First reported 5 Mar 2014•Latest report 7 Apr 2026
Definition
What this concern includes
Includes clinical or care-record entries explicitly described as falsified, knowingly false, or backfilled to represent an observation, action or care event that did not occur.
Not included
Excludes ordinary error, incompleteness, omission, inconsistency, ambiguity or accidental inaccuracy.
Excludes retrospective entries accurately identified as retrospective and truthfully recording their evidential basis.
Excludes documentation-quality or audit deficiencies that do not directly establish a knowingly false entry.
Excludes disagreements about clinical judgment where the record truthfully states the information and decision made.
Reports
8
Distinct published reports
Individual concerns
9
A report can raise multiple concerns
Date range
2014–2026
First to latest report issue date
Stated actions
28
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.
East London NHS Foundation Trust3
Care Quality Commission1
Department of Health and Social Care1
Essex Partnership University NHS Foundation Trust1
HM Prison and Probation Service1
Lewisham and Greenwich NHS Trust1
Metropolitan Police Service1
New Park Residential Home1
North London NHS Foundation Trust1
Practice Plus Group1
Priory Group1
Radcliffe Manor House1
Stoke-on-Trent City Council1
Thameside Prison1
NHS trust5
Independent healthcare provider2
Residential care home2
English unitary authority1
Executive agency1
Health and social care service regulator1
Ministerial department1
Police force1
Prison or young offender institution1
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.
Inner South London
Concerns raised1
Failure to ensure truthful observation records
This report raised 8 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.
Essex
Concerns raised2
Falsification of patient observation records
Falsification of observation logs
This report raised 29 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.
Inner North London
Concerns raised1
Falsification of safe and supportive observation records
This report raised 9 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.7
Action
Develop and test an electronic observations platform with prompts, daily checks and safeguards against delayed, missed or falsified entries.
Stated by East London NHS Foundation TrustStated in progressThe respondent said that this action was in progress when they made their response on 31 July 2024.
Action
Implement the essential Inpatient Safety Suite covering observation practice and honesty in documentation.
Stated by East London NHS Foundation TrustStated completedThe respondent said that this action was complete when they made their response on 31 July 2024.
Action
Deliver face-to-face Honesty in Documentation training across inpatient services.
Stated by East London NHS Foundation TrustStated completedThe respondent said that this action was complete when they made their response on 31 July 2024.
Action
Continue work promoting honesty in documentation.
Stated by East London NHS Foundation TrustStated in progressThe respondent said that this action was in progress when they made their response on 31 July 2024.
Action
Explore non-CCTV tools for assuring observation authenticity and review relevant national improvement workstreams.
Stated by East London NHS Foundation TrustStated plannedThe respondent said that this action was planned when they made their response on 31 July 2024.
Stated by East London NHS Foundation TrustStated in progressThe respondent said that this action was in progress when they made their response on 31 July 2024.
Action
Develop a consistent process supporting reflection, personal accountability and regulatory referral where indicated, alongside disciplinary procedures.
Stated by East London NHS Foundation TrustStated plannedThe respondent said that this action was planned when they made their response on 31 July 2024.
Inner North London
Concerns raised1
Failure to accurately record required observations
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.
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.14
Action
Implement the live Inpatient Safety Suite as essential training for inpatient nursing staff, including observation and honesty-in-documentation training, with compliance oversight.
Stated by East London NHS Foundation TrustStated completedThe respondent said that this action was complete when they made their response on 31 July 2024.
Action
Develop and deliver Honesty in Documentation training face to face across all inpatient services.
Stated by East London NHS Foundation TrustStated completedThe respondent said that this action was complete when they made their response on 31 July 2024.
Action
Facilitate weekly directorate safety discussions for inpatient staff to review observation data, identify practice gaps and disseminate learning.
Stated by East London NHS Foundation TrustStated completedThe respondent said that this action was complete when they made their response on 31 July 2024.
Action
Implement observation board relay to reduce missed observations and improve handover between staff.
Stated by East London NHS Foundation TrustStated completedThe respondent said that this action was complete when they made their response on 31 July 2024.
Action
Test and pilot a Microsoft PowerApps application for documenting observations before planned inpatient-wide scaling.
Stated by East London NHS Foundation TrustStated in progressThe respondent said that this action was in progress when they made their response on 31 July 2024.
Action
Communicate and regularly update staff on accountability, accurate observation records, honesty and procedures for missed observations.
Stated by East London NHS Foundation TrustStated completedThe respondent said that this action was complete when they made their response on 31 July 2024.
Action
Use the Standard Observation Measurement tool to oversee observation completion and support ward and directorate improvement.
Stated by East London NHS Foundation TrustStated completedThe respondent said that this action was complete when they made their response on 31 July 2024.
Action
Conduct senior-staff night visits with spot-check audits and observation of practice.
Stated by East London NHS Foundation TrustStated completedThe respondent said that this action was complete when they made their response on 31 July 2024.
Action
Continue work on honesty in documentation.
Stated by East London NHS Foundation TrustStated plannedThe respondent said that this action was planned when they made their response on 31 July 2024.
Action
Explore non-CCTV assurance tools for detecting falsified observations and review relevant national improvement workstreams.
Stated by East London NHS Foundation TrustStated plannedThe respondent said that this action was planned when they made their response on 31 July 2024.
Action
Complete external Human Factors and Patient Safety analysis of inpatient observation practice to identify redesign opportunities.
Stated by East London NHS Foundation TrustStated in progressThe respondent said that this action was in progress when they made their response on 31 July 2024.
Stated by East London NHS Foundation TrustStated in progressThe respondent said that this action was in progress when they made their response on 31 July 2024.
Action
Design internal governance for reviewing missed-observation cases and learning, with reporting to Patient Safety and Quality Assurance committees.
Stated by East London NHS Foundation TrustStated plannedThe respondent said that this action was planned when they made their response on 31 July 2024.
Action
Develop a consistent process for staff learning from poor observation practice through reflection, accountability and regulatory referral where indicated, alongside disciplinary procedures.
Stated by East London NHS Foundation TrustStated plannedThe respondent said that this action was planned when they made their response on 31 July 2024.
Nottinghamshire
Concerns raised1
Falsification of records to indicate completed care plan and risk assessment reviews
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 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
Evaluate shortlisted digital care planning systems to improve linked risk assessment, trend analysis and point-of-care record keeping.
Stated by Trustees of Radcliffe Manor HouseStated in progressThe respondent said that this action was in progress when they made their response on 27 September 2022.
Action
Fully implement the selected digital care planning system for all residents.
Stated by Trustees of Radcliffe Manor HouseStated plannedThe respondent said that this action was planned when they made their response on 27 September 2022.
Action
Improve management oversight of care plan documentation.
Stated by Swift Management Services LimitedStated completedThe respondent said that this action was complete when they made their response on 27 September 2022.
East London
Concerns raised1
Failure to maintain accurate records of clinical observations
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 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.2
Action
Provide medical-record-keeping training to Borough Lead Nurses and cascade the learning to staff during induction and away days.
Stated by East London NHS Foundation TrustStated plannedThe respondent said that this action was planned when they made their response on 5 May 2021.
Action
Develop and roll out an electronic observations system enabling real-time recording of patient observations in RIO.
Stated by East London NHS Foundation TrustStated in progressThe respondent said that this action was in progress when they made their response on 5 May 2021.
Respondent positions A position is what a respondent says about the concern when they do not describe a specific action.1
Position
Professional concerns about nurses’ conduct and registration are for the NMC to investigate and sanction.
Stated by Department of Health and Social CareRedirects responsibilityThe respondent said that another organisation was responsible for deciding or taking action.
Stoke-on-Trent and North Staffordshire
Concerns raised1
Falsification of pressure sore repositioning records
This report raised 15 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
Share investigation learning with New Park House and recommend improvements to recording practices.
Stated by Stoke-on-Trent City CouncilStated completedThe respondent said that this action was complete when they made their response on 14 July 2015.
Respondent positions A position is what a respondent says about the concern when they do not describe a specific action.1
Position
The investigation found no evidence that the pressure-sore management plan was inadequately followed or that records had been falsified.
Stated by Stoke-on-Trent City CouncilDisputes the concernThe respondent disagreed with part of the concern or the basis for it.
London (West)
Concerns raised1
Deliberate falsification of nursing records
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 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
Use information about alleged nursing-record falsification to inform planning and delivery of the next inspection.
Stated by Care Quality CommissionStated plannedThe respondent said that this action was planned when they made their response on 5 March 2014.
Respondent positions A position is what a respondent says about the concern when they do not describe a specific action.3
Position
No evidence of deliberate nursing-record falsification was identified during inspections.
Stated by Care Quality CommissionDisputes the concernThe respondent disagreed with part of the concern or the basis for it.
Position
Deliberate record falsification is difficult to identify through routine monitoring or inspections unless reported by staff, patients or relatives.
Stated by Care Quality CommissionUnable to actThe respondent said that a constraint prevented them from taking the relevant action.
Position
Alleged deliberate record falsification may require referral to the relevant professional regulatory body, such as the NMC or GMC.
Stated by Care Quality CommissionRedirects responsibilityThe respondent said that another organisation was responsible for deciding or taking action.
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Includes clinical or care-record entries explicitly described as falsified, knowingly false, or backfilled to represent an observation, action or care event that did not occur.
