Recurring concern
Unreliable escalation by care staff for required medical attention
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Request correctionFirst reported 5 Sep 2013•Latest report 30 Jan 2026
What this concern includes
Includes inadequate or unembedded escalation procedures and failures by care staff to obtain medical assessment or advice when deterioration, pain or a recognised condition requires it.
Not included
- Quality of treatment after medical input was obtained
- Routine healthcare access delays outside the care-staff escalation process
- Generic care staffing or training concerns that do not impair clinical escalation
- Reports
- 48
- Individual concerns
- 53
- Date range
- 2013–2026
- Stated actions
- 75
Distinct published reports
A report can raise multiple concerns
First to latest report issue date
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.
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.
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Concerns raised1
Failure to re-refer residents to SALT when indicated
This report raised 11 other concerns. They are not shown here because they do not form part of this recurring concern.
Responses linked to these concernsEach 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
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Action
Refer residents meeting the threshold to Speech and Language Therapy and schedule required follow-up reviews.
Stated by Hc-One Limited -
Action
Assign the Care Manager oversight of communication and escalation between Speech and Language Therapy and home staff.
Stated by Hc-One Limited
-
Concerns raised3
Failure to seek medical assistance when insulin is refused over an extended period
Failure to seek urgent GP attention during attendance at the home
Failure to recognise and seek help for a deteriorating condition
This report raised 7 other concerns. They are not shown here because they do not form part of this recurring concern.
Responses linked to these concernsEach 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
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Action
Prioritise diabetes care planning, including instructions for seeking medical assistance when insulin or medication is refused.
Stated by Adbolton Hall Limited -
Action
Meet with the visiting GP to provide oversight of improvements and establish direct notification of future concerns.
Stated by Adbolton Hall Limited -
Action
Deliver Nutrition and Diabetes Management Training to nursing home staff.
Stated by Adbolton Hall Limited
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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Position
Diabetes care is considered adequately assessed and provided because relevant authorities were satisfied the home’s complex-needs admissions were safe.
Stated by Adbolton Hall Limited
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Concerns raised2
Failure to seek medical assistance following seizures
Failure to seek and communicate appropriate medical follow-up for deteriorating residents
This report raised 11 other concerns. They are not shown here because they do not form part of this recurring concern.
Responses linked to these concernsEach statement is shown once, even when linked to more than one concern.
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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Position
Medical advice was sought appropriately, and no urgent referral was recommended or documented by the out-of-hours doctor.
Stated by Southwinds Limited
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Concerns raised1
Failure to escalate the urgency of requirements for medical assistance
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 concernsEach 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.4
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Action
Revise the call-termination guidance and circulate it to all EOC supervisors.
Stated by North West Ambulance Service NHS Trust -
Action
Brief all call takers individually on the revised guidance and obtain signed confirmation that they understand it.
Stated by North West Ambulance Service NHS Trust -
Action
Establish a reminder system to prompt periodic recirculation of call-termination guidance to call takers.
Stated by North West Ambulance Service NHS Trust
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Action
Produce an incident-based case study and use it in scheduled training and workshops for new and existing call takers.
Stated by North West Ambulance Service NHS Trust
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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Position
The emergency call was processed correctly and received the correct response code based on the information provided.
Stated by North West Ambulance Service NHS Trust
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Concerns raised1
Failure to seek medical direction on future management after a peri-arrest
This report raised 13 other concerns. They are not shown here because they do not form part of this recurring concern.
Responses linked to these concernsEach statement is shown once, even when linked to more than one 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 of care home staff to identify when medical concerns require escalation and medical review
Responses linked to these concernsEach 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.4
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Action
Train the home manager, deputy manager and unit leaders in early recognition of sick and deteriorating residents.
Stated by Care UK Community Partnerships Ltd -
Action
Book all shift leaders onto forthcoming Care Home Support training in recognising sick and deteriorating residents.
Stated by Care UK Community Partnerships Ltd -
Action
Cascade deterioration-recognition training to shift leaders and remaining care-home staff, reinforcing the principles through individual supervision.
Stated by Care UK Community Partnerships Ltd
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Action
Audit staff responses to unwell residents through management discussions, walkarounds and out-of-hours escalation oversight.
Stated by Care UK Community Partnerships Ltd
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Concerns raised1
Failure to seek doctors' input when presentation or level of risk changes
This report raised 7 other concerns. They are not shown here because they do not form part of this recurring concern.
Responses linked to these concernsEach statement is shown once, even when linked to more than one 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
Inconsistent policies governing NEWS observation escalation
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 concernsEach 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
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Action
Introduce a revised NEWS policy allowing contact with the staff member best placed to provide timely assistance.
Stated by University Hospitals Sussex NHS Foundation Trust
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Concerns raised1
Lack of clear procedures for Care Assistants escalating health concerns
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 concernsEach 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
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Action
Undertake a comprehensive ratings inspection of Belong Wigan Care Village, including review of the provider’s response to the report findings.
Stated by Care Quality Commission -
Action
Remind Support Workers how to escalate health concerns and seek external professional advice through staff training, induction, supervision, reviews and audits.
Stated by Belong
Respondent positions A position is what a respondent says about the concern when they do not describe a specific action.2
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Position
The provider’s response and inspection consideration were sufficient, so no written confirmation or further action evidence was requested.
Stated by Care Quality Commission
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Position
Following inspection and document review, no further investigation into the death or regulated activities was considered necessary.
Stated by Care Quality Commission
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Concerns raised1
Failure of nursing staff to recognise and implement recommended NEWS escalation measures
This report raised 10 other concerns. They are not shown here because they do not form part of this recurring concern.
Responses linked to these concernsEach statement is shown once, even when linked to more than one concern.
No linked response statementsNo respondent-stated action or position is linked to these concerns in the published data.
Data last updated 7 September 2026