Recurring concern
Insufficient safe staffing and senior cover out of hours
- Reports that mention this concern
- 44
- Times this concern has been raised
- 48
- Stated actions linked to this concern
- 53
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.
What is 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.
Trends
Reports over time
Reports mentioning this concern, 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.
Reports and published responses 44 reports
See individual reports that have raised this concern, and the actions taken in response
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Concerns raised1
Lack of out-of-hours consultant radiologist cover for hospitals in Exeter, Plymouth and Torbay
Linked responses
- NHS Cornwall and the Isles of Scilly Integrated Care Board
- NHS Devon Integrated Care Board
Stated actions 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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NHS Cornwall and the Isles of Scilly Integrated Care Board and NHS Devon Integrated Care Board
Ask provider organisations to review out-of-hours imaging escalation pathways and assurance processes for major trauma and complex radiological findings.
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NHS Cornwall and the Isles of Scilly Integrated Care Board and NHS Devon Integrated Care Board
Seek governance assurance that out-of-hours escalation pathways, learning from investigations, and access to senior radiological expertise remain appropriate for complex cases.
Respondent positions A position is what a respondent says about the concern when they do not describe a specific action.1
-
NHS Cornwall and the Isles of Scilly Integrated Care Board and NHS Devon Integrated Care Board
The Integrated Care Boards did not identify an absence of consultant radiologist cover across Devon hospitals, while acknowledging complex-case escalation concerns.
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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.
Linked response
- Mid Yorkshire Teaching NHS Trust
Stated actions 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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Mid Yorkshire Teaching NHS Trust
Audit overnight CT response times and review the workforce model supporting CT provision at DDH.
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Mid Yorkshire Teaching NHS Trust
Progress towards an on-site overnight radiographer model while monitoring response times and prioritisation of critically unwell patients.
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Mid Yorkshire Teaching NHS Trust
Approve a business case for a dedicated DDH anaesthetic consultant on-call rota.
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Mid Yorkshire Teaching NHS Trust
Implement the dedicated anaesthetic rota following recruitment.
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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Mid Yorkshire Teaching NHS Trust
Median overnight CT request-to-scan times are comparable with other Trust sites, although time-critical delays still require mitigation.
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Mid Yorkshire Teaching NHS Trust
Moving to an on-site overnight radiographer model is subject to workforce availability.
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Mid Yorkshire Teaching NHS Trust
Implementing the dedicated out-of-hours anaesthetic consultant rota is subject to recruitment.
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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.
Linked responses
- Cumbria Health Limited
- Department of Health and Social Care
Stated actions 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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Cumbria Health Limited
Implement an overnight process for breached response times, including welfare calls and priority clinical escalation where deterioration is suspected.
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Department of Health and Social Care
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.
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Concerns raised1
Failure to provide N+1 onsite perfusionist coverage for simultaneous out-of-hours CPB procedures
Linked response
- 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.1
-
Department of Health and Social Care
Determining safe perfusionist staffing levels, including out-of-hours cover, is the responsibility of individual NHS trusts and employers.
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Concerns raised1
Insufficient radiologist capacity for reporting CT scans
Linked responses
- Department of Health and Social Care
- University Hospitals Birmingham NHS Foundation Trust
Stated actions An action is something a respondent says it has done, is doing, or plans to do in response to the concern raised.2
-
University Hospitals Birmingham NHS Foundation Trust
Reconfigure weekend out-of-hours radiology reporting across three hospitals by separating emergency and inpatient streams and adding reporting capacity.
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Department of Health and Social Care
Publish a new 10 Year Workforce Plan to support appropriate NHS staffing and workforce distribution.
Respondent positions A position is what a respondent says about the concern when they do not describe a specific action.3
-
University Hospitals Birmingham NHS Foundation Trust
Radiology workload may reasonably exceed RCR session figures during acute reporting, because the guidance is for departmental planning and emergency demand cannot be controlled.
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University Hospitals Birmingham NHS Foundation Trust
The Trust considers its radiology service appropriately provisioned because it uses RCR guidance as a planning benchmark and the reconfigured workload is manageable.
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Department of Health and Social Care
NHS Trusts and other employers are responsible for determining staffing levels and workforce composition, including appropriate weekend cover.
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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.
Linked response
- Mid and South Essex NHS Foundation Trust
Stated actions 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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Mid and South Essex NHS Foundation Trust
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.
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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.
Linked responses
- Barking, Havering and Redbridge University Hospitals NHS Trust
- Department of Health and Social Care
Stated actions 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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Barking, Havering and Redbridge University Hospitals NHS Trust
Recruit additional Learning Disability-qualified nurses for acute wards and emergency departments.
Respondent positions A position is what a respondent says about the concern when they do not describe a specific action.2
-
Department of Health and Social Care
BHRUT is responsible for responding fully to the concerns, so the Department will not duplicate its response.
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Barking, Havering and Redbridge University Hospitals NHS Trust
The Trust cannot provide continuous learning disability nursing cover because suitably qualified nurses are unavailable and not recruitable.
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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.
Linked response
- University Hospitals Birmingham NHS Foundation Trust
Stated actions 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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University Hospitals Birmingham NHS Foundation Trust
Complete demand-and-capacity modelling to define the substantive workforce needed for additional resilience.
Respondent positions A position is what a respondent says about the concern when they do not describe a specific action.1
-
University Hospitals Birmingham NHS Foundation Trust
Current emergency department staffing, rota review and escalation processes are considered sufficiently resilient and meet RCEM minimum criteria.
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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.
Linked responses
- NHS England
- University Hospitals of North Midlands NHS Trust
Stated actions 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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NHS England
Implement seven-day clinical standards and require acute trusts to provide board assurance of compliance.
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NHS England
Grow the urgent and emergency care workforce, including introducing more flexible ways of working.
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NHS England
Develop local workforce planning and distribute future training posts to match doctors’ supply with population need.
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University Hospitals of North Midlands NHS Trust
Review weekend demand and prepare a business case for extending dedicated fragility-fracture theatre capacity to Saturdays.
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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NHS England
Staffordshire and Stoke-on-Trent Integrated Care System is responsible for local urgent and emergency care workforce arrangements.
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University Hospitals of North Midlands NHS Trust
A dedicated weekend fragility-fracture theatre depends on available clinical and financial resources.
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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.
Linked response
- Bournemouth Churches Housing Association Limited
Stated actions 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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Bournemouth Churches Housing Association Limited
Maintain additional Night Response Team presence at Dorset Lodge during evening hours.
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Bournemouth Churches Housing Association Limited
Review the Night Response Team offer to enhance physical evening presence across sites.
Respondent positions A position is what a respondent says about the concern when they do not describe a specific action.2
-
Bournemouth Churches Housing Association Limited
Weekend staffing was not commissioned; residents were assessed as suitable for available support, with 24/7 accommodation available for greater needs.
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Bournemouth Churches Housing Association Limited
A move to 24/7 accommodation was not pursued because it was considered unsuitable and the resident preferred to remain at Dorset Lodge.
Actions and positions describe what organisations say in published responses. Implementation is not independently verified.
Data last updated 7 September 2026