Recurring concern
Unreliable emergency-department triage
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Request correctionFirst reported 9 May 2014•Latest report 10 Oct 2025
What this concern includes
Includes failures of the emergency-department triage process, including adoption and application of the triage system, triage procedures, recognition of clinically significant symptoms or relevant history, prioritisation and escalation, where the deficiency directly affects safe emergency-department triage.
Not included
- Excludes failures of the specifically named Manchester Triage System, which is tracked as a separate concern.
- Excludes ambulance call triage, GP appointment triage and other non-emergency-department triage processes.
- Excludes generic emergency-department crowding, staffing or capacity deficiencies unless they directly result in an unsafe emergency-department triage failure.
- Excludes downstream assessment, treatment or communication failures after triage where triage itself was not deficient.
- Reports
- 16
- Individual concerns
- 17
- Date range
- 2014–2025
- Stated actions
- 17
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 of triage to prompt for neutropenic sepsis
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.
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 at triage to escalate referrals for medical review within 10 minutes of admission
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
Provide ongoing Sepsis training on the Sepsis 6 bundle and NEWS documentation, escalation and implementation to medical and nursing staff.
Stated by Cwm Taf Morgannwg University Local Health Board
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Concerns raised1
Failure to ensure timely visual assessment and escalation of seriously unwell patients at A&E admission
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 operate a Rapid Access Treatment Protocol for timely triage
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.
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 prioritise children’s cases appropriately for timely assessment
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.
No linked response statementsNo respondent-stated action or position is linked to these concerns in the published data.
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Concerns raised1
Lack of full triage before streaming
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.1
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Action
Review the streaming process and all adult and child streaming protocols, including exclusion criteria and consideration of triage before streaming.
Stated by NHS Luton Clinical Commissioning Group
Data last updated 7 September 2026