Navigating the Complexities of HSE Enterprise Risk Management: A Guide for Healthcare Professionals

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Managing risks in healthcare is not just a regulatory requirement but a cornerstone of ensuring patient safety and operational efficiency. Enterprise Risk Management (ERM) emerges as a critical, best practice framework that empowers organisations to foresee, evaluate, and mitigate risks effectively. The Health Service Executive (HSE) has outlined a comprehensive approach to ERM in the HSE Enterprise Risk Management Policy and Procedures 2023.  Their best practice approach is aligned to the ISO 31000:2018 Risk Management – Guidelines.

This article dives into the nuances of the HSE’s Enterprise Risk Management Policy and Procedures, demonstrating how healthcare providers can integrate these principles to enhance their risk management strategies, ensure compliance, and improve overall healthcare outcomes.

What is Enterprise Risk Management (ERM)?

The HSE document states that “Enterprise Risk Management (ERM) in healthcare promotes a comprehensive framework for making risk-based decisions that guide the protection and development of high-quality services and their contribution to improving healthcare outcomes. It enables better management of uncertainty and associated risks and opportunities. In particular, it guides the organisation to address risks comprehensively and coherently, instead of trying to manage them individually.”

ERM is a proactive risk management process that aims to identify and manage risk on an enterprise-wide basis, that is, inclusive of all risks whether to do with management or service delivery processes. Integrating ERM not only assists in complying with stringent regulatory obligations, such as those set by HIQA and the MHC, but also helps to drive improvements in patient care and service delivery.

The Scope of the HSE Enterprise Risk Management Framework

The HSE’s Enterprise Risk Management framework is designed to be comprehensive and adaptable across various levels of healthcare from national health services, including Hospital Groups and Community Health Organisations (CHOs), the National Ambulance Services (NAS) and other national services. This extensive scope ensures that the ERM framework is not only applicable to strategic risks but also operational risks that healthcare entities face daily. Central to this framework is the alignment of local risk policies with the HSE Enterprise Risk Management Policy and Procedure, thereby promoting consistency and ensuring that every unit aligns with broader healthcare objectives.

Key Components of the ERM Process

The Enterprise Risk Management process outlined by the HSE is aligned with the ISO 31000:2018. It consists of several crucial steps:

Each of these steps is integral to building a robust Enterprise Risk Management system that not only complies with regulatory requirements but also enhances your organisation’s capacity to deliver safe and high-quality healthcare. For more detail on the HSE ERM process read our blog here.

Roles and Responsibilities in ERM

The effectiveness of an Enterprise Risk Management (ERM) framework significantly depends on the clear definition and distribution of roles and responsibilities among your healthcare organisation’s staff. At the heart of the HSE’s ERM policy is a collaborative approach, where every individual, from board members to front-line staff, plays a crucial role in the risk management process.

Risk roles common to each level of the health service include:

Tools and Techniques for Effective Risk Management

To support the systematic approach to risk management outlined in the HSE’s ERM policy, several tools and techniques are recommended to facilitate the identification, analysis, and monitoring of risks:

These tools not only enhance your healthcare organisation’s ability to manage risks effectively but also foster a culture of continuous improvement and vigilance against potential threats. By adopting and adapting these techniques, you can strengthen your risk management framework, thereby enhancing your resilience and capacity to deliver safe and effective healthcare services.


Enterprise Risk Management is emerging as a critical component in the healthcare sector, not just to support compliance with regulatory standards but as a cornerstone of high-quality patient care. ERM is beneficial because it provides a holistic view of all risks facing your organisation, rather than managing risks individually within silos. This approach helps you to manage risk proactively and can lead to better resource allocation, strategic planning, improved care, and ultimately, enhanced decision-making and organisational resilience.

As detailed within the HSE Enterprise Risk Management Policy and Procedures 2023, HSE services are required to align their local policies to the ERM. Implementing the ERM framework not only protects against adverse outcomes but also enhances your service’s ability to pursue opportunities with a clear understanding of risk exposure. Embarking on this change can be daunting and time consuming on internal resources. However, HCI is expertly positioned to assist you in reviewing and aligning their local risk policies with the broader HSE Enterprise Risk Management framework. By leveraging HCI’s extensive expertise in policy and procedure development, along with their deep understanding of healthcare regulatory compliance and risk management, HCI can provide invaluable guidance in ensuring that local policies not only meet the necessary standards but also integrate seamlessly with the overarching ERM framework.

For more information on HCI’s Risk Management support services contact or call 01 629 2559.

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