Recurring concern
Unreliable recording of required observations in care and custody
- Reports that mention this concern
- 83
- Times this concern has been raised
- 90
- Stated actions linked to this concern
- 181
What this concern includes
Includes failures in recording required patient or prisoner observations, including inaccurate, delayed, anticipatory, incomplete or falsified entries, where records do not reliably reflect the observations performed. Includes paper, electronic and ACCT-related observation records across care and custody settings.
What is not included
- Excludes failures to perform or maintain the required observation itself where the recording process is not deficient.
- Excludes unclear observation requirements, observation-level decisions and generic observation assurance or auditing where inaccurate or delayed recording is not the shared unsafe condition.
- Excludes general clinical, care or custody record-keeping deficiencies unrelated to required observations.
- Excludes recording of non-observation activities, such as searches, movements, inspections or clinical decisions, unless the assertion specifically concerns a required observation record.
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 83 reports
See individual reports that have raised this concern, and the actions taken in response
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Concerns raised1
Failure to accurately record the frequency of checks in progress notes
This report raised 1 other concern. 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 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.
Linked responses
- Department of Health and Social Care
- East London 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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East London NHS Foundation Trust
Provide medical-record-keeping training to Borough Lead Nurses and cascade the learning to staff during induction and away days.
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East London NHS Foundation Trust
Develop and roll out an electronic observations system enabling real-time recording of patient observations in RIO.
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
Professional concerns about nurses’ conduct and registration are for the NMC to investigate and sanction.
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Concerns raised1
Failure to record a full set of observations, including a pain score, before diverting patients from A&E
This report raised 7 other concerns. They are not shown here because they do not form part of this recurring concern.
Linked responses
- Barts Health NHS Trust
- North East London 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.1
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Barts Health NHS Trust and North East London NHS Foundation Trust
Add vital signs, pain score and diversion-decision rationale to ambulance pre-arrival documentation at Whipps Cross, with random manual auditing.
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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Barts Health NHS Trust and North East London NHS Foundation Trust
Existing documentation processes at other Barts Health Emergency Departments are considered sufficient for recording decisions to divert patients.
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Concerns raised1
Misleading recording of resident observation intervals
This report raised 4 other concerns. They are not shown here because they do not form part of this recurring concern.
Linked response
- Cole Valley Nursing Home
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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Cole Valley Nursing Home
Implement and maintain a centralized post-fall protocol folder containing guidance, a NEWS chart, and a timed observation log.
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Concerns raised1
Delays and omissions in recording GP visit observations
This report raised 5 other concerns. They are not shown here because they do not form part of this recurring concern.
Linked response
- NHS Greater Manchester Integrated Care Board
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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NHS Greater Manchester Integrated Care Board
Ensure appropriate checks that the GP carries basic equipment and updates records at consultation where possible.
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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NHS Greater Manchester Integrated Care Board
The failure to carry equipment and update records did not impact the patient's outcome.
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Concerns raised1
Failure to record vital signs observations in the observation chart
This report raised 7 other concerns. They are not shown here because they do not form part of this recurring concern.
Linked response
- Blackpool Teaching Hospitals 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.3
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Blackpool Teaching Hospitals NHS Foundation Trust
Monitor NEWS2 chart completion through ward-level spot audits, immediate gap management and shared-learning governance discussions.
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Blackpool Teaching Hospitals NHS Foundation Trust
Conduct regular Emergency Department spot audits and huddles to verify NEWS2 recording, prompt escalation and completion of fluid charts.
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Blackpool Teaching Hospitals NHS Foundation Trust
Complete daily real-time Consistency in Care Audits reviewing NEWS2 and fluid-balance compliance and manage identified inconsistencies.
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Concerns raised1
Failure to record the timing and findings of resident observations
This report raised 12 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 accurately record ACCT observations in the ACCT document
This report raised 2 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 maintain complete and reliable welfare-check records
This report raised 7 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 accurately record NEWS observations and scores
This report raised 4 other concerns. They are not shown here because they do not form part of this recurring concern.
Linked response
- The 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.1
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The Trust
Remind nurses to assess, score and accurately record patients’ overall observations, including confusion.
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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The Trust
Omitting the confusion score caused no adverse outcome because deterioration was recognised and escalated promptly.
Actions and positions describe what organisations say in published responses. Implementation is not independently verified.
Data last updated 7 September 2026