Recurring concern
Failure to discuss patient care options and decisions
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Request correctionFirst reported 27 Oct 2014•Latest report 25 Jun 2026
What this concern includes
Includes failures to discuss consequential patient-care options, decisions, expected outcomes or treatment rationale with the patient, including discussion before or during decisions about transfers, further treatment, assessment or other management.
Not included
- Excludes the broader informed-consent process where the asserted concern is specifically validity of consent, material-risk disclosure, time for consideration or consent documentation.
- Excludes generic communication failures that do not concern a consequential patient-care option, decision or treatment rationale.
- Excludes failures to involve families or carers where patient-facing discussion is not the shared unsafe condition.
- Excludes failures in clinical decision-making or treatment after the relevant options and rationale were adequately discussed with the patient.
- Reports
- 8
- Individual concerns
- 8
- Date range
- 2014–2026
- Stated actions
- 12
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 a system for involving patients in decisions about the timing of required procedures
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 the revised Devices MDT governance documents, including referral criteria, clinical reasoning, patient involvement, escalation and action-accountability requirements.
Stated by East Kent Hospitals University NHS Foundation Trust -
Action
Apply the strengthened MDT governance model, where appropriate, to other Cardiology Service MDTs.
Stated by East Kent Hospitals University 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
The specialist extraction centre, in consultation with the patient, makes the final decision about whether and when lead extraction occurs.
Stated by East Kent Hospitals University NHS Foundation Trust
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Concerns raised1
Failure to provide complete information about treatment options before consent
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.4
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Action
Amend the consent policy to require additional consultant input, Best Interests Meetings where applicable, and documentation of operative and conservative-treatment risks.
Stated by University College London Hospital (UCLH -
Action
Record subspecialty agreement to implement the amended consent policy through local governance committees.
Stated by University College London Hospital (UCLH -
Action
Audit implementation of the amended consent policy within six months.
Stated by University College London Hospital (UCLH
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Action
Incorporate the PFD learning into subspecialty Trust induction covering ward-round documentation and the consent policy within three months.
Stated by University College London Hospital (UCLH
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Concerns raised1
Failure to provide recommendations for discussing anticoagulation withholding risks and benefits with patients
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.
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
Assess the issue through the guidelines surveillance process to determine whether guidance recommendations should be updated or newly issued.
Stated by National Institute for Health and Care Excellence
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Concerns raised1
Lack of discussion of birthing options before labour
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.
No linked response statementsNo respondent-stated action or position is linked to these concerns in the published data.
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Concerns raised1
Failure to discuss relevant ERCP patient factors with the patient
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
Operate two permanent consultant-staffed clinics to discuss ERCP indications, risks and alternatives with referred outpatients.
Stated by Nottingham University Hospitals NHS Trust -
Action
Provide inpatient information booklets and obtain consent through ERCP endoscopist ward reviews before procedures.
Stated by Nottingham University Hospitals NHS Trust
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Concerns raised1
Insufficient discussion with patients about their care
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 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.2
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Position
Care plans and team communication were clear, although lost clinical notes prevented demonstrating that structure.
Stated by St George'S University Hospitals NHS Foundation Trust
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Position
There were repeated discussions with the patient about amputation, despite lost records preventing corroboration.
Stated by St George'S University Hospitals NHS Foundation Trust
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Concerns raised1
Failure to discuss treatment reasoning and efficacy with patients
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
Emphasise informed decision-making practice through clinical forums and the patient safety newsletter.
Stated by Norfolk and Suffolk NHS Foundation Trust
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Concerns raised1
Failure to ensure full and meaningful discussion before initiating the End-of-Life Care Pathway
This report raised 12 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
Review and update the DNACPR policy to require clear, accurate communication and discussion with patients or those close to them.
Stated by Tameside General Hospital -
Action
Create and disseminate a DNACPR policy DVD through the Trust intranet and staff screen savers.
Stated by Tameside General Hospital
Data last updated 7 September 2026