Recurring concern
Insufficient safe staffing and senior cover out of hours
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Request correctionFirst reported 26 Nov 2013•Latest report 26 May 2026
What this concern includes
Includes recurring deficiencies in staffing capacity, experienced staff availability, senior clinical review, or ward management cover that specifically undermine safe weekend or out-of-hours care.
Not included
- Excludes staffing or leadership deficiencies not materially connected to weekend or out-of-hours safe care.
- Excludes failures of diagnostic, referral, documentation, audit or communication processes unless the report directly identifies inadequate weekend staffing or senior cover as the unsafe condition.
- Excludes generic workforce shortages where no specific safe-care or senior-cover consequence is supported.
- Reports
- 44
- Individual concerns
- 48
- Date range
- 2013–2026
- Stated actions
- 53
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
Lack of out-of-hours consultant radiologist cover for hospitals in Exeter, Plymouth and Torbay
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
Ask provider organisations to review out-of-hours imaging escalation pathways and assurance processes for major trauma and complex radiological findings.
Stated by NHS Cornwall and the Isles of Scilly Integrated Care Board and NHS Devon Integrated Care Board -
Action
Seek governance assurance that out-of-hours escalation pathways, learning from investigations, and access to senior radiological expertise remain appropriate for complex cases.
Stated by NHS Cornwall and the Isles of Scilly Integrated Care Board and NHS Devon Integrated Care Board
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 Integrated Care Boards did not identify an absence of consultant radiologist cover across Devon hospitals, while acknowledging complex-case escalation concerns.
Stated by NHS Cornwall and the Isles of Scilly Integrated Care Board and NHS Devon Integrated Care Board
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Concerns raised1
Delays in obtaining scans due to insufficient on-call staffing
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 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
Audit overnight CT response times and review the workforce model supporting CT provision at DDH.
Stated by Mid Yorkshire Teaching NHS Trust -
Action
Progress towards an on-site overnight radiographer model while monitoring response times and prioritisation of critically unwell patients.
Stated by Mid Yorkshire Teaching NHS Trust -
Action
Approve a business case for a dedicated DDH anaesthetic consultant on-call rota.
Stated by Mid Yorkshire Teaching NHS Trust
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Action
Implement the dedicated anaesthetic rota following recruitment.
Stated by Mid Yorkshire Teaching NHS Trust
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
Median overnight CT request-to-scan times are comparable with other Trust sites, although time-critical delays still require mitigation.
Stated by Mid Yorkshire Teaching NHS Trust
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Position
Moving to an on-site overnight radiographer model is subject to workforce availability.
Stated by Mid Yorkshire Teaching NHS Trust -
Position
Implementing the dedicated out-of-hours anaesthetic consultant rota is subject to recruitment.
Stated by Mid Yorkshire Teaching NHS Trust
-
Concerns raised1
Insufficient overnight capacity to triage waiting calls
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
Implement an overnight process for breached response times, including welfare calls and priority clinical escalation where deterioration is suspected.
Stated by Cumbria Health Limited -
Action
Implement the clinical review findings by expanding overnight support for 999 call handlers and clinicians and providing urgent in-home care with next-day follow-up.
Stated by Department of Health and Social Care
-
Concerns raised1
Failure to provide N+1 onsite perfusionist coverage for simultaneous out-of-hours CPB procedures
Responses linked to these concernsEach 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
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Position
Determining safe perfusionist staffing levels, including out-of-hours cover, is the responsibility of individual NHS trusts and employers.
Stated by Department of Health and Social Care
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Concerns raised1
Insufficient radiologist capacity for reporting CT scans
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
Reconfigure weekend out-of-hours radiology reporting across three hospitals by separating emergency and inpatient streams and adding reporting capacity.
Stated by University Hospitals Birmingham NHS Foundation Trust -
Action
Publish a new 10 Year Workforce Plan to support appropriate NHS staffing and workforce distribution.
Stated by Department of Health and Social Care
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
Radiology workload may reasonably exceed RCR session figures during acute reporting, because the guidance is for departmental planning and emergency demand cannot be controlled.
Stated by University Hospitals Birmingham NHS Foundation Trust
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Position
The Trust considers its radiology service appropriately provisioned because it uses RCR guidance as a planning benchmark and the reconfigured workload is manageable.
Stated by University Hospitals Birmingham NHS Foundation Trust -
Position
NHS Trusts and other employers are responsible for determining staffing levels and workforce composition, including appropriate weekend cover.
Stated by Department of Health and Social Care
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Concerns raised1
Insufficient experienced doctor skill mix on the Labour Ward
This report raised 15 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
Adopt a rota requiring junior registrars to pair with senior registrars and establish supervision and risk-mitigation arrangements when the intended skill mix is unavailable.
Stated by Mid and South Essex NHS Foundation Trust
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Concerns raised1
Lack of nursing cover during weekends and holiday periods by staff with relevant learning disability training
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.1
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Action
Recruit additional Learning Disability-qualified nurses for acute wards and emergency departments.
Stated by Barking, Havering and Redbridge University Hospitals NHS Trust
Respondent positions A position is what a respondent says about the concern when they do not describe a specific action.2
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Position
BHRUT is responsible for responding fully to the concerns, so the Department will not duplicate its response.
Stated by Department of Health and Social Care
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Position
The Trust cannot provide continuous learning disability nursing cover because suitably qualified nurses are unavailable and not recruitable.
Stated by Barking, Havering and Redbridge University Hospitals NHS Trust
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Concerns raised1
Insufficient doctor staffing capacity in the department
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 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
Complete demand-and-capacity modelling to define the substantive workforce needed for additional resilience.
Stated by University Hospitals Birmingham 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
Current emergency department staffing, rota review and escalation processes are considered sufficiently resilient and meet RCEM minimum criteria.
Stated by University Hospitals Birmingham NHS Foundation Trust
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Concerns raised1
Limited weekend clinical cover for injuries sustained on Fridays
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 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
Implement seven-day clinical standards and require acute trusts to provide board assurance of compliance.
Stated by NHS England -
Action
Grow the urgent and emergency care workforce, including introducing more flexible ways of working.
Stated by NHS England -
Action
Develop local workforce planning and distribute future training posts to match doctors’ supply with population need.
Stated by NHS England
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Action
Review weekend demand and prepare a business case for extending dedicated fragility-fracture theatre capacity to Saturdays.
Stated by University Hospitals of North Midlands NHS Trust
Respondent positions A position is what a respondent says about the concern when they do not describe a specific action.2
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Position
Staffordshire and Stoke-on-Trent Integrated Care System is responsible for local urgent and emergency care workforce arrangements.
Stated by NHS England
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Position
A dedicated weekend fragility-fracture theatre depends on available clinical and financial resources.
Stated by University Hospitals of North Midlands NHS Trust
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Concerns raised1
Insufficient staffing and supervision of residents outside staffed hours and at weekends
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 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
Maintain additional Night Response Team presence at Dorset Lodge during evening hours.
Stated by Bournemouth Churches Housing Association Limited -
Action
Review the Night Response Team offer to enhance physical evening presence across sites.
Stated by Bournemouth Churches Housing Association Limited
Respondent positions A position is what a respondent says about the concern when they do not describe a specific action.2
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Position
Weekend staffing was not commissioned; residents were assessed as suitable for available support, with 24/7 accommodation available for greater needs.
Stated by Bournemouth Churches Housing Association Limited
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Position
A move to 24/7 accommodation was not pursued because it was considered unsuitable and the resident preferred to remain at Dorset Lodge.
Stated by Bournemouth Churches Housing Association Limited
Data last updated 7 September 2026