Recurring concern
Unreliable recording of required observations in care and custody
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Request correctionFirst reported 23 Oct 2013•Latest report 19 May 2026
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.
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.
- Reports
- 83
- Individual concerns
- 90
- Date range
- 2013–2026
- Stated actions
- 181
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 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.
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 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 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
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 Trust -
Action
Develop and roll out an electronic observations system enabling real-time recording of patient observations in RIO.
Stated by East London NHS Foundation 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
Professional concerns about nurses’ conduct and registration are for the NMC to investigate and sanction.
Stated by Department of Health and Social Care
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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.
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
Add vital signs, pain score and diversion-decision rationale to ambulance pre-arrival documentation at Whipps Cross, with random manual auditing.
Stated by Barts Health NHS Trust and North East London NHS Foundation 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
Existing documentation processes at other Barts Health Emergency Departments are considered sufficient for recording decisions to divert patients.
Stated by Barts Health NHS Trust and North East London NHS Foundation Trust
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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.
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
Implement and maintain a centralized post-fall protocol folder containing guidance, a NEWS chart, and a timed observation log.
Stated by Cole Valley Nursing Home
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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.
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
Ensure appropriate checks that the GP carries basic equipment and updates records at consultation where possible.
Stated by NHS Greater Manchester Integrated Care Board
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 failure to carry equipment and update records did not impact the patient's outcome.
Stated by NHS Greater Manchester Integrated Care Board
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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.
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
Monitor NEWS2 chart completion through ward-level spot audits, immediate gap management and shared-learning governance discussions.
Stated by Blackpool Teaching Hospitals NHS Foundation Trust -
Action
Conduct regular Emergency Department spot audits and huddles to verify NEWS2 recording, prompt escalation and completion of fluid charts.
Stated by Blackpool Teaching Hospitals NHS Foundation Trust -
Action
Complete daily real-time Consistency in Care Audits reviewing NEWS2 and fluid-balance compliance and manage identified inconsistencies.
Stated by Blackpool Teaching Hospitals NHS Foundation Trust
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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.
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 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.
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 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.
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 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.
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
Remind nurses to assess, score and accurately record patients’ overall observations, including confusion.
Stated by The 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
Omitting the confusion score caused no adverse outcome because deterioration was recognised and escalated promptly.
Stated by The Trust
Data last updated 7 September 2026