Recurring concern
Failure to enable professional challenge of clinical decisions
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Request correctionFirst reported 25 Jul 2018•Latest report 27 Feb 2026
What this concern includes
Includes failures of clinical-care arrangements, culture or supervision that prevent or discourage staff from raising, discussing or escalating a material challenge to another clinician's decision, including challenges to discharge decisions and differing findings between junior doctors and consultants.
Not included
- Excludes generic speaking-up, communication or workplace-culture concerns where no clinical decision or patient-safety challenge is involved.
- Excludes poor clinical decisions where no failure to enable, receive or act on professional challenge is identified.
- Excludes failures of formal complaints, incident reporting or whistleblowing systems unless the asserted unsafe condition is specifically the inability to challenge a clinical decision during care.
- Excludes disagreements that were appropriately raised, considered and resolved without an identified safety deficiency.
- Reports
- 5
- Individual concerns
- 5
- Date range
- 2018–2026
- Stated actions
- 9
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 challenge a Consultant's view to discharge
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
Implement Martha’s Rule, including daily patient check-ins, rapid review access and advertised escalation routes for concerns about deterioration, treatment or discharge planning.
Stated by East Suffolk and North Essex NHS Foundation Trust
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Concerns raised1
Failure to encourage junior doctors to challenge or discuss differing findings with consultant colleagues
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.1
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Action
Issue and distribute a safety alert sharing learning and reinforcing listening to differing professional views, including junior clinicians’ concerns.
Stated by Betsi Cadwaladr University LHB
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Concerns raised1
Failure to promote and facilitate professional challenge
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
Pilot CTG interpretation training covering SBAR handover, escalation and professional challenge, with competency assessment and planned online rollout.
Stated by Nottingham University Hospitals NHS Trust -
Action
Embed CTG, SBAR, escalation and professional-challenge concepts into multiprofessional emergency training and in-situ skills drills.
Stated by Nottingham University Hospitals NHS Trust -
Action
Update the Maternity Communication guideline to incorporate CTG, SBAR, escalation and professional-challenge concepts.
Stated by Nottingham University Hospitals NHS Trust
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Action
Hold communication events enabling staff to meet leadership and raise professional challenges.
Stated by Nottingham University Hospitals NHS Trust
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Concerns raised1
Inability of junior staff to challenge or review clinical decisions
This report raised 9 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
Implement an organisational development plan supporting multidisciplinary teamwork and clinical leadership in maternity services.
Stated by Cwm Taf Morgannwg University Local Health Board -
Action
Deliver Royal College of Midwives-supported clinical leadership and team-working study days.
Stated by Cwm Taf Morgannwg University Local Health Board -
Action
Provide multidisciplinary PROMPT training and reflection opportunities focused on emergency communication and caesarean-section decision-making.
Stated by Cwm Taf Morgannwg University Local Health Board
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Concerns raised1
Failure of multidisciplinary team members to challenge incorrect clinical decisions
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.
No linked response statementsNo respondent-stated action or position is linked to these concerns in the published data.
Data last updated 7 September 2026