First reported 7 Oct 2014•Latest report 30 Mar 2026
Definition
What this concern includes
Includes failures of the clinical assessment process for children, including incomplete examination or assessment, omitted assessment components, and failure to document the assessment or the reason it was not completed, across emergency and comparable clinical settings.
Not included
Excludes generic clinical-record deficiencies where the underlying child assessment was completed and the issue is only later record access or transmission.
Excludes failures concerning adults unless the report explicitly links them to the same child-assessment process.
Excludes failures limited to a specific diagnostic test, treatment, escalation or observation process when incomplete child clinical assessment is not itself identified.
Excludes generic staffing, training or documentation deficiencies that are not directly part of completing or recording a clinical assessment of a child.
Reports
7
Distinct published reports
Individual concerns
11
A report can raise multiple concerns
Date range
2014–2026
First to latest report issue date
Stated actions
17
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.
NHS England5
Royal College of General Practitioners3
Royal College of Paediatrics and Child Health3
Department of Health and Social Care2
Royal College of Emergency Medicine2
Care Quality Commission1
Department for Business, Energy & Industrial Strategy1
Doncaster and Bassetlaw Teaching Hospitals NHS Foundation Trust1
George Eliot Hospital NHS Trust1
Healthcare Safety Investigation Branch1
Joint Royal Colleges Ambulance Liaison Committee1
National Institute for Health and Care Excellence1
NHS Pathways1
Royal Surrey NHS Foundation Trust1
The Royal Society For The Prevention Of Accidents1
Executive non-departmental public body5
Health professional body4
NHS trust3
Professional body3
Ministerial department2
Health and social care service regulator1
Health professional committee1
Registered charity1
Sub-organisation1
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.
Warwickshire
Concerns raised1
Lack of practical mechanisms for adapting assessment of neurodivergent children
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 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
Run monthly multidisciplinary simulation sessions covering paediatric abdominal pain, neurodivergence, communication and escalation.
Stated by George Eliot Hospital NHS TrustStated in progressThe respondent said that this action was in progress when they made their response on 25 June 2026.
Action
Amend the paediatric casualty card to record children’s communication, sensory or behavioural needs.
Stated by George Eliot Hospital NHS TrustStated in progressThe respondent said that this action was in progress when they made their response on 25 June 2026.
Action
Provide specialist Play Specialist support to improve communication and reduce anxiety for neurodivergent children.
Stated by George Eliot Hospital NHS TrustStated completedThe respondent said that this action was complete when they made their response on 25 June 2026.
Action
Implement the FLACC behavioural pain assessment tool within the Clinical Assessment Unit.
Stated by George Eliot Hospital NHS TrustStated in progressThe respondent said that this action was in progress when they made their response on 25 June 2026.
Action
Develop and deliver a communications campaign promoting Hospital Passports and “All About Me” tools.
Stated by George Eliot Hospital NHS TrustStated in progressThe respondent said that this action was in progress when they made their response on 25 June 2026.
Respondent positions A position is what a respondent says about the concern when they do not describe a specific action.1
Position
Practical mechanisms in GIRFT guidance fall outside the Trust’s direct remit; the Trust will comply with any enhanced guidance GIRFT issues.
Stated by George Eliot Hospital NHS TrustOutside remitThe respondent said that this matter was outside its role or authority.
Surrey
Concerns raised1
Failure to routinely obtain and listen to parents’ or guardians’ information about children with profound disabilities
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.9
Action
Maintain a Learning Disabilities and Autism policy with emergency admission guidance and requirements for carer involvement.
Stated by Royal Surrey NHS Foundation TrustStated completedThe respondent said that this action was complete when they made their response on 20 May 2025.
Action
Implement Martha’s Rule across adult and paediatric services, addressing its three delivery metrics for patient, family, carer and staff escalation.
Stated by Royal Surrey NHS Foundation TrustStated in progressThe respondent said that this action was in progress when they made their response on 20 May 2025.
Action
Continue rolling out Oliver McGowan Mandatory Training on Learning Disability and Autism to the health and adult social care workforce.
Stated by Department of Health and Social CareStated in progressThe respondent said that this action was in progress when they made their response on 20 May 2025.
Action
Create a single patient record through the NHS App, bringing together patient health information, test results, and letters.
Stated by Department of Health and Social CareStated plannedThe respondent said that this action was planned when they made their response on 20 May 2025.
Action
Support rollout of Martha’s Rule and engage with NHS England as pilot data emerge.
Stated by Royal College of Paediatrics and Child HealthStated in progressThe respondent said that this action was in progress when they made their response on 20 May 2025.
Action
Collaborate with NHS England and the Royal College of Nursing to develop a single national Paediatric Early Warning System for England.
Stated by Royal College of Paediatrics and Child HealthStated in progressThe respondent said that this action was in progress when they made their response on 20 May 2025.
Action
Publish interim guidance on mandatory learning disability and autism training for providers and CQC staff.
Stated by Care Quality CommissionStated completedThe respondent said that this action was complete when they made their response on 20 May 2025.
Action
Publish and maintain a Learning Disabilities Toolkit with emergency-department guidance on reasonable adjustments, intra-abdominal pathology and aspiration.
Stated by Royal College of Emergency MedicineStated completedThe respondent said that this action was complete when they made their response on 20 May 2025.
Action
Participate in developing the emergency-department version of the national paediatric early warning system, including parental or carer concern in escalation responses.
Stated by Royal College of Emergency MedicineStated in progressThe respondent said that this action was in progress when they made their response on 20 May 2025.
Surrey
Concerns raised2
Failure to document general practice assessment of febrile seizures
Failure to undertake a detailed history and full neurological examination in general practice
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.
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
Ask colleagues from seven NHS regions to share learning and available guidance with Integrated Care Boards for cascading to relevant healthcare professionals.
Stated by NHS EnglandStated plannedThe respondent said that this action was planned when they made their response on 31 March 2023.
Action
Replace the epilepsy guideline with updated recommendations on referral and information and support after a first seizure.
Stated by National Institute for Health and Care ExcellenceStated completedThe respondent said that this action was complete when they made their response on 31 March 2023.
Respondent positions A position is what a respondent says about the concern when they do not describe a specific action.4
Position
NICE is responsible for producing clinical guidance on the diagnosis, treatment and management of febrile seizures.
Stated by NHS EnglandRedirects responsibilityThe respondent said that another organisation was responsible for deciding or taking action.
Position
Existing national guidance is considered sufficient for managing febrile seizures.
Stated by NHS EnglandExisting arrangements considered sufficientThe respondent said that existing arrangements were sufficient, so no further action was needed.
Position
Existing national guidance and the Clinical Knowledge Summary are considered sufficient to support timely assessment, investigation and referral for febrile seizures.
Stated by National Institute for Health and Care ExcellenceExisting arrangements considered sufficientThe respondent said that existing arrangements were sufficient, so no further action was needed.
Position
RCEM will not lead development of further guidance because the project would be a significant undertaking, but can contribute with other organisations.
Stated by Royal College of Emergency MedicineUnable to actThe respondent said that a constraint prevented them from taking the relevant action.
Hull and East Riding of Yorkshire
Concerns raised1
Failure to question the nature of vomitus in young children
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.1
Action
Provide a children’s and young people’s curriculum covering paediatric emergencies, gastrointestinal conditions, examinations and complex-disease liaison, with trainee assessment before qualification.
Stated by Royal College of General PractitionersStated completedThe respondent said that this action was complete when they made their response on 29 September 2022.
Plymouth, Torbay and South Devon
Concerns raised1
Failure of NHS Pathways questions to allow meaningful assessment of pain in children
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.
Respondent positions A position is what a respondent says about the concern when they do not describe a specific action.1
Position
Functional-capacity questions were considered the most meaningful available method for assessing children's pain remotely.
Stated by NHS EnglandExisting arrangements considered sufficientThe respondent said that existing arrangements were sufficient, so no further action was needed.
Manchester South
Concerns raised2
Failure to complete or fully document child assessments
Failure to value-check subjective assessments in young children
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.
No linked response statements
No respondent-stated action or position is linked to these concerns in the published data.
South Yorkshire (Eastern)
Concerns raised3
Failure to document haematoma location and size
Failure to document Glasgow Coma Score assessments and results
Failure to undertake and document complete clinical observations
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 the clinical assessment process for children, including incomplete examination or assessment, omitted assessment components, and failure to document the assessment or the reason it was not completed, across emergency and comparable clinical settings.
