Managing Risk, Safeguarding and Accountability When Working With ICBs
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When mental health services are delivered across organisational boundaries, risk and safeguarding arrangements become more complex. Commissioners expect providers to demonstrate not only strong internal safeguarding systems, but also clarity about how risk is managed jointly with ICBs and NHS Trusts.
This closely links to risk and safeguarding expectations and quality and governance arrangements. Providers that cannot clearly articulate shared accountability are often viewed as higher risk partners.
Why shared risk requires explicit governance
Integrated delivery models can blur responsibility if not carefully managed. Commissioners therefore expect:
- clear ownership of safeguarding decisions
- defined escalation thresholds
- formal joint governance arrangements
Informal agreements are rarely sufficient when safeguarding issues arise.
Safeguarding roles across system partners
Providers must be clear about how their safeguarding responsibilities align with those of Trusts and local authorities. This includes:
- who leads safeguarding enquiries
- how information is shared
- how disagreements are resolved
Role clarity reduces delay and prevents duplication.
Joint risk assessment and escalation
Effective system working involves shared approaches to risk. In practice this often includes:
- joint risk assessment tools
- agreed escalation routes
- multi-agency risk review forums
Commissioners expect escalation to be timely and well documented.
Managing positive risk-taking
Integrated models must balance safeguarding with recovery-focused practice. Providers are expected to demonstrate:
- defensible decision-making
- involvement of individuals and families
- shared professional judgement
This is particularly important in community-based mental health services.
Learning from incidents across organisations
When incidents occur, commissioners expect joint learning rather than isolated responses. This includes:
- shared incident reviews
- system-wide learning actions
- clear communication with partners
Providers that contribute openly to learning are often trusted more by system partners.
Safeguarding assurance for commissioners
From a commissioning perspective, assurance is provided when providers can show:
- robust safeguarding governance
- clear accountability frameworks
- evidence of effective joint working
This reassurance supports continued commissioning and service development.
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