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The QED Group

Solutions to Accreditation Challenges
Risk Management and Contract Management

The QED Group
Carolyn Searle
The QED Group

Before we start:
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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 Group

Risk 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
The QED Group

1. Strategy
The QED Group

Strategy
The QED Group

2. Structure
The QED Group

Risk Management Framework
Strategic
Risk

Operational
Risk

Program/
Project Risk

1. Identified as an
adjunct to
Strategic Plan
2. Assessed by Board
3. 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 SubCommittee or
senior Executive
4. Risks Retired as
program/project
ceases.
The QED Group

Sample Risk Matrix
Likelihood
Insignificant

Minor

Moderate

Major

Catastrophic

Low

Medium

High

Extreme

Extreme

Low

Medium

High

High

Extreme

Low

Medium

Medium

High

Extreme

Low

Low

Medium

Medium

High

Low

Low

Medium

Medium

Medium

Consequence

Almost Certain

Likely

Possible

Unlikely

Low
The QED Group

Risk Assessment Process – Likelihood
Rare:
Unlikely:
Possible:
Likely:
Almost Certain:

The event will only occur in exceptional circumstances or as
a result of a combination of unusual events
The event may occur at some time but not likely to occur in
the foreseeable future
The event may occur within the foreseeable future or
medium term
The event will probably occur in most circumstances
The event will occur in most circumstances
Risk Assessment Process –
Consequence

The QED Group

Insignificant

Minor

Medium

Legal and
Regulatory
Compliance

Insignificant legal
regulatory or
internal policy
failure

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

Reputational

No harm done to
organisation’s
reputation.
Complaints
resolved by Team
manager or
member of staff.
No injury, near
miss.

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

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.

Limited legal, regulatory Major regulatory, legal or
failure - reportable
internal policy failure.
incident to regulator.
Visit by regulators in
relation to noncompliance.
Increased attention
Significant or consistent
from local media
adverse national
and/or heightened
media/public attention
concern by local
(local). Major complaints
community. Significant
by stakeholders.
complaints about
services.
One or two employees
An event resulting in:
requiring medical
• permanent injury/
treatment or lost injury illness or
time.
hospitalisation(single
employee
• medical treatment (>3
employees)
Loss of less than
Loss between $500,000
$500,000, includes
to $2M
losses of < $500,000
that threaten the
overall budget of a
single service.

Workplace
Health and
Safety

Financial

Isolated event, minor
injury requiring only
first aid treatment

Major

Catastrophic
Significant legal
regulatory or policy
failure – substantial
criminal, financial
penalties.
Serious adverse public or
media publicity (local,
state and national level).
Loss of confidence by
stakeholders and
media/public.
An event resulting in
death or permanent
injury/ illness or
hospitalisation of
multiple employees.

Loss greater than $2M.
Risk Assessment Process –
Consequence

The QED Group

Insignificant

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 replanning 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
The QED Group

4. Stories
The QED Group

5. Simplicity
The QED Group
The QED Group

ML Contract Management
Are you following your organisation’s
set processes?
The QED Group

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
The QED Group

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
The QED Group

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
The QED Group

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
The QED Group

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
The QED Group

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
The QED Group

For more information, please contact
• Tarun Philip
(02) 9925 4022
tarun@kwelasolutions.com
• Kim Wilson
(02) 9925 4021
Kim@kwelasolutions.com

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Medicare Locals - Accreditation Challenges Webinar

  • 1. The QED Group Solutions to Accreditation Challenges Risk Management and Contract Management The QED Group Carolyn Searle
  • 2. The QED Group Before we start: • You are on mute. • Click the Orange button to minimise the webinar control panel • If you have a question, please type it into the questions section of the webinar control panel . We will answer each question personally after the webinar.
  • 3. 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
  • 4. The QED Group Risk 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
  • 5. The QED Group Success strategies for implementing risk management in Medicare Locals
  • 6. The QED Group 1. Strategy
  • 8. The QED Group 2. Structure
  • 9. The QED Group Risk Management Framework Strategic Risk Operational Risk Program/ Project Risk 1. Identified as an adjunct to Strategic Plan 2. Assessed by Board 3. 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 SubCommittee or senior Executive 4. Risks Retired as program/project ceases.
  • 10. The QED Group Sample Risk Matrix Likelihood Insignificant Minor Moderate Major Catastrophic Low Medium High Extreme Extreme Low Medium High High Extreme Low Medium Medium High Extreme Low Low Medium Medium High Low Low Medium Medium Medium Consequence Almost Certain Likely Possible Unlikely Low
  • 11. The QED Group Risk Assessment Process – Likelihood Rare: Unlikely: Possible: Likely: Almost Certain: The event will only occur in exceptional circumstances or as a result of a combination of unusual events The event may occur at some time but not likely to occur in the foreseeable future The event may occur within the foreseeable future or medium term The event will probably occur in most circumstances The event will occur in most circumstances
  • 12. Risk Assessment Process – Consequence The QED Group Insignificant Minor Medium Legal and Regulatory Compliance Insignificant legal regulatory or internal policy failure Minor legal, regulatory failure (able to be resolved with no penalty) Reputational No harm done to organisation’s reputation. Complaints resolved by Team manager or member of staff. No injury, near miss. Minor adverse publicity in particular locations. Minor complaints about products and/or services. 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. Limited legal, regulatory Major regulatory, legal or failure - reportable internal policy failure. incident to regulator. Visit by regulators in relation to noncompliance. Increased attention Significant or consistent from local media adverse national and/or heightened media/public attention concern by local (local). Major complaints community. Significant by stakeholders. complaints about services. One or two employees An event resulting in: requiring medical • permanent injury/ treatment or lost injury illness or time. hospitalisation(single employee • medical treatment (>3 employees) Loss of less than Loss between $500,000 $500,000, includes to $2M losses of < $500,000 that threaten the overall budget of a single service. Workplace Health and Safety Financial Isolated event, minor injury requiring only first aid treatment Major Catastrophic Significant legal regulatory or policy failure – substantial criminal, financial penalties. Serious adverse public or media publicity (local, state and national level). Loss of confidence by stakeholders and media/public. An event resulting in death or permanent injury/ illness or hospitalisation of multiple employees. Loss greater than $2M.
  • 13. Risk Assessment Process – Consequence The QED Group Insignificant 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 replanning 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
  • 14. The QED Group 3. Sponsorship
  • 15. The QED Group 4. Stories
  • 16. The QED Group 5. Simplicity
  • 18. The QED Group ML Contract Management Are you following your organisation’s set processes?
  • 19. The QED Group 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
  • 20. The QED Group 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
  • 21. The QED Group 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
  • 22. The QED Group 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
  • 23. The QED Group 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
  • 24. The QED Group 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
  • 25. The QED Group For more information, please contact • Tarun Philip (02) 9925 4022 tarun@kwelasolutions.com • Kim Wilson (02) 9925 4021 Kim@kwelasolutions.com