2.14 The NHS Capital Investment Manual requires NHS Trusts to assess risk at a level sufficient to assure the Trust that the preferred option in an OBC is affordable and represents the optimum solution. The 2000 OBC did not have a risk register. In early 2001 the Campus partners commissioned a risk assessment from Ernst & Young which was delivered in May 2001. It was a static assessment and was not integrated into the scheme's ongoing management. While there were plans to update the assessment in 2002, it was not updated until the autumn of 2003. A further update took place in the autumn of 2004 and was incorporated into the 2004 OBC.
2.15 There were a number of areas specific to the Campus scheme which were not covered in the risk assessments. There was no risk/impact assessment of;
■ having two sponsor NHS Trusts and three Senior Responsible Officers;
■ commissioners' reluctance to support the scheme's development costs;
■ the absence of strategic support; or
■ the cost-benefit implications of Imperial College's research to the vision of the Campus.
Although the Campus partners recognised the need to address the final bullet after the 2003 Gateway review (Appendix 2), they were unable to identify an appropriate methodology to quantify either risk or benefit in conjunction with Imperial College.
2.16 None of the risk assessments were used in a structured way as active risk registers for the ongoing management of the scheme. As the 2005 Independent Review Panel noted (Appendix 2), in 2003 the scheme was focussed on procurement when in reality it still needed to satisfy the pre-conditions of a robust Outline Business Case.
2.17 Following the Gateway review in November 2003 (Appendix 2), the Campus partners accepted the need to introduce and embed a risk register, assumptions log and issues log as primary project control tools. However, during the summer and autumn of 2004 the Project Director recognised that the project team did not have the capacity, or financial resources, to absorb significantly different ways of working at the same time as producing a new OBC. The Project Director decided to concentrate on the OBC with the firm intention of introducing the Gateway recommendations for project controls immediately after submission of the revised OBC. The Campus partners' December 2004 OBC included a risk management strategy, an updated risk register and the commitment to an active risk management process.