Stakeholder and Responsibility Mapping

#Identify who is affected

A stakeholder is a person or group affected by the proposed work, involved in delivering it or able to influence its direction. Begin with patients, carers and the staff performing the relevant tasks. Then consider supporting roles such as administration, information technology, data governance and service management.

Look beyond the most visible or senior participants. A change may create extra work for reception staff, alter a carer's responsibilities or make access harder for people with disabilities. Include perspectives from different shifts, locations and levels of digital confidence where these differences are relevant to the proposed use.

#Distinguish participation from authority

Being consulted is not the same as having authority to approve a decision. For each important activity, identify who performs the work, who owns the decision, who provides advice and who needs to be informed. Use role descriptions that remain understandable when individual staff members change.

Map decisions about clinical safety, data access, procurement, technical changes and evaluation separately. One person or committee may not have authority across all these areas. Where responsibilities overlap, explain how disagreements will be resolved and who can pause activity if a concern cannot be addressed promptly.

#Make the map usable in practice

Responsibility requires more than a name in a document. Check that each role has the time, information, skills and authority needed to carry out its duties. Identify cover for absence and a clear escalation route. Avoid assigning accountability to a group without specifying how that group makes decisions.

Review the map with the people it describes and update it when scope or working arrangements change. Record where patient and staff input can influence decisions, rather than collecting views after choices are effectively fixed. Unresolved ownership is a practical risk that should be addressed before work depends on it.

#Common misunderstandings

A stakeholder map is not simply a contact list. It should show whose care, work or wellbeing may be affected, what knowledge each group contributes, and where responsibility for decisions sits. Listing someone does not mean their perspective has been heard or their agreement obtained.

Participation and authority are also different. A person may offer essential experience without holding formal decision-making power. Equally, someone responsible for a decision may need input from people who will experience its consequences. Consulting a group does not transfer accountability to that group.

Another misunderstanding is that every stakeholder needs access to every detail. In healthcare, involvement must respect confidentiality, consent and relevant information-sharing requirements. The map should clarify involvement without exposing unnecessary personal information.

Finally, a completed map is not permanent. Responsibilities, care arrangements and people’s preferences can change. Reviewing the map at agreed points helps reveal gaps, outdated assumptions and duties that remain unassigned.

#Questions worth asking a clinician

• Who have you included in the stakeholder map, including carers, non-participants and others indirectly affected, and whose perspectives are still missing?
• For each key responsibility, who should be consulted, who carries out the work, and who has final decision authority?
• How will you involve affected people who face barriers to participation, and who is responsible for ensuring their views reach decision-makers?
• What staff time, funding and support are available for each assigned responsibility, and who will address any resource gaps?
• Who should concerns or unresolved disagreements be escalated to, and who takes over key responsibilities when the usual person is unavailable?