First reported 2 Oct 2020•Latest report 7 Apr 2025
Definition
What this concern includes
Includes failures in arranging, accessing, performing or providing clinically required cardiology tests, including delays in carrying out tests and inadequate out-of-hours or weekend availability where these can delay subsequent cardiac care or referral.
Not included
Excludes failures in cardiology assessment, specialist referral or treatment after the required cardiology tests have been completed and made available.
Excludes generic delays in blood tests, ECGs or other investigations where no cardiology-testing context is identified.
Excludes failures limited to interpreting, communicating or acting on completed cardiology-test results when test access and completion were reliable.
Excludes general cardiology service capacity or consultant availability deficiencies where the specific unsafe condition is not access to clinically required cardiology tests.
Reports
5
Distinct published reports
Individual concerns
5
A report can raise multiple concerns
Date range
2020–2025
First to latest report issue date
Stated actions
9
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.
Department of Health and Social Care2
NHS Greater Manchester Integrated Care Board2
Department for Digital, Culture, Media and Sport1
Department for Transport1
Faculty of Intensive Care Medicine1
NHS Central East Integrated Care Board1
NHS England1
Northamptonshire Safeguarding Children Partnership1
North West Anglia NHS Foundation Trust1
Royal College of Emergency Medicine1
Royal College of Radiologists1
Integrated care board3
Ministerial department3
Executive non-departmental public body1
Health professional body1
NHS trust1
Other public body1
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.
Cambridgeshire and Peterborough
Concerns raised1
Failure to obtain echocardiography for critically unwell patients in shock
This report raised 21 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.6
Action
Include focused cardiac ultrasound for shock assessment in the emergency medicine training curriculum.
Stated by Royal College of Emergency MedicineStated completedThe respondent said that this action was complete when they made their response on 15 April 2025.
Action
Provide echocardiography training to trainees.
Stated by North West Anglia NHS Foundation TrustStated completedThe respondent said that this action was complete when they made their response on 15 April 2025.
Action
Review HiLLO descriptors and consider clarifying echocardiography training and skills requirements.
Stated by Faculty of Intensive Care MedicineStated in progressThe respondent said that this action was in progress when they made their response on 15 April 2025.
Action
Consult on GPICS version 3 guidance, including standards for echocardiography access, image storage, training and quality assurance.
Stated by Faculty of Intensive Care MedicineStated in progressThe respondent said that this action was in progress when they made their response on 15 April 2025.
Action
Work with hospital cardiology service providers to improve reliable access to emergent out-of-hours echocardiography.
Stated by Faculty of Intensive Care MedicineStated in progressThe respondent said that this action was in progress when they made their response on 15 April 2025.
Action
Work with providers to gain assurance that critically ill patients have 24/7 access to transthoracic or focused echocardiography.
Stated by NHS Central East Integrated Care BoardStated plannedThe respondent said that this action was planned when they made their response on 15 April 2025.
Respondent positions A position is what a respondent says about the concern when they do not describe a specific action.2
Position
Pre-arrest focused cardiac ultrasound was not a reasonable expectation because the applicable emergency medicine curriculum did not include shock assessment.
Stated by Royal College of Emergency MedicineDisputes the concernThe respondent disagreed with part of the concern or the basis for it.
Position
The case was not caused by inability to perform echocardiography; appropriately trained clinicians could have performed the procedure if cardiogenic shock was suspected.
Stated by North West Anglia NHS Foundation TrustDisputes the concernThe respondent disagreed with part of the concern or the basis for it.
Manchester South
Concerns raised1
Shortage of suitably qualified professionals to carry out essential cardiac tests
This report raised 2 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
Deliver the Long-Term Workforce Plan, including expanded education, training, recruitment, retention, and strategic workforce planning.
Stated by NHS EnglandStated in progressThe respondent said that this action was in progress when they made their response on 4 July 2024.
Action
Support local services to recover elective care, reduce waiting times, improve diagnostic turnaround, and create additional capacity for complex and urgent care.
Stated by NHS EnglandStated plannedThe respondent said that this action was planned when they made their response on 4 July 2024.
Respondent positions A position is what a respondent says about the concern when they do not describe a specific action.1
Position
NHS Trusts, rather than NHS England, are responsible for ensuring safe staffing levels in day-to-day hospital operations.
Stated by NHS EnglandRedirects responsibilityThe respondent said that another organisation was responsible for deciding or taking action.
Berkshire
Concerns raised1
Unavailability of cardiac stress testing for asymptomatic individuals
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 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.1
Position
The DVLA can act only on information received from licence holders or healthcare professionals about known medical conditions.
Stated by Department for TransportUnable to actThe respondent said that a constraint prevented them from taking the relevant action.
Manchester South
Concerns raised1
Unavailability of out-of-hours cardiac testing in District General Hospitals
This report raised 2 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.1
Position
Emergency cardiac scans outside normal hours are addressed by transferring patients to a tertiary centre.
Stated by Department of Health and Social CareExisting arrangements considered sufficientThe respondent said that existing arrangements were sufficient, so no further action was needed.
Manchester South
Concerns raised1
Delays in cardiology tests being carried out
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 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.1
Action
Implement the changed NT-proBNP testing and referral pathway, including urgency thresholds for echocardiography and heart failure services.
Stated by NHS Greater Manchester Integrated Care BoardStated completedThe respondent said that this action was complete when they made their response on 26 November 2020.
Respondent positions A position is what a respondent says about the concern when they do not describe a specific action.1
Position
There were no delays; investigations and referrals followed correct, timely processes and pathways, so the reported cardiology-timescale risk did not arise in this case.
Stated by NHS Greater Manchester Integrated Care BoardDisputes the concernThe respondent disagreed with part of the concern or the basis for it.
Pin
Get email alerts
Request correction
Includes failures in arranging, accessing, performing or providing clinically required cardiology tests, including delays in carrying out tests and inadequate out-of-hours or weekend availability where these can delay subsequent cardiac care or referral.
