1. Risk Assessment & Management: The Role of Evidence, Politics and Practice Steve Morgan Practice Based Evidence www.practicebasedevidence.com

2. Steve Morgan ~ www.practicebasedevidence.com What Use is the Evidence Base? Research interests too politically motivated Research interests too politically motivated Evidence base is too narrow to reflect realities in practice Evidence base is too narrow to reflect realities in practice Hard v. Soft evidence Hard v. Soft evidence Actuarial &/or Clinical Judgement Actuarial &/or Clinical Judgement A preoccupation with numbers A preoccupation with numbers

3. Steve Morgan ~ www.practicebasedevidence.com The Politics of Fear Operating within a blame culture Operating within a blame culture Media reporting and public interest Media reporting and public interest Extreme events distort reality Extreme events distort reality Not completing the risk assessment may have become the ‘greatest risk’ for many practitioners Not completing the risk assessment may have become the ‘greatest risk’ for many practitioners Risk assessment becomes a discriminatory practice Risk assessment becomes a discriminatory practice

4. Steve Morgan ~ www.practicebasedevidence.com The Politics of Practice Who are we really serving? Who are we really serving? What about service user choice, involvement, responsibility and decision- making What about service user choice, involvement, responsibility and decision- making Does legislation provide conflict or clarity? Does legislation provide conflict or clarity? A focus on paperwork turns practitioners into administrators A focus on paperwork turns practitioners into administrators

5. Steve Morgan ~ www.practicebasedevidence.com Supporting Good Practice Department of Health: Best Practice in Risk Management Department of Health: Best Practice in Risk Management Supporting a structured clinical judgement approach Supporting a structured clinical judgement approach NIMHE New Ways of Working… dispersed responsibility NIMHE New Ways of Working… dispersed responsibility A place for positive risk-taking… A place for positive risk-taking… What role does gut reaction/intuition play? What role does gut reaction/intuition play?

6. Steve Morgan ~ www.practicebasedevidence.com Main Messages The evidence base that we have is robust… but, it is also too narrow and lacks accessibility to all The evidence base that we have is robust… but, it is also too narrow and lacks accessibility to all Practitioners (of all professions) take risks in every decision… we need to develop an evidence base & narrative for why & how Practitioners (of all professions) take risks in every decision… we need to develop an evidence base & narrative for why & how Practice is an equation only partly based on the research evidence Practice is an equation only partly based on the research evidence