First reported 6 Nov 2013•Latest report 22 Dec 2025
Definition
What this concern includes
Includes failures of the dedicated fluid-balance recording process, including records of intravenous fluids, fluid intake and output, and food or fluid offers and consumption, where the recording deficiency impairs reliable assessment of fluid status.
Not included
Excludes failures to administer prescribed fluids when the recording process itself is not deficient.
Excludes general poor maintenance of clinical or nursing records unrelated to fluid balance.
Excludes failures in fluid-balance assessment, escalation or treatment decisions unless they also involve unreliable fluid-balance recording.
Reports
46
Distinct published reports
Individual concerns
50
A report can raise multiple concerns
Date range
2013–2025
First to latest report issue date
Stated actions
87
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.
Department of Health and Social Care6
University Hospitals Sussex NHS Foundation Trust4
Blackpool Teaching Hospitals NHS Foundation Trust3
Care Quality Commission3
NHS England3
Ashford and St Peter'S Hospitals NHS Foundation Trust2
General Medical Council2
Greater Manchester Mental Health NHS Foundation Trust2
Pennine Acute Hospitals NHS Trust2
Royal College of Obstetricians and Gynaecologists2
Stockport NHS Foundation Trust2
Academy of Medical Royal Colleges1
Amberley Hall Care Home1
Athena Care Homes (UK) Limited1
Barking, Havering and Redbridge University Hospitals NHS Trust1
NHS trust30
Healthcare site13
Ministerial department6
Nursing home4
Private limited company4
Executive non-departmental public body3
Health and care professional regulator3
Health and social care service regulator3
Health professional body3
Integrated care board3
Independent healthcare provider2
Local health board2
Clinical commissioning group1
English county council1
English unitary authority1
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.
Northamptonshire
Concerns raised1
Failure to accurately and completely record fluid and food intake
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 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.4
Action
Use electronic fluid-balance charts in Nevercentre to improve accessibility, calculation and documentation accuracy.
Stated by University Hospitals of Northamptonshire NHS GroupStated completedThe respondent said that this action was complete when they made their response on 24 February 2026.
Action
Roll out updated food-and-fluid charts across both hospitals, including prompts for chart commencement, visitor-provided food and oral nutritional supplements.
Stated by University Hospitals of Northamptonshire NHS GroupStated plannedThe respondent said that this action was planned when they made their response on 24 February 2026.
Action
Audit MUST completion and the accuracy of food-and-fluid charts through Nutrition Nurses and use findings to monitor compliance.
Stated by University Hospitals of Northamptonshire NHS GroupStated completedThe respondent said that this action was complete when they made their response on 24 February 2026.
Action
Deliver evaluated monthly nutrition and hydration training through the Clinical Skills Nursing Programme, including documentation standards.
Stated by University Hospitals of Northamptonshire NHS GroupStated in progressThe respondent said that this action was in progress when they made their response on 24 February 2026.
Lancashire and Blackburn with Darwen
Concerns raised1
Inaccurate fluid balance charting failing to account for all sources of fluid provision
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.2
Action
Test and develop risk-based fluid monitoring, including patient and family recording of fluid intake for inclusion in fluid balance charts.
Stated by East Lancashire Hospitals NHS TrustStated in progressThe respondent said that this action was in progress when they made their response on 14 October 2025.
Action
Monitor implementation of revised professional standards through internal assurance processes, escalating issues to the Quality Committee until embedded in business as usual.
Stated by East Lancashire Hospitals NHS TrustStated in progressThe respondent said that this action was in progress when they made their response on 14 October 2025.
Nottinghamshire
Concerns raised1
Inaccurate and inadequate completion of fluid balance charts
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 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.6
Action
Conduct weekly fluid-balance audits with monthly matron oversight and ward-level action plans for non-compliance.
Stated by Doncaster and Bassetlaw Teaching Hospitals NHS Foundation TrustStated completedThe respondent said that this action was complete when they made their response on 29 August 2025.
Action
Transition to electronic fluid-balance charting to improve accuracy and provide real-time oversight.
Stated by Doncaster and Bassetlaw Teaching Hospitals NHS Foundation TrustStated completedThe respondent said that this action was complete when they made their response on 29 August 2025.
Action
Deliver ongoing education and training on fluid balance and hydration assessment through Medicine and Quality Improvement teams.
Stated by Doncaster and Bassetlaw Teaching Hospitals NHS Foundation TrustStated in progressThe respondent said that this action was in progress when they made their response on 29 August 2025.
Action
Implement the AKI Care Bundle, including electronic prompts for fluid-balance charting, in pilot areas.
Stated by Doncaster and Bassetlaw Teaching Hospitals NHS Foundation TrustStated completedThe respondent said that this action was complete when they made their response on 29 August 2025.
Action
Roll out the AKI Care Bundle across the Trust in February 2026.
Stated by Doncaster and Bassetlaw Teaching Hospitals NHS Foundation TrustStated plannedThe respondent said that this action was planned when they made their response on 29 August 2025.
Action
Host a multidisciplinary Gastroenterology Masterclass addressing comprehensive nutrition and hydration assessment and fluid-intake monitoring.
Stated by Doncaster and Bassetlaw Teaching Hospitals NHS Foundation TrustStated plannedThe respondent said that this action was planned when they made their response on 29 August 2025.
Blackpool and the Fylde
Concerns raised1
Inaccurate recording of fluid balances for internal hospital reviews
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 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.6
Action
Roll out the newly developed Trust fluid-balance chart across the organisation.
Stated by Blackpool Teaching Hospitals NHS Foundation TrustStated plannedThe respondent said that this action was planned when they made their response on 24 January 2025.
Stated by Blackpool Teaching Hospitals NHS Foundation TrustStated in progressThe respondent said that this action was in progress when they made their response on 24 January 2025.
Action
Establish a lead team to update the Trust fluid-balance policy using Quality Improvement recommendations.
Stated by Blackpool Teaching Hospitals NHS Foundation TrustStated plannedThe respondent said that this action was planned when they made their response on 24 January 2025.
Action
Operate the launched Clinical Community to scale, spread and embed fluid-balance improvements across the organisation.
Stated by Blackpool Teaching Hospitals NHS Foundation TrustStated completedThe respondent said that this action was complete when they made their response on 24 January 2025.
Action
Introduce mandatory afternoon checks and QR-code guidance to reinforce fluid-balance policy changes.
Stated by Blackpool Teaching Hospitals NHS Foundation TrustStated plannedThe respondent said that this action was planned when they made their response on 24 January 2025.
Action
Maintain organisation-wide line of sight over fluid-balance chart completion through the updated record-keeping audit methodology.
Stated by Blackpool Teaching Hospitals NHS Foundation TrustStated completedThe respondent said that this action was complete when they made their response on 24 January 2025.
Worcestershire
Concerns raised1
Failure to properly record fluid intake and output on fluid balance charts
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.3
Action
Share Trust-wide learning and required actions to improve fluid-balance documentation in the electronic patient record.
Stated by Worcestershire Acute Hospitals NHS TrustStated completedThe respondent said that this action was complete when they made their response on 25 September 2024.
Action
Provide ward-based education on nutrition, hydration, MUST assessment and fluid-balance recording through induction, specialist training and HCA study days.
Stated by Worcestershire Acute Hospitals NHS TrustStated completedThe respondent said that this action was complete when they made their response on 25 September 2024.
Action
Develop and deliver a local training package addressing fluid-balance and electronic-record changes.
Stated by Worcestershire Acute Hospitals NHS TrustStated in progressThe respondent said that this action was in progress when they made their response on 25 September 2024.
Surrey
Concerns raised1
Inadequate recording of fluid input and output
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 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
Disseminate a quick reference guide explaining how to manage parenteral nutrition entries in the electronic fluid-balance chart.
Stated by Ashford and St Peter'S Hospitals NHS Foundation TrustStated completedThe respondent said that this action was complete when they made their response on 5 August 2024.
Action
Conduct the electronic fluid-balance discovery work with subject-matter experts to define required data feeds.
Stated by Ashford and St Peter'S Hospitals NHS Foundation TrustStated in progressThe respondent said that this action was in progress when they made their response on 5 August 2024.
Action
Conduct a gap analysis to identify updates needed to improve fluid-balance-chart accessibility and viewing.
Stated by Ashford and St Peter'S Hospitals NHS Foundation TrustStated plannedThe respondent said that this action was planned when they made their response on 5 August 2024.
Action
Provide fluid-balance recording training through induction, student workbooks, preceptorship, and ward-based clinical education.
Stated by Ashford and St Peter'S Hospitals NHS Foundation TrustStated completedThe respondent said that this action was complete when they made their response on 5 August 2024.
Action
Reinforce fluid-balance practice through daily safety huddles and recurring ward handover topics.
Stated by Ashford and St Peter'S Hospitals NHS Foundation TrustStated completedThe respondent said that this action was complete when they made their response on 5 August 2024.
Action
Set ward times for recording catheter, drain, and nasogastric-tube outputs and monitor chart-review compliance.
Stated by Ashford and St Peter'S Hospitals NHS Foundation TrustStated completedThe respondent said that this action was complete when they made their response on 5 August 2024.
Action
Carry out a ward quality-improvement project to improve oral hydration and fluid balance.
Stated by Ashford and St Peter'S Hospitals NHS Foundation TrustStated in progressThe respondent said that this action was in progress when they made their response on 5 August 2024.
Action
Provide ward-focused tea-trolley education on accurate fluid-balance recording.
Stated by Ashford and St Peter'S Hospitals NHS Foundation TrustStated in progressThe respondent said that this action was in progress when they made their response on 5 August 2024.
Action
Review fluid-balance charts during weekly senior-nurse care rounds.
Stated by Ashford and St Peter'S Hospitals NHS Foundation TrustStated completedThe respondent said that this action was complete when they made their response on 5 August 2024.
South Wales Central
Concerns raised1
Failure to maintain fluid balance charts
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 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.
West Sussex, Brighton and Hove
Concerns raised1
Failure to keep accurate records of fluid input and output
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 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.3
Action
Oversee further fluid-balance audits across all maternity birth settings and receive the results through perinatal quality surveillance arrangements.
Stated by NHS Surrey and Sussex Integrated Care BoardStated in progressThe respondent said that this action was in progress when they made their response on 9 May 2024.
Action
Request completion of an additional fluid-balance compliance audit before the end of the year.
Stated by NHS Surrey and Sussex Integrated Care BoardStated completedThe respondent said that this action was complete when they made their response on 9 May 2024.
Action
Approach NICE to suggest an addendum to the Intrapartum care guideline addressing hyponatraemia risks, fluid balance monitoring and related neonatal notification.
Stated by Royal College of Obstetricians and GynaecologistsStated plannedThe respondent said that this action was planned when they made their response on 9 May 2024.
Respondent positions A position is what a respondent says about the concern when they do not describe a specific action.1
Position
At the time, applicable guidance did not require accurate fluid-balance monitoring during labour.
Stated by NHS Surrey and Sussex Integrated Care BoardDisputes the concernThe respondent disagreed with part of the concern or the basis for it.
Essex
Concerns raised1
Omissions in required food and fluid chart recording
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 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 Food and Fluid Refresher training to inpatient nursing staff.
Stated by Essex Partnership University NHS Foundation TrustStated in progressThe respondent said that this action was in progress when they made their response on 28 December 2023.
Norfolk
Concerns raised1
Incomplete food and fluid charting
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.
No linked response statements
No respondent-stated action or position is linked to these concerns in the published data.
Pin
Get email alerts
Request correction
Includes failures of the dedicated fluid-balance recording process, including records of intravenous fluids, fluid intake and output, and food or fluid offers and consumption, where the recording deficiency impairs reliable assessment of fluid status.
