Recurring concern
Unreliable escalation of abnormal clinical observations
- Reports that mention this concern
- 39
- Times this concern has been raised
- 44
- Stated actions linked to this concern
- 59
What this concern includes
Includes failures in the dedicated process for recognising, interpreting, thresholding, communicating, reviewing or escalating abnormal clinical observations, including physiological, neurological and early-warning observations, where the deficiency can delay appropriate care.
What is not included
- Excludes general clinical deterioration failures where no abnormal-observation trigger or observation-based escalation process is identified.
- Excludes failures to perform or record observations when no associated failure to recognise, review or escalate abnormal findings is asserted.
- Excludes failures limited to communicating an already recognised observation to a specific recipient when the broader observation-escalation process is not deficient.
- Excludes condition-specific assessment or treatment pathways where abnormal observations are only incidental and the named condition supplies the more specific supported boundary.
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 39 reports
See individual reports that have raised this concern, and the actions taken in response
-
Concerns raised2
Failure to act on early warning scores
Miscalculation of early warning scores
This report raised 12 other concerns. They are not shown here because they do not form part of this recurring concern.
Linked response
- The 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
-
The Trust
Provide Critical Care outreach support and follow-up when elevated early warning scores are identified.
-
The Trust
Deliver the Trust-wide project and improvement measures to improve accurate acute monitoring using early warning scores.
-
The Trust
Pilot the revised Maternity Early Warning Scoring Chart and make necessary alterations before embedding it in practice.
-
The Trust
Introduce a newborn observation chart based on the British Association of Paediatric Medicine Newborn Early Warning Score.
-
Concerns raised1
Failure to recognise abnormal observations and escalate care
This report raised 1 other concern. They are not shown here because they do not form part of this recurring concern.
Linked response
- Leicestershire Partnership 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.1
-
Leicestershire Partnership NHS Trust
Introduce an adapted Track and Trigger system across three prison healthcare teams and train staff to use it.
-
Concerns raised2
Failure to ensure qualified checking and interpretation of Early Warning Observation Chart observations
Failure to act on Early Warning Observation Chart trigger scores through appropriate escalation of care
This report raised 1 other concern. They are not shown here because they do not form part of this recurring concern.
No linked response statementsNo respondent-stated action or position is linked to these concerns in the published data.
-
Concerns raised1
Failure to refer patients to the Critical Care Outreach Team at required NEWS thresholds
This report raised 8 other concerns. They are not shown here because they do not form part of this recurring concern.
No linked response statementsNo respondent-stated action or position is linked to these concerns in the published data.
-
Concerns raised1
Failure to act on or escalate elevated Early Warning Scores
This report raised 18 other concerns. They are not shown here because they do not form part of this recurring concern.
No linked response statementsNo respondent-stated action or position is linked to these concerns in the published data.
-
Concerns raised1
Subjective interpretation of Early Warning Scores
This report raised 11 other concerns. They are not shown here because they do not form part of this recurring concern.
Linked response
- Stockport 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
-
Stockport NHS Foundation Trust
Roll out Patientrack phase one across wards for electronic vital-sign input.
-
Stockport NHS Foundation Trust
Introduce Patientrack alert functionality in the planned second rollout phase.
-
Concerns raised1
Failure to escalate care after deteriorating neurological observations
This report raised 8 other concerns. They are not shown here because they do not form part of this recurring concern.
No linked response statementsNo respondent-stated action or position is linked to these concerns in the published data.
-
Concerns raised1
Failure to act on NEWS scores
This report raised 6 other concerns. They are not shown here because they do not form part of this recurring concern.
No linked response statementsNo respondent-stated action or position is linked to these concerns in the published data.
-
Concerns raised3
Failure to contact a consultant when Early Warning Scores indicate clinical deterioration
Failure to refer patients to consultant level when Early Warning Scores indicate escalation
Lack of a single standardised Early Warning Score calculation system
This report raised 1 other concern. They are not shown here because they do not form part of this recurring concern.
No linked response statementsNo respondent-stated action or position is linked to these concerns in the published data.
Actions and positions describe what organisations say in published responses. Implementation is not independently verified.
Data last updated 7 September 2026