Recurring concern
Failure to involve families and carers in safety-critical care decisions
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Request correctionFirst reported 2 Dec 2014•Latest report 2 May 2026
What this concern includes
Includes failures to consider, seek, enable or appropriately use family or carer involvement in safety-critical care planning, risk management or consequential care decisions where their information, support or protective role is materially relevant; include the anchor's failure to consider and advocate for family contact and comparable failures involving family participation in risk management and planning.
Not included
- Excludes routine family communication, updates or contact where no safety-critical care decision, risk-management arrangement or protective-support need is involved.
- Excludes professional-to-professional communication and generic advocacy failures where family or carer involvement is not the bounded safety control.
- Excludes cases where family or carer involvement is inappropriate, refused, legally restricted or not materially relevant because of consent, confidentiality, capacity or safeguarding considerations.
- Excludes failures limited to discharge, mental-health-specific family involvement or family complaints where an existing narrower named process provides the more faithful boundary.
- Reports
- 16
- Individual concerns
- 18
- Date range
- 2014–2026
- Stated actions
- 31
Distinct published reports
A report can raise multiple concerns
First to latest report issue date
Described in published responses
Reports over time
Reports over time
Reports about this concern issued each year.
* 2026 is projected from reports observed to 7 Sep 2026.
Most frequent recipients
Most frequent recipients
Reports about this concern sent to each recipient.
Concerns and responses across reports
Only concerns grouped under this recurring concern are included. Select any concern, action or position to view the source wording.
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Concerns raised1
Failure to respond adequately to attempts to formulate a family safety plan
This report raised 5 other concerns. They are not shown here because they do not form part of this recurring concern.
Responses linked to these concernsEach statement is shown once, even when linked to more than one concern.
Actions described in response An action is something a respondent says it has done, is doing, or plans to do in response to the concern raised.4
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Action
Circulate Trust-wide expectations for contacting and communicating with police.
Stated by East London NHS Foundation Trust -
Action
Integrate safeguarding work with Local Authority colleagues through joint case-review and planning forums.
Stated by East London NHS Foundation Trust -
Action
Review and strengthen risk assessment and management processes, including clinical-recording-system changes and staff training.
Stated by East London NHS Foundation Trust
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Action
Provide staff guidance and regular advice to service users and carers on safeguarding, community safety and police routes for mitigating identified risks.
Stated by East London NHS Foundation Trust
Respondent positions A position is what a respondent says about the concern when they do not describe a specific action.1
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Position
Family and community safety risks should be addressed through safeguarding, community safety pathways or police liaison rather than direct health responses.
Stated by East London NHS Foundation Trust
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Concerns raised1
Lack of family involvement in risk management and planning
This report raised 10 other concerns. They are not shown here because they do not form part of this recurring concern.
Responses linked to these concernsEach statement is shown once, even when linked to more than one concern.
Actions described in response An action is something a respondent says it has done, is doing, or plans to do in response to the concern raised.1
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Action
Deliver Triangle of Care training and carer-involvement simulation sessions for Brighton Haven staff.
Stated by Sussex Partnership NHS Foundation Trust
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Concerns raised1
Failure to consider and advocate for family contact
This report raised 7 other concerns. They are not shown here because they do not form part of this recurring concern.
Responses linked to these concernsEach statement is shown once, even when linked to more than one concern.
Actions described in response An action is something a respondent says it has done, is doing, or plans to do in response to the concern raised.2
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Action
Complete a joint review of HMP Hewell’s food refusal policy to clarify consideration of next-of-kin contact where serious health risks are identified.
Stated by HM Prison and Probation Service -
Action
Deliver awareness sessions to prison and healthcare staff on supporting prisoners who refuse food, including contact with next of kin.
Stated by HM Prison and Probation Service
Respondent positions A position is what a respondent says about the concern when they do not describe a specific action.3
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Position
Practice Plus Group is responsible for responding to concerns about healthcare delivery at HMP Hewell.
Stated by HM Prison and Probation Service
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Position
The food and fluid refusal pathway is considered robust and fit for purpose regardless of the reason for refusal.
Stated by Practice Plus Group -
Position
Family advocacy was not considered necessary because the patient did not request family support and no benefit from contact was identified.
Stated by Practice Plus Group
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Concerns raised1
Lack of clear guidance and protocols for clinicians to seek and include family or other relevant views in care and safety planning
This report raised 1 other concern. They are not shown here because they do not form part of this recurring concern.
Responses linked to these concernsEach statement is shown once, even when linked to more than one concern.
Actions described in response An action is something a respondent says it has done, is doing, or plans to do in response to the concern raised.3
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Action
Publish national best-practice guidance promoting proactive involvement of trusted others in safety assessment and management.
Stated by NHS England -
Action
Launch nationally available e-learning training complementing the suicide-safety guidance for mental health practitioners.
Stated by NHS England -
Action
Share draft personalised-care guidance with Integrated Care Boards on involving families, carers and support networks in care and safety planning.
Stated by NHS England
Respondent positions A position is what a respondent says about the concern when they do not describe a specific action.1
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Position
Published suicide safety guidance clarifies national expectations for proactively involving trusted others in safety planning.
Stated by NHS England
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Concerns raised1
Failure to communicate diagnosis, treatment options, rationale and discharge plans with family representatives
This report raised 5 other concerns. They are not shown here because they do not form part of this recurring concern.
Responses linked to these concernsEach statement is shown once, even when linked to more than one concern.
Actions described in response An action is something a respondent says it has done, is doing, or plans to do in response to the concern raised.2
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Action
Allocate a multidisciplinary team member on ward rounds to update families about all aspects of patient care.
Stated by County Durham and Darlington NHS Foundation Trust -
Action
Conduct regular retrospective clinical-record audits to monitor compliance with family communication standards.
Stated by County Durham and Darlington NHS Foundation Trust
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Concerns raised1
Failure to routinely involve family in patients' risk assessment, care planning and safety planning
This report raised 5 other concerns. They are not shown here because they do not form part of this recurring concern.
Responses linked to these concernsEach statement is shown once, even when linked to more than one concern.
Actions described in response An action is something a respondent says it has done, is doing, or plans to do in response to the concern raised.4
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Action
Provide each patient with a named nurse who agrees at least weekly family or carer contact and audits involvement in care planning and risk assessment.
Stated by Nottinghamshire Healthcare NHS Foundation Trust -
Action
Invite families and carers to ward multidisciplinary meetings using a standard template and audit invitations and involvement.
Stated by Nottinghamshire Healthcare NHS Foundation Trust -
Action
Introduce collaborative care-planning conversations with every newly admitted patient and their relative or carer.
Stated by Nottinghamshire Healthcare NHS Foundation Trust
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Action
Strengthen SAFETool training with family and carer involvement content and reflective case studies.
Stated by Nottinghamshire Healthcare NHS Foundation Trust
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Concerns raised1
Lack of a communication strategy supporting joint working and family involvement in pressure-ulcer care
This report raised 5 other concerns. They are not shown here because they do not form part of this recurring concern.
Responses linked to these concernsEach statement is shown once, even when linked to more than one concern.
Actions described in response An action is something a respondent says it has done, is doing, or plans to do in response to the concern raised.3
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Action
Develop an information leaflet explaining how families can contact District Nursing for pressure-area-care advice.
Stated by NHS Greater Manchester Integrated Care Board -
Action
Include joint-working Quality Statements in the service’s next assessment and follow up actions addressing previously identified communication shortfalls.
Stated by Care Quality Commission -
Action
Follow up the registered manager’s investigation into failures to keep families informed and seek assurance that resulting actions mitigate communication risks.
Stated by Care Quality Commission
Respondent positions A position is what a respondent says about the concern when they do not describe a specific action.1
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Position
The care home provider is responsible for keeping family members updated about residents’ health, including pressure ulcer management and nursing advice.
Stated by NHS Greater Manchester Integrated Care Board
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Concerns raised2
Failure to ensure carers' participation in sling assessments
Failure to discuss sling use with new carers
This report raised 6 other concerns. They are not shown here because they do not form part of this recurring concern.
Responses linked to these concernsEach statement is shown once, even when linked to more than one concern.
Actions described in response An action is something a respondent says it has done, is doing, or plans to do in response to the concern raised.1
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Action
Introduce a countywide communication-focused role supporting joint client visits, delegated tasks, and liaison between HASE and external care agencies.
Stated by Herefordshire and Worcestershire Health and Care NHS Trust
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Concerns raised1
Extremely limited family and carer involvement in care planning and ward rounds
This report raised 3 other concerns. They are not shown here because they do not form part of this recurring concern.
Responses linked to these concernsEach statement is shown once, even when linked to more than one concern.
Actions described in response An action is something a respondent says it has done, is doing, or plans to do in response to the concern raised.4
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Action
Complete Triangle of Care self-assessments across Adult Mental Health inpatient areas and review findings to agree improvement actions.
Stated by Nottinghamshire Healthcare NHS Foundation Trust -
Action
Recruit and deploy a Carer Peer Support Worker for acute wards to strengthen liaison with patients, families, carers, and multidisciplinary teams.
Stated by Nottinghamshire Healthcare NHS Foundation Trust -
Action
Introduce admission-based Carer Contact Plans recording patients’ preferences for family and carer involvement and information sharing.
Stated by Nottinghamshire Healthcare NHS Foundation Trust
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Action
Deliver bespoke family-intervention training to the Beech Ward multidisciplinary team.
Stated by Nottinghamshire Healthcare NHS Foundation Trust
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Concerns raised1
Failure to prepare care plans with relevant family input
This report raised 12 other concerns. They are not shown here because they do not form part of this recurring concern.
Responses linked to these concernsEach statement is shown once, even when linked to more than one concern.
Actions described in response An action is something a respondent says it has done, is doing, or plans to do in response to the concern raised.2
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Action
Use an in-person pre-admission form documenting resident and family input, with family involvement subject to the resident’s consent where they have capacity.
Stated by Runwood Homes PLC -
Action
Complete new-resident risk assessments within 24 hours and care plans within seven days, prioritising high-risk assessments within six hours and reviewing plans with families and when needs change.
Stated by Runwood Homes PLC
Data last updated 7 September 2026