Sample Boundary Risk Score
The following is an illustrative example showing the format and level of detail you receive from a Boundary Risk Assessment. All data is fictional and does not represent any specific organisation.
Acute Trust Discharge → GP Practice
This example assesses the governance at the boundary between an acute NHS Trust's discharge process and a GP practice's receipt workflow.
| Flow | Raw Score | Cascade-Adjusted | Key Finding | Priority Action |
|---|---|---|---|---|
| Identity | 2 | 2 | PDS lookup at discharge. No verification at GP receipt point. | Implement bidirectional identity verification at boundary. |
| Consent | 2 | 2 | Generic DSA covers sharing. No boundary-specific DPIA. | Create boundary-specific DPIA for Trust-GP discharge pathway. |
| Provenance | 1 | 1 | Author identified but no structured metadata. PDF discharge letters. | Migrate to structured discharge messaging with FHIR metadata. |
| Clinical Intent | 1 | 1 | Free-text discharge summary. No structured action codes or urgency classification. | Implement structured action coding in discharge workflow. |
| Alert & Responsibility | 1 | 1 | MVRT failure: Discharge completes without confirmed GP receipt. No escalation pathway. | Urgent: Implement confirmed receipt and clinically-timed escalation. |
| Service Routing | 2 | 1 | Cascade-adjusted: Clinical Intent < 2 caps Service Routing. | Address Clinical Intent first; routing improvement follows. |
| Outcome | 1 | 1 | No structured outcome feedback. Trust never learns if GP follow-up occurred. | Establish cross-boundary outcome reporting mechanism. |
How to read the scores
Raw scores reflect the auditor's assessment of each flow based on documentary, demonstrable, and observed evidence.
Cascade-adjusted scores apply the dependency rules. In this example, Service Routing has a raw score of 2 but is adjusted to 1 because Clinical Intent scores below Level 2. This reflects the structural reality that routing decisions cannot be clinically governed when clinical intent is not communicated.
MVRT compliance is assessed within the Alert & Responsibility flow. In this example, the boundary fails MVRT — discharge completes without confirmed GP receipt. This is flagged as an urgent priority action.
Overall rating considers cascade-adjusted scores and critical flow performance. Alert & Responsibility is designated as a critical flow — its failure floors the overall rating to Not Assured regardless of other scores.
Learn more about how the scoring works: Seven Flows Methodology →
Maturity levels
| Level | Description | Evidence Requirement |
|---|---|---|
| 0 — Absent | No governance at this boundary for this flow | N/A |
| 1 — Initial | Ad hoc, person-dependent, undocumented | Documentary only |
| 2 — Developing | Documented processes exist but not consistently applied | Documentary + Demonstrable |
| 3 — Managed | Consistently applied, MVRT compliant (for A&R), monitored | Documentary + Demonstrable + Observed |
| 4 — Optimised | All lower levels plus continuous improvement, cross-boundary audit | Full evidence hierarchy + improvement evidence |