Recurring concern
Unreliable staff access to and understanding of safety-critical guidance
- Reports that mention this concern
- 13
- Times this concern has been raised
- 13
- Stated actions linked to this concern
- 10
What this concern includes
Includes failures of staff-facing arrangements to provide access to safety-critical guidance or learning material and to verify that relevant staff have accessed, considered and understood it, including computer-based material and associated acknowledgement or comprehension checks.
What is not included
- Excludes substantive deficiencies in the guidance itself where access or staff understanding is not the reported unsafe condition.
- Excludes generic staff training, staffing or communication deficiencies that are not specifically tied to access to or understanding of safety-critical guidance.
- Excludes failures to implement a safety change after staff have reliably accessed and understood the relevant guidance.
- Excludes named systems, pathways or hazard-specific guidance where that narrower concern provides 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 13 reports
See individual reports that have raised this concern, and the actions taken in response
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Concerns raised1
Lack of checks that staff have considered and understood safety material
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.
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Concerns raised1
Unavailability of the policy to all healthcare staff in the surgery
This report raised 6 other concerns. They are not shown here because they do not form part of this recurring concern.
Linked response
- Swanage Medical Practice
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
-
Swanage Medical Practice
Create an electronic-record alert for drugs in the specified prescribing group, warning prescribers about dosage and alcohol-related risks.
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Concerns raised1
Insufficient dissemination, awareness and continuous training on the Vascular Pathway
This report raised 10 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 ensure staff awareness of the Standard Operating Procedure for Enhanced Care/Observation
This report raised 4 other concerns. They are not shown here because they do not form part of this recurring concern.
Linked response
- South Tyneside and Sunderland 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
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South Tyneside and Sunderland NHS Foundation Trust
Develop E-learning packages for SafeCare and EICO and make them accessible to relevant staff through the Electronic Staff Record system.
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South Tyneside and Sunderland NHS Foundation Trust
Add required SafeCare and EICO competencies to staff learning profiles and compliance matrices within the Electronic Staff Record system.
-
Concerns raised1
Lack of staff knowledge of applicable clinical guidelines and policies
This report raised 19 other concerns. They are not shown here because they do not form part of this recurring concern.
Linked response
- Department of Health and Social Care
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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Department of Health and Social Care
The Trust is responsible for setting out and implementing actions to address the identified maternity-service safety risks.
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Concerns raised1
Lack of guidance for frontline staff on promptly capturing evidence after falls
This report raised 2 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
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Stockport NHS Foundation Trust
Run the Safer Mobility Collaborative, including immediate post-fall assessment, staff statements and patient discussions to confirm safety actions.
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Stockport NHS Foundation Trust
Use thrice-weekly Quality Safety Leadership Summits to monitor falls, confirm investigations have started and verify inclusion of immediate statements.
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Concerns raised1
Lack of clear guidance and staff understanding of medical conditions relevant to exercise
This report raised 10 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.
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Concerns raised1
Failure to make the falls protocol clearly available to staff
This report raised 7 other concerns. They are not shown here because they do not form part of this recurring concern.
Linked response
- Care First Class (UK) 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.1
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Care First Class (UK) Limited
Disseminate the falls protocol to staff and incorporate it into new-staff induction.
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Concerns raised1
Failure of managers and staff to access computer-based health and safety material
This report raised 5 other concerns. They are not shown here because they do not form part of this recurring concern.
Linked response
- Agd Equipment 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.1
-
Agd Equipment Limited
Roll out refresher training and awareness raising so employees know where to find health and safety documents.
Respondent positions A position is what a respondent says about the concern when they do not describe a specific action.1
-
Agd Equipment Limited
Health and safety documents were available electronically and in hard copy, contrary to any premise that the company lacked accessible documentation.
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Concerns raised1
Insufficient visibility of the heparin administration poster’s direction to seek haematology advice for underweight patients
This report raised 3 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.
Actions and positions describe what organisations say in published responses. Implementation is not independently verified.
Data last updated 7 September 2026