.

Practical implications

To strengthen the clinical management of risk (and thus reduce harm) in mental health settings a systematic approach to risk assessment should be present. This involves clinicians working in partnership with both service users and carers. Based on the results, more needs to be done to actively involve carers and the service user in formulating the risk management plan. Not only will this promote positive risk management within the organization it will also enable individual “recovery”.


By auditing the organizational processes that underpin the management of risk, deficiencies in clinical care can be identified. Mental Health Trusts can promote positive risk management within their organization by engaging service users and their carers in managing risk.



Bowers, A. (2011), "Clinical risk assessment and management of service users", Clinical Governance: An International Journal, Vol. 16 No. 3, pp. 190-202.



Emerald Group Publishing Limited

Copyright © 2011, Emerald Group Publishing Limited

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