Failure to seek medical attention when a person's condition warrants it
First to latest report 5 Sep 2013 — 16 Jun 2026
Reports that mention this concern
56
Times this concern has been raised
61
Stated actions linked to this concern
81
What this concern includes
Includes failures to recognise the need for and promptly seek medical, paramedic or other appropriate clinical assistance when a person's injury, pain, fall, deterioration or other condition warrants it, including failures in care homes and emergency-response settings.
What is not included
Excludes delays or failures occurring after medical assistance has already been requested, including ambulance attendance or hospital handover delays.
Excludes failures limited to the quality of assessment or treatment after medical assistance has been obtained.
Excludes failures to seek advice about routine care arrangements where no immediate or clinically warranted need for medical attention is identified.
Excludes generic staffing, training, communication or documentation deficiencies unless they directly result in failure to seek warranted medical attention.
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.
Care Quality Commission9
NHS England4
Department of Health and Social Care3
Recipient name withheld3
National Institute for Health and Care Excellence2
University Hospitals Sussex NHS Foundation Trust2
Abbey Care Village1
Adbolton Hall1
Angel Solutions (UK) Ltd1
Appello Careline Limited1
Association of Ambulance Chief Executives1
Barts Health NHS Trust1
Belle Green Court1
Bury Borough Council1
Care First Class (UK) Limited1
NHS trust20
Health and social care service regulator9
Private limited company7
Residential care home7
Executive non-departmental public body5
Healthcare site5
Type not available5
English metropolitan district council4
Ministerial department4
Domiciliary care provider3
Nursing home3
Care-home operator2
Health professional body2
Police force2
Company limited by guarantee1
Reports and published responses 56 reports
See individual reports that have raised this concern, and the actions taken in response
West Sussex, Brighton and Hove
Concerns raised1
Failure to recontact the EMA when a caller reports deterioration
This report raised 8 other concerns. They are not shown here because they do not form part of this recurring concern.
Linked responses
Appello Careline Limited
Association of Ambulance Chief Executives
NHS England
TSA
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
TSA
Strengthen CPD and learning programmes for QSF-certified organisations, covering records, operator competence, training, decision-support tools, escalation, and information-sharing with emergency services.
Respondent positions A position is what a respondent says about the concern when they do not describe a specific action.6
Appello Careline Limited
The failure to communicate deterioration was an individual failure to follow established procedures, not a deficiency in those procedures.
Disputes the concernThe respondent disagreed with part of the concern or the basis for it.
Appello Careline Limited
Further procedural change is not considered necessary because established training, audit and supervision processes will continue reinforcing compliance.
No action considered necessaryThe respondent said that no further action was needed.
Appello Careline Limited
Existing procedures, training, auditing and continuous improvement provide a robust framework for managing the identified risks.
Existing arrangements considered sufficientThe respondent said that existing arrangements were sufficient, so no further action was needed.
Association of Ambulance Chief Executives
The specific case concerns should be addressed by Appello and SECAMB, rather than by the national ambulance membership organisation.
Redirects responsibilityThe respondent said that another organisation was responsible for deciding or taking action.
NHS England
Concerns about Apello Careline’s emergency-call guidance, information handling and artificial intelligence trials are outside NHS England’s remit.
Outside remitThe respondent said that this matter was outside its role or authority.
NHS England
Apello Careline is best placed to respond to concerns about its emergency-call guidance, information handling and artificial intelligence trials.
Redirects responsibilityThe respondent said that another organisation was responsible for deciding or taking action.
Kent and Medway
Concerns raised1
Failure of prison officers who restrain prisoners to recognise ABD and treat it as a medical emergency
This report raised 1 other concern. They are not shown here because they do not form part of this recurring concern.
No linked response statements
No respondent-stated action or position is linked to these concerns in the published data.
Inner North London
Concerns raised1
Failure to call an ambulance promptly for a medical emergency
Linked response
FOLD
Stated actions An action is something a respondent says it has done, is doing, or plans to do in response to the concern raised.3
FOLD
Review and strengthen welfare escalation procedures for prompt emergency-service contact when guests present serious symptoms.
FOLD
Require immediate ambulance calls when a guest’s vital signs and temperature are high, regardless of hallucinations or antidepressant history.
FOLD
Contract and deploy Frontline Medical Response medical staff and life-support equipment at all nighttime events to support welfare assessment and escalation.
Nottinghamshire
Concerns raised1
Failure to escalate deteriorating patients for medical assessment
This report raised 5 other concerns. They are not shown here because they do not form part of this recurring concern.
Linked response
Doncaster and Bassetlaw Teaching Hospitals 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
Doncaster and Bassetlaw Teaching Hospitals NHS Foundation Trust
Strengthen verbal handovers during shift changes to support identification and escalation of safety concerns.
Doncaster and Bassetlaw Teaching Hospitals NHS Foundation Trust
Launch and embed Trust-wide Safety Huddles at BDGH for real-time identification and escalation of safety concerns.
Worcestershire
Concerns raised1
Failure to recognise post-fall deterioration and seek timely medical assessment
This report raised 5 other concerns. They are not shown here because they do not form part of this recurring concern.
Linked response
Green Range 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
Green Range Limited
Developed an action plan addressing unwitnessed falls, medical attention, record keeping, auditing and staff training.
Green Range Limited
Provided fall prevention and management training to staff.
Inner North London
Concerns raised1
Failure to escalate significant post-fall injuries for medical review
This report raised 6 other concerns. They are not shown here because they do not form part of this recurring concern.
Linked responses
Daryel Care
London Borough of Islington
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
Daryel Care
Deliver mandatory refresher training on falls, head-injury recognition, recording, and escalation protocols to all care staff.
Daryel Care
Update care-documentation guidance and training with structured prompts for detailed injury descriptions and recording the rationale for non-escalation after initial reporting.
Respondent positions A position is what a respondent says about the concern when they do not describe a specific action.4
Daryel Care
The fall and developing injury were recorded in care notes, and the head injury was escalated promptly to the multi-disciplinary team.
Disputes the concernThe respondent disagreed with part of the concern or the basis for it.
Daryel Care
Clinical oversight, including decisions about post-discharge medical review, was understood to be led by the Rapid Response team within the multi-agency framework.
Redirects responsibilityThe respondent said that another organisation was responsible for deciding or taking action.
Daryel Care
Prior hospital assessment, existing MDT escalation, no acute red flags, and imminent care handover supported continued observation without separate immediate medical re-escalation.
Existing arrangements considered sufficientThe respondent said that existing arrangements were sufficient, so no further action was needed.
London Borough of Islington
Daryel Care reported the fall to Adult Social Care, while ambulance attendance and hospital treatment had already addressed the immediate response.
Disputes the concernThe respondent disagreed with part of the concern or the basis for it.
West Yorkshire (Western)
Concerns raised1
Failure to seek further medical care when prescribed antibiotics cannot be obtained
This report raised 1 other concern. They are not shown here because they do not form part of this recurring concern.
Linked response
WCG Abbey Ltd
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
WCG Abbey Ltd
Update the medication policy to require medical advice when emergency medication is unavailable for three hours.
Essex
Concerns raised1
Failure to trigger a Medical Emergency call when elevated NEWS scores require medical review
This report raised 4 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.3
Mid and South Essex NHS Foundation Trust
Share learning from the case and reinforce NEWS2 escalation, trigger-response-team and local escalation requirements with surgical staff.
Mid and South Essex NHS Foundation Trust
Establish a hospital out-of-hours service in the surgical department to provide a more robust response and senior support to surgical wards.
Mid and South Essex NHS Foundation Trust
Reiterate NEWS and local clinical escalation processes to new surgical residents during standard induction.
Respondent positions A position is what a respondent says about the concern when they do not describe a specific action.1
Mid and South Essex NHS Foundation Trust
NEWS2 escalation, trigger response, out-of-hours support and consultant acting-down arrangements provide sufficient staffing safeguards for urgent surgical cases.
Existing arrangements considered sufficientThe respondent said that existing arrangements were sufficient, so no further action was needed.
County Durham and Darlington
Concerns raised1
Failure to obtain timely medical advice after a resident fall
This report raised 5 other concerns. They are not shown here because they do not form part of this recurring concern.
Linked response
Four Seasons Health Care Group
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
Four Seasons Health Care Group
Apply the Group Falls Policy and supporting flowcharts covering falls protocols, referrals, care planning, risk assessment and post-fall actions.
South Yorkshire (Western)
Concerns raised1
Failure to promptly seek medical attention for residents who require it
This report raised 3 other concerns. They are not shown here because they do not form part of this recurring concern.
Linked response
Sheffcare
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
Sheffcare
Update admissions, falls prevention and risk-assessment policies to require timely assessment, injury monitoring and medical escalation.
Sheffcare
Roll out refresher training on pre-admission assessments, detailed care notes, falls documentation and escalation, using anonymised scenarios and monthly monitoring.
Sheffcare
Discuss falls, documentation and escalation requirements with staff through huddles, supervision and management briefings.
Sheffcare
Complete a quality-assurance systems review for linked care plans, risk assessments, falls escalation and care-note updating.
Actions and positions describe what organisations say in published responses. Implementation is not independently verified.
Actions and positions describe what organisations say in published responses. Implementation is not independently verified.