First reported 1 Sep 2014•Latest report 4 Apr 2024
Definition
What this concern includes
Includes failures in arrangements for providing, selecting, authorising or supporting senior nurses who lead nursing shifts or direct nursing care, including insufficient senior nursing leadership capacity, inadequate empowerment to escalate concerns and unreliable procedures for determining which nurse clinicians are appropriate to lead.
Not included
Excludes generic nursing staffing shortages where the report does not identify an effect on senior nursing leadership or nursing-shift leadership.
Excludes generic clinical leadership, medical leadership or organisational governance deficiencies that do not concern senior nursing leadership of patient care.
Excludes failures of frontline nurse competence, communication, documentation or escalation where senior nursing leadership capacity or assurance is not the shared unsafe condition.
Excludes general staff empowerment or workplace-culture concerns without a direct connection to senior nursing leadership and safe patient-care oversight.
Reports
7
Distinct published reports
Individual concerns
7
A report can raise multiple concerns
Date range
2014–2024
First to latest report issue date
Stated actions
11
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.
Care Quality Commission1
Greater Manchester Mental Health NHS Foundation Trust1
Hc-One Limited1
Lancashire Teaching Hospitals NHS Foundation Trust1
Manchester University NHS Foundation Trust1
NHS England1
NHS Greater Manchester Integrated Care Board1
NHS Surrey and Sussex Integrated Care Board1
Royal Free London NHS Foundation Trust1
Sherwood Forest Hospitals NHS Foundation Trust1
Sussex Partnership NHS Foundation Trust1
NHS trust6
Integrated care board2
Executive non-departmental public body1
Health and social care service regulator1
Private limited company1
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.
Nottinghamshire
Concerns raised1
Insufficient paediatric nursing capacity and senior nurse support in the Emergency Department
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 concerns
Each 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.9
Action
Roster registered children’s nurses during identified peak emergency-department attendance periods.
Stated by Sherwood Forest Hospitals NHS Foundation TrustStated completedThe respondent said that this action was complete when they made their response on 15 April 2024.
Action
Require adult nurses caring for children to complete specified paediatric experience, training, study days, e-learning and supervised shadowing.
Stated by Sherwood Forest Hospitals NHS Foundation TrustStated completedThe respondent said that this action was complete when they made their response on 15 April 2024.
Action
Record paediatric nursing staffing as a significant risk and review it monthly through specialty and Trust risk committees.
Stated by Sherwood Forest Hospitals NHS Foundation TrustStated completedThe respondent said that this action was complete when they made their response on 15 April 2024.
Action
Develop a rotational pathway for registered children’s nurses through continuous Emergency Department and paediatric collaboration.
Stated by Sherwood Forest Hospitals NHS Foundation TrustStated plannedThe respondent said that this action was planned when they made their response on 15 April 2024.
Action
Train an Emergency Department adult nurse as a paediatric nurse, increasing staffing by one whole-time equivalent.
Stated by Sherwood Forest Hospitals NHS Foundation TrustStated in progressThe respondent said that this action was in progress when they made their response on 15 April 2024.
Action
Provide newly qualified registered children’s nurses with discipline-specific preceptors, supernumerary practice and Emergency Department induction.
Stated by Sherwood Forest Hospitals NHS Foundation TrustStated completedThe respondent said that this action was complete when they made their response on 15 April 2024.
Action
Review Emergency Department escalation processes for proactively identifying and escalating nursing staffing concerns.
Stated by Sherwood Forest Hospitals NHS Foundation TrustStated completedThe respondent said that this action was complete when they made their response on 15 April 2024.
Action
Add a peak-time Band 5 registered-nurse shift and improve Healthroster displays to identify children’s-area registered children’s nurse cover gaps.
Stated by Sherwood Forest Hospitals NHS Foundation TrustStated completedThe respondent said that this action was complete when they made their response on 15 April 2024.
Action
Implement a supervisory Band 7 Nurse in Charge role providing visible senior nursing support across the Emergency Department, with supernumerary deployment from July 2024.
Stated by Sherwood Forest Hospitals NHS Foundation TrustStated plannedThe respondent said that this action was planned when they made their response on 15 April 2024.
Respondent positions A position is what a respondent says about the concern when they do not describe a specific action.1
Position
Recruitment challenges mean the Trust is unable to meet RCPCH paediatric nursing workforce standards despite active recruitment.
Stated by Sherwood Forest Hospitals NHS Foundation TrustUnable to actThe respondent said that a constraint prevented them from taking the relevant action.
Manchester North
Concerns raised1
Failure to ensure sufficiently experienced nursing staff in charge of the specialist high-risk unit
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 concerns
Each statement is shown once, even when linked to more than one concern.
Respondent positions A position is what a respondent says about the concern when they do not describe a specific action.3
Position
The Trust disputes that staff experience and skill mix were inadequate during the relevant weekend, stating no concerns had been identified.
Stated by Greater Manchester Mental Health NHS Foundation TrustDisputes the concernThe respondent disagreed with part of the concern or the basis for it.
Position
Existing staffing reviews, weekend briefings and escalation systems are considered sufficient to identify and address changing clinical and staffing needs.
Stated by Greater Manchester Mental Health NHS Foundation TrustExisting arrangements considered sufficientThe respondent said that existing arrangements were sufficient, so no further action was needed.
Position
Greater Manchester Mental Health NHS Foundation Trust is responsible for addressing the specific operational changes arising from the concerns.
Stated by NHS EnglandRedirects responsibilityThe respondent said that another organisation was responsible for deciding or taking action.
Brighton and Hove
Concerns raised1
Lack of ward management and matron leadership
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 concerns
Each statement is shown once, even when linked to more than one concern.
No linked response statements
No respondent-stated action or position is linked to these concerns in the published data.
Manchester West
Concerns raised1
Use of agency nurses as senior staff in charge of shifts
This report raised 4 other concerns. They are not shown here because they do not form part of this recurring concern.
Responses linked to these concerns
Each 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
Action
Block-book agency staff where possible to improve familiarity with home standards and residents’ needs.
Stated by Hc-One LimitedStated completedThe respondent said that this action was complete when they made their response on 13 September 2019.
Action
Complete and distribute a strengthened agency-staff orientation booklet across the company.
Stated by Hc-One LimitedStated plannedThe respondent said that this action was planned when they made their response on 13 September 2019.
Manchester City
Concerns raised1
Insufficient senior nursing staff in leadership roles
This report raised 8 other concerns. They are not shown here because they do not form part of this recurring concern.
Responses linked to these concerns
Each statement is shown once, even when linked to more than one concern.
No linked response statements
No respondent-stated action or position is linked to these concerns in the published data.
Preston and West Lancashire
Concerns raised1
Deficient procedures for determining which nurse clinicians may lead a nursing shift
This report raised 13 other concerns. They are not shown here because they do not form part of this recurring concern.
Responses linked to these concerns
Each statement is shown once, even when linked to more than one concern.
No linked response statements
No respondent-stated action or position is linked to these concerns in the published data.
Inner North London
Concerns raised1
Lack of clarity of ward leadership and support
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 concerns
Each statement is shown once, even when linked to more than one concern.
No linked response statements
No respondent-stated action or position is linked to these concerns in the published data.