Paul Moore, the Chief Risk Officer at University Hospital of South Manchester NHS Foundation Trust has been developing thinking along parallel lines. The work with Southwark has included testing the perceptions of the shadow clinical commissioning board around risk appetite, and comparing this to how business cases were being developed by the executive. The risk appetite tool is now being drafted up to be tested mid-September and then subsequently published as a means to help boards improve their decision taking. For further information contact john.bullivant@good-governance.org.uk