Quality assessment – Organisational Resilience Assessment (ORA) diagnostic tool

Quality assessment – Organisational Resilience Assessment (ORA) diagnostic tool

The client

A mental health foundation trust – healthcare


Quality assessment and improvement

Our challenge was to help the client achieve the following outputs:

  • understand their ability to withstand and adapt positively to challenges and change
  • identify risk, and areas of strength and for improvement
  • understand whether governance structures provide sufficient control of decision-making processes and clear accountability
  • understand key organisational risks and vulnerabilities and highlight structures and processes that provide early warning signs
  • understand the organisation’s ability to learn from adverse events, and whether their structures that underpin the ability to adapt and change are sufficient
  • view and explore differences between staff groups in order to build consensus


Verita and an academic from Imperial College teamed-up to develop ORA to assess organisational resilience based on a systematic literature review, and analysis of almost 200 independent investigations (conducted by Verita) across acute, secondary and mental health care providers in England between 2002 and 2013. The organizational resilience assessment (ORA) tool uses a team-based approach to identify factors that strengthen or lessen resilience. The team involved partner Peter Killwick and senior consultant Gemma Caprio.

The assessment was run three times – once with senior trust managers, once with middle managers/senior clinicians and once with front line staff. The sessions were interactive and the participants engaged in a series of questions and responses are fed into an application that generates a score for 10 indicators that are known to underpin resilience such as leadership, risk focus, adaptability and the ability to learn when things go wrong. Additionally, “softer” intelligence was captured from debate that led to the score being decided.


We were able to pinpoint areas of weakness within the department. We were also able to indicate whether the weakness was attributable to attitude, structure, process or practice.


The client found our assessment to be quick and cost-effective, and it enabled them to develop improved and targeted solutions. This trust has subsequently commissioned Verita to undertake a further ten ORA assessments based on their experience.