Ensuring patient and staff safety is the cornerstone of a well-run GP practice. For Practice Managers, however, navigating the requirements for this can feel like being caught between two powerful forces: Health and Safety legislation and the Care Quality Commission (CQC). These are not separate hurdles but two sides of the same coin, creating a "dual imperative" for robust risk management. A failure to meet a legal duty, such as an adequate fire risk assessment, is not just a breach of health and safety law; it is also a direct breach of the CQC's Fundamental Standards. This can create a form of "double jeopardy," where a single failing could trigger parallel investigations and enforcement actions from both the Health and Safety Executive (HSE) and the CQC. This guide provides a clear, actionable overview of the core risk assessments your practice must have in place. Understanding this list is the first step to moving beyond a simple tick-box exercise and building a dynamic culture of risk management that protects your patients, your staff, and your practice's reputation.
Statutorily Mandatory Risk Assessments
These assessments are non-negotiable legal duties for every GP practice in the UK. Failure to complete and document them is a breach of the law and will also be viewed by the CQC as a failure to provide safe care.
Risk Assessment | Brief Description |
General Health & Safety | This is the foundational assessment for the entire practice. It involves identifying broad, day-to-day hazards like slips and trips, manual handling of records or supplies, and risks from the general work environment. If you have five or more staff, this must be documented in writing. |
Fire Safety | A designated 'Responsible Person' (typically the GP Partners or practice owner) is legally required to carry out a comprehensive fire risk assessment. This involves identifying fire hazards (e.g., faulty electronics, oxygen cylinders), people particularly at risk (e.g., frail patients), and ensuring adequate escape routes, warning systems, and emergency plans are in place. |
COSHH (Control of Substances Hazardous to Health) | This assessment covers the risks from exposure to hazardous substances. The scope is broad, including not just cleaning chemicals but also biological agents like blood, urine, and saliva, creating a direct link to your infection control procedures. |
Legionella | This assessment focuses on the risk of Legionella bacteria growing in the practice's hot and cold water systems. Healthcare premises are considered higher risk due to the presence of vulnerable patients, so you must assess and control risks in water tanks, taps, and pipework. |
DSE (Display Screen Equipment) | This applies to almost all practice staff who use computers daily for an hour or more. A workstation assessment is required for each user to analyse their screen, keyboard, chair, and general work environment to reduce risks like musculoskeletal issues and eye strain. |
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CQC Compliance-Driven Risk Assessments
These assessments are essential for proving to the CQC that your practice is meeting its Fundamental Standards, particularly around providing safe, effective, and well-led care. They form the backbone of your clinical and operational governance systems.
Risk Assessment | Brief Description |
Clinical Governance & Medical Emergency | A high-level assessment of risks in your clinical systems, such as the potential for delayed referrals or failure to act on test results. It critically includes your practice's readiness to handle an on-site medical emergency, covering the availability of drugs, equipment like defibrillators, and staff competency. |
Medicines Management & Prescribing | This covers the entire lifecycle of medicines in the practice. It assesses risks in prescribing (e.g., errors, high-risk drugs), secure storage (including the cold chain for vaccines), administration, and the disposal of unused medicines. |
Infection Prevention & Control (IPC) | A practice-wide assessment on the risk of transmitting healthcare-associated infections. It must cover hand hygiene, use of Personal Protective Equipment (PPE), environmental cleaning standards, decontamination of medical instruments, and clinical waste management. |
Safeguarding (Children and Vulnerable Adults) | This involves assessing your systems to protect patients from abuse and neglect. It includes ensuring staff are trained to the correct level, recruitment processes are safe (DBS checks), and referral pathways to social services are clear and effective. |
Premises, Security & Environment | This goes beyond basic health and safety to assess the overall suitability of the practice environment. It covers patient privacy and dignity (e.g., preventing conversations being overheard at reception), physical security of records and drugs, and accessibility for patients with disabilities. |
Medical Equipment Maintenance & Calibration | This assesses the clinical risk from inaccurate or faulty medical equipment, such as blood pressure monitors or weighing scales. The assessment should inform a clear schedule for regular servicing and calibration of all clinical devices to prevent patient harm. |
Staffing, Competency & Training | This crucial assessment evaluates whether you have enough appropriately skilled staff to meet patient needs safely. It's not just about numbers, but about the right skill mix, cover for absences, and systems for induction, appraisal, and ongoing training to ensure competency. |
Lone Working | Assesses the specific risks to staff who work by themselves without direct supervision. This applies to staff conducting home visits but also those working in the practice outside of normal hours. It considers risks like personal safety and medical emergencies. |
Work-Related Stress | This assesses the risk of staff suffering ill health from work-related stress. It involves looking at factors like workload and demands, staff control over their work, and support from management and colleagues, which are key components of a well-led organisation. |
Information Governance & Cybersecurity | This addresses the significant risk to sensitive patient data. It covers compliance with UK GDPR, the security of both digital and physical records, and the mandatory clinical risk assessment of any new health IT system (like an online consultation platform) under the DCB0160 standard. |
Business Continuity & Emergency Planning | This assesses the practice's preparedness for major incidents that could disrupt services, such as a flood, fire, or major IT failure. The assessment informs a formal plan to maintain critical functions and patient care during a crisis. |
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Systematically addressing the assessments on this list is fundamental to compliance. For the CQC, these documents are the primary evidence that your practice is 'Safe' and 'Well-led'. However, an outstanding practice leverages this process for more than just compliance. It uses risk management as a proactive tool for driving quality improvement and fostering a deep-rooted culture of safety. By viewing risk management not as a regulatory burden, but as a dynamic engine for service improvement, you can ensure you provide the safest possible care and are always ready to demonstrate excellence to the CQC.
Disclaimer: This article is for informational purposes only as of July 2025 and does not constitute legal or regulatory advice. The responsibility for creating, implementing, and maintaining a robust risk management system lies with the practice's leadership and management team. We strongly recommend consulting the latest official guidance from the Care Quality Commission (CQC), the Health and Safety Executive (HSE), and other statutory bodies to ensure full compliance with all specific requirements for your practice.