Self-Assessment

Healthcare Boundary Risk Score: Free Self-Assessment

Answer ten questions about your organisational boundaries. In five minutes, you'll have an indicative score that shows where your governance is strongest and where the structural gaps are. Based on the Seven Flows governance methodology.

This is not a substitute for a full Boundary Risk Assessment — it's a directional indicator that tells you whether boundary risk is material for your organisation.

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Question 1 — Identity

When data crosses your organisational boundaries, is patient identity independently verified by the receiving organisation at the point of crossing?

Question 2 — Consent

Do your boundary-specific data sharing arrangements have dedicated DPIAs covering each organisational boundary?

Question 3 — Provenance

When clinical data arrives from another organisation, can the receiving clinician verify the source, authorship, and integrity of that data through structured metadata?

Question 4 — Clinical Intent

When you refer or discharge a patient, is the clinical intent communicated in structured, coded form — not just free text?

Question 5 — Alert & Responsibility (MVRT)

When clinical responsibility transfers across an organisational boundary, does the system require confirmed bilateral acceptance before the transfer completes?

Question 6 — Escalation

If a clinical communication sent across a boundary is not acknowledged within a defined timeframe, does an automated escalation pathway trigger?

Question 7 — Service Routing

Are routing decisions at organisational boundaries based on clinical criteria and governance considerations, or primarily on capacity?

Question 8 — Outcome

After a patient crosses a boundary (referral, discharge, transfer), does the originating organisation routinely receive structured outcome data from the receiving organisation?

Question 9 — Constitutional Awareness

Do your data sharing agreements distinguish between same-domain boundaries (e.g., NHS-to-NHS) and cross-domain boundaries (e.g., NHS-to-Private, Care-to-Insurance)?

Question 10 — Hazard Log

Does your clinical safety hazard log include boundary-specific risks — risks that arise specifically from data, responsibility, or patient crossing between your organisation and others?

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Per-question breakdown

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Why Measure Your Clinical Boundary Risk?

Every healthcare organisation operates across organisational boundaries — referral pathways, discharge interfaces, diagnostic partnerships, insurer pre-authorisation flows. Each boundary is a point where patient data crosses between separate governance frameworks, where clinical responsibility transfers between independent organisations, and where the assumptions of one system meet the reality of another.

Existing governance frameworks — CQC, DCB 0129/0160, PSIRF, DSPT — assess safety within an organisation. None measures what happens between them. The result is a structural blind spot: boundaries where patient identity isn't verified on receipt, where clinical intent degrades from structured coding to free text, where responsibility is relinquished before it is accepted, and where outcome data never flows back.

Who should take this assessment?

Clinical Safety Officers whose hazard logs don't yet include boundary-specific risks. Private healthcare groups managing post-acquisition integration or NHS sub-contracting boundaries. PE investors and acquirers pricing governance risk across portfolio boundaries. Anyone accountable for clinical governance at the joins between organisations.

What the score tells you

This self-assessment evaluates your governance across the Seven Flows: Identity, Consent, Provenance, Clinical Intent, Alert & Responsibility, Service Routing, and Outcome — plus escalation mechanisms, constitutional awareness, and hazard log coverage. Your score is indicative, not diagnostic. It tells you whether boundary risk is material for your organisation and where the structural gaps are most likely.

A full Boundary Risk Assessment provides per-boundary scoring with cascading failure logic, statutory traceability, Constitutional Transition Analysis, and a funded remediation roadmap. The self-assessment tells you whether that conversation is worth having. In our experience, it almost always is.

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