Unreliable inter-agency information sharing for coordinated care
First to latest report 29 May 2013 — 15 Jun 2026
Reports that mention this concern
212
Times this concern has been raised
235
Stated actions linked to this concern
492
What this concern includes
Includes failures of the inter-agency care information-sharing system, including inadequate arrangements, communication channels, shared records or contact mechanisms when these prevent timely access to relevant care, needs or risk information between agencies.
What is not included
Excludes information-sharing failures unrelated to coordination between agencies supporting a person.
Excludes failures confined to a single organisation's records, assessment, documentation or communication process unless the report directly links them to inter-agency information sharing.
Excludes generic staffing, confidentiality, policy or technology deficiencies that are not specifically tied to the unsafe inter-agency information-sharing condition.
Excludes hazards involving public access to harmful information or physical communication and rescue equipment.
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.
Department of Health and Social Care57
NHS England39
Ministry of Justice14
Home Office11
Greater Manchester Health and Social Care Partnership9
HM Prison and Probation Service8
NHS Greater Manchester Integrated Care Board8
Care Quality Commission7
Greater Manchester Mental Health NHS Foundation Trust7
Birmingham and Solihull Mental Health NHS Foundation Trust6
Metropolitan Police Service6
College of Policing5
Greater Manchester Police5
Midlands Partnership University NHS Foundation Trust5
Pennine Care NHS Foundation Trust5
NHS trust106
Ministerial department68
Executive non-departmental public body45
Police force30
Integrated care board24
Type not available20
Healthcare site19
Private limited company15
English county council12
Health-system partnership12
English metropolitan district council11
Executive agency11
English unitary authority9
National policing body8
Health and social care service regulator7
Reports and published responses 212 reports
See individual reports that have raised this concern, and the actions taken in response
Derby and Derbyshire
Concerns raised1
Failure of multi-agencies to share patients' past medical history, including previous falls history
This report raised 1 other concern. They are not shown here because they do not form part of this recurring concern.
No linked response statements
No respondent-stated action or position is linked to these concerns in the published data.
Manchester South
Concerns raised1
Failure of NHS information-sharing systems to share detailed illness histories beyond the OOH GP service
This report raised 10 other concerns. They are not shown here because they do not form part of this recurring concern.
No linked response statements
No respondent-stated action or position is linked to these concerns in the published data.
Manchester South
Concerns raised1
Lack of structured and direct information sharing between hospital and ambulance services
This report raised 3 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 Midlands Ambulance Service NHS Trust
Health Services Safety Investigations Body
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
East Midlands Ambulance Service NHS Trust
Implement the SBAR communication framework for clinical handovers.
East Midlands Ambulance Service NHS Trust
Develop and seek regional agreement for a maternity-specific SBAR handover model.
East Midlands Ambulance Service NHS Trust
Implement the maternity-specific SBAR handover model across the EMAS footprint.
Respondent positions A position is what a respondent says about the concern when they do not describe a specific action.3
Health Services Safety Investigations Body
The HSIB cannot investigate this case because it occurred before the organisation became operational and falls outside its investigation criteria.
Unable to actThe respondent said that a constraint prevented them from taking the relevant action.
Department of Health and Social Care
Operational concerns are for the involved NHS trusts to address.
Redirects responsibilityThe respondent said that another organisation was responsible for deciding or taking action.
Department of Health and Social Care
HSIB cannot investigate incidents occurring before its establishment because they do not meet its investigation criteria.
Unable to actThe respondent said that a constraint prevented them from taking the relevant action.
Manchester South
Concerns raised1
Limited information sharing between adult safeguarding board members
This report raised 3 other concerns. They are not shown here because they do not form part of this recurring concern.
Linked response
Trafford Safeguarding 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
Trafford Safeguarding Board
Update TARGet meeting terms of reference to strengthen safeguarding-partner information sharing and multi-agency risk assessment and management planning.
Inner South London
Concerns raised1
Failure to inform the relevant HTT of consent to contact support persons
This report raised 6 other concerns. They are not shown here because they do not form part of this recurring concern.
No linked response statements
No respondent-stated action or position is linked to these concerns in the published data.
Portsmouth and South East Hampshire
Concerns raised1
Failure of the emergency information-relay system between birthing centres and hospitals
This report raised 11 other concerns. They are not shown here because they do not form part of this recurring concern.
Linked response
South Central Ambulance Service 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
South Central Ambulance Service NHS Foundation Trust
Update the Standard Operating Procedure and Clinical Directive to require clinicians to identify time-critical transfers and prioritise qualifying inter-facility calls as Category 1.
South Central Ambulance Service NHS Foundation Trust
Issue a reminder to Emergency Departments and birthing units across the South Central area about the process for requesting time-critical transfers.
Manchester West
Concerns raised1
Failure to communicate vital transfer information to patients, families and receiving clinicians
This report raised 3 other concerns. They are not shown here because they do not form part of this recurring concern.
No linked response statements
No respondent-stated action or position is linked to these concerns in the published data.
Central Hampshire
Concerns raised1
Failure to provide PER staff with relevant previous self-harm and suicide risk information
This report raised 12 other concerns. They are not shown here because they do not form part of this recurring concern.
Linked response
Hampshire and Isle of Wight Constabulary
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
Hampshire and Isle of Wight Constabulary
Use the next custody newsletter to reinforce PER completion, inspection, warning-page, envelope, risk-marker and external-information responsibilities.
Respondent positions A position is what a respondent says about the concern when they do not describe a specific action.3
Hampshire and Isle of Wight Constabulary
Detention officers completing PERs had access to Hampshire Constabulary systems and the Police National Computer, but not other forces’ internal systems.
Disputes the concernThe respondent disagreed with part of the concern or the basis for it.
Hampshire and Isle of Wight Constabulary
Obtaining information from every external agency on every occasion is impracticable, so officers cannot routinely obtain all external data.
Unable to actThe respondent said that a constraint prevented them from taking the relevant action.
Hampshire and Isle of Wight Constabulary
Officers must rely on each police force or agency to place relevant information on the national Police National Computer.
Redirects responsibilityThe respondent said that another organisation was responsible for deciding or taking action.
Liverpool and the Wirral
Concerns raised1
Failure to ensure effective information exchange during mental health service transfers
This report raised 1 other concern. They are not shown here because they do not form part of this recurring concern.
Linked response
Mersey Care 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
Mersey Care NHS Foundation Trust
Amend the transfer policy to require timely, comprehensive handover of information for CPA and non-CPA service users.
Mersey Care NHS Foundation Trust
Circulate the inquest outcome and transfer-policy changes through operational management meetings, consultant forums and a Quality Practice Alert.
Mersey Care NHS Foundation Trust
Consider including an audit of transfer processes in the Junior Doctor Audit programme.
Manchester South
Concerns raised1
Limited information sharing between health professionals to identify service access and need for psychiatric referral
This report raised 4 other concerns. They are not shown here because they do not form part of this recurring concern.
Linked response
Grosvenor Medical Centre
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
Grosvenor Medical Centre
Wrote to the mental health lead requesting improved communication between Healthy Minds and GPs.
Actions and positions describe what organisations say in published responses. Implementation is not independently verified.
Actions and positions describe what organisations say in published responses. Implementation is not independently verified.