Risk assessment is a central concept in predicting health care needs and implementing a preventive strategy. However, risk-assessment tools are subject to misuse and it is argued that they can reduce the key role of clinical judgement in decision-making. This article explores the problems of numerical tools and describes how a non-numerical tool was developed and implemented in the author’s trusts. It highlights the findings of subsequent audit and suggests that non-numerical tools can facilitate improved clinical outcomes and resource allocation and enhance professional accountability and responsibility.