First reported 16 Dec 2013•Latest report 20 Feb 2026
Definition
What this concern includes
Includes failures of resuscitation-specific training, competence assessment, refresher provision, guidance alignment, practical preparation and supporting aids where these affect staff ability to recognise when resuscitation is required and deliver it safely across healthcare and comparable care settings.
Not included
Excludes general first-aid or emergency-response training deficiencies where resuscitation competence is not the identified unsafe condition.
Excludes failures of resuscitation equipment availability, serviceability or deployment where staff competence is not deficient.
Excludes clinical errors during resuscitation where the responsible staff had appropriate resuscitation competence and the problem lies in another control.
Excludes generic training, staffing or communication deficiencies not specifically tied to resuscitation competence.
Reports
30
Distinct published reports
Individual concerns
32
A report can raise multiple concerns
Date range
2013–2026
First to latest report issue date
Stated actions
51
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.
Care Quality Commission4
HM Prison and Probation Service4
NHS England3
Department of Health and Social Care2
Wandsworth Prison2
Barons Park Care1
Birmingham and Solihull Mental Health NHS Foundation Trust1
Bupa Care Homes (GL) Limited1
Camino Healthcare Limited1
College of Policing1
East Kent Hospitals University NHS Foundation Trust1
East London NHS Foundation Trust1
Edgware Community Hospital1
Father of the deceased1
Foreign, Commonwealth & Development Office1
NHS trust8
Executive agency4
Health and social care service regulator4
Ministerial department4
Executive non-departmental public body3
Healthcare site3
Prison or young offender institution3
Type not available3
Health and care professional regulator2
Nursing home2
Police force2
Private limited company2
Residential care home2
Care-home operator1
Domiciliary care provider1
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.
Staffordshire South
Concerns raised1
Failure to ensure responding staff have basic resuscitation training
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 concerns
Each statement is shown once, even when linked to more than one concern.
No linked response statements
No respondent-stated action or position is linked to these concerns in the published data.
Manchester West
Concerns raised1
Lack of cardiopulmonary resuscitation training for custody officers in Spain
Responses linked to these concerns
Each statement is shown once, even when linked to more than one concern.
No linked response statements
No respondent-stated action or position is linked to these concerns in the published data.
North London
Concerns raised1
Insufficient staff training for resuscitation when a patient collapses
This report raised 2 other concerns. They are not shown here because they do not form part of this recurring concern.
Responses linked to these concerns
Each statement is shown once, even when linked to more than one concern.
No linked response statements
No respondent-stated action or position is linked to these concerns in the published data.
Birmingham and Solihull
Concerns raised1
Insufficient resuscitation expertise in GP practices
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 concerns
Each 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.5
Action
Ask the CQC to ensure inspections check that primary care services have equipment and skills to address respiratory emergencies.
Stated by NHS EnglandStated completedThe respondent said that this action was complete when they made their response on 15 July 2016.
Action
Conduct contract visits to ensure GP practices adhere to emergency equipment, training and protocol guidance.
Stated by Birmingham South Central CCGStated plannedThe respondent said that this action was planned when they made their response on 15 July 2016.
Action
Assist the practice involved in the incident to identify and address issues highlighted by the incident.
Stated by Birmingham South Central CCGStated in progressThe respondent said that this action was in progress when they made their response on 15 July 2016.
Action
Circulate learning from the incident to all commissioned GP practices.
Stated by Birmingham South Central CCGStated plannedThe respondent said that this action was planned when they made their response on 15 July 2016.
Action
Circulate incident learning to surrounding clinical commissioning groups for dissemination to their practices.
Stated by Birmingham South Central CCGStated plannedThe respondent said that this action was planned when they made their response on 15 July 2016.
Respondent positions A position is what a respondent says about the concern when they do not describe a specific action.3
Position
Except in remote or inaccessible locations, practices may rely on rapid access to emergency services when determining appropriate equipment and training.
Stated by NHS EnglandExisting arrangements considered sufficientThe respondent said that existing arrangements were sufficient, so no further action was needed.
Position
The CQC is responsible for using its inspection regime to ensure primary care services carry necessary equipment and skills for respiratory emergencies.
Stated by NHS EnglandRedirects responsibilityThe respondent said that another organisation was responsible for deciding or taking action.
Position
General practice is not an emergency service and is not contracted, equipped or organised to deliver team-based emergency care.
Stated by Wychall Lane SurgeryOutside remitThe respondent said that this matter was outside its role or authority.
West Yorkshire Eastern
Concerns raised1
Failure of First Aid provision to maintain effective resuscitation capability
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 concerns
Each 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
Action
Refresh all first aiders’ first-aid training regularly in line with HSE guidance.
Stated by W.E.Rawson LimitedStated plannedThe respondent said that this action was planned when they made their response on 14 December 2015.
Respondent positions A position is what a respondent says about the concern when they do not describe a specific action.1
Position
It is difficult to prepare non-medical first aiders to avoid freezing from shock during incidents as severe as this one.
Stated by W.E.Rawson LimitedUnable to actThe respondent said that a constraint prevented them from taking the relevant action.
Suffolk
Concerns raised1
Inadequate resuscitation training for health care professionals involved in patient care
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 concerns
Each statement is shown once, even when linked to more than one concern.
No linked response statements
No respondent-stated action or position is linked to these concerns in the published data.
Buckinghamshire
Concerns raised1
Lack of guidance for CPR-trained staff on when to commence CPR
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 concerns
Each 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
Action
Issue interim First Aid Guidance for staff during consultation on the revised policy instruction.
Stated by Governing Governor of HMP Grendon and SpringhillStated completedThe respondent said that this action was complete when they made their response on 5 December 2014.
Action
Publish a revised First Aid at Work policy instruction after consultation.
Stated by Governing Governor of HMP Grendon and SpringhillStated plannedThe respondent said that this action was planned when they made their response on 5 December 2014.
Action
Provide all Grendon and Springhill staff with written advice on responding to a non-breathing person through a booklet, induction and the local intranet.
Stated by Governing Governor of HMP Grendon and SpringhillStated plannedThe respondent said that this action was planned when they made their response on 5 December 2014.
Leicester City and South Leicestershire
Concerns raised1
Failure to maintain effective and current first aid training and competence
This report raised 2 other concerns. They are not shown here because they do not form part of this recurring concern.
Responses linked to these concerns
Each 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.5
Action
Review and strengthen the staff training system using a skills matrix and training plan.
Stated by Barons Park Nursing Home LtdStated in progressThe respondent said that this action was in progress when they made their response on 30 July 2014.
Action
Allocate staff to scheduled training sessions rather than relying on open attendance.
Stated by Barons Park Nursing Home LtdStated completedThe respondent said that this action was complete when they made their response on 30 July 2014.
Action
Require employees to keep training current through an employment-contract clause.
Stated by Barons Park Nursing Home LtdStated completedThe respondent said that this action was complete when they made their response on 30 July 2014.
Action
Provide key-area training to all nursing and care staff.
Stated by Barons Park Nursing Home LtdStated in progressThe respondent said that this action was in progress when they made their response on 30 July 2014.
Action
Review training effectiveness through staff feedback and course-participant evaluation.
Stated by Barons Park Nursing Home LtdStated plannedThe respondent said that this action was planned when they made their response on 30 July 2014.
West Sussex
Concerns raised1
Lack of staff training in cardiopulmonary resuscitation and defibrillator use
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 concerns
Each 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
Action
Implement monthly emergency incident drills to practise CPR and related emergency skills.
Stated by Partnerships in Care Group LimitedStated completedThe respondent said that this action was complete when they made their response on 6 March 2014.
Action
Deliver company-wide Immediate Life Support training, including defibrillator use, to qualified nurses and doctors.
Stated by Partnerships in Care Group LimitedStated completedThe respondent said that this action was complete when they made their response on 6 March 2014.
Action
Provide CPR and defibrillator training with competency sign-off and repeat training where staff do not meet the required standard.
Stated by Partnerships in Care Group LimitedStated completedThe respondent said that this action was complete when they made their response on 6 March 2014.
Surrey
Concerns raised3
Unclear alignment of resuscitation training with current guidance
Failure to initiate resuscitation when a patient is not breathing normally
Misleading resuscitation aide memoires in staff resuscitation bags
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 concerns
Each statement is shown once, even when linked to more than one concern.
No linked response statements
No respondent-stated action or position is linked to these concerns in the published data.
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Includes failures of resuscitation-specific training, competence assessment, refresher provision, guidance alignment, practical preparation and supporting aids where these affect staff ability to recognise when resuscitation is required and deliver it safely across healthcare and comparable care settings.
