Recurring concern

Unreliable handling of healthcare information-disclosure constraints in emergency call advice

First to latest report 29 Jul 2014 — 1 Dec 2025

Reports that mention this concern
2
Times this concern has been raised
2
Stated actions linked to this concern
2

What this concern includes

Includes failures in emergency call-handling and urgent-call advice processes to recognise, explain or appropriately account for legal or procedural limits on healthcare providers disclosing sensitive patient information to concerned members of the public, including communication and understanding of those limits across NHS 111 or comparable services.

What is not included
  • Excludes general confidentiality, consent or information-sharing failures where the deficiency is not part of emergency call advice to members of the public.
  • Excludes failures in clinical triage, ambulance dispatch or emergency response after the advice has been given, unless the disclosure-constraint advice itself is deficient.
  • Excludes ordinary patient, family or professional communication where no emergency call-handling or urgent-call advice context is identified.
  • Excludes generic legal, policy, training or communication deficiencies unless they directly impair recognition or explanation of healthcare information-disclosure constraints during emergency call advice.

Reports and published responses 2 reports

See individual reports that have raised this concern, and the actions taken in response

  1. Manchester South

    AI-generated summary

    Lewis Bates · Prevention of Future Deaths report

    This summary was generated using AI from the published report. Please read the original report for the complete account.

    Report summary

    Lewis Bates was reported missing after leaving his mother and stepfather’s house, having previously expressed an intention to end his life if he could not see his children. His body was found approximately two hours and 21 minutes after the missing-persons report. Concerns included the absence of guidance for call handlers about reasonable enquiries, advice to contact healthcare providers, and apparent confusion about the applicable police response process.

    Read the report on judiciary.uk

    Source evidence

    How this individual concern was interpreted

    PFD Monitor created a concise, searchable interpretation from the report wording shown below.

    PFD Monitor interpretation

    Failure to account for healthcare information-disclosure constraints when directing callers to make enquiries

    Wider context from the report

    “2. In the context of the advice given by the call handler, I am concerned that the additional enquiries the caller was asked to undertake included contacting Mr Bates’s GP surgery and the local hospital, notwithstanding the potential legal constraints on healthcare providers disclosing information to a concerned member of the public. ”

    Source location

    Lewis Bates · Prevention of Future Deaths report
    Page 2 · concerns

    Open source report

    Source evidence

    How this respondent action was interpreted

    PFD Monitor created a concise, searchable interpretation from the published response wording shown below.

    PFD Monitor interpretation

    Issue formal guidance defining unreasonable enquiries for informants and setting out lawful alternatives when healthcare or sensitive information is relevant.

    Verbatim wording from the response

    “By the end of February 2026, GMP will issue formal guidance for call handlers clearly outlining:”

    Source location

    Response from Greater Manchester Police
    Page 3 · response
    Published 3 December 2025

    Open published response

    Source evidence

    How this respondent action was interpreted

    PFD Monitor created a concise, searchable interpretation from the published response wording shown below.

    PFD Monitor interpretation

    Disseminate a reminder to call handlers through bespoke correspondence and FCCO digital wallboards that members of the public should not be asked to contact GP surgeries for information.

    Verbatim wording from the response

    “To prevent any future mistakes, bespoke correspondence has been forwarded to Call Handlers; and internal FCCO digital wallboards have been updated with a reminder that this does not constitute a reasonable enquiry for a member of the public reporting a concern for welfare and/or a potential missing person.”

    Source location

    Response from Greater Manchester Police
    Page 3 · response
    Published 3 December 2025

    Open published response

    Source evidence

    How this respondent position was interpreted

    PFD Monitor created a concise, searchable interpretation from the published response wording shown below.

    PFD Monitor interpretation

    The request for callers to contact GP surgeries appears to be an isolated individual-learning incident, not a problem in existing tools or training.

    Verbatim wording from the response

    “The Call Handler responsible has been given organisational learning feedback regarding this incident which will be filed in their personal records.”

    Source location

    Response from Greater Manchester Police
    Page 3 · response
    Published 3 December 2025

    Open published response

  2. County Durham and Darlington

    AI-generated summary

    Gary William Million · Prevention of Future Deaths report

    This summary was generated using AI from the published report. Please read the original report for the complete account.

    Report summary

    Gary William Million telephoned 111 on 23 November 2013 but could not provide clear information about his location and then became silent. There was a prolonged delay in locating his address, including an incorrect address being given to the ambulance, and the crew attended the correct address at 01:10. The concerns included inadequate procedures and training for locating potentially seriously ill callers, communication issues with BT, weaknesses in the investigation and insufficiently robust follow-up procedures.

    Read the report on judiciary.uk

    Source evidence

    How this individual concern was interpreted

    PFD Monitor created a concise, searchable interpretation from the report wording shown below.

    PFD Monitor interpretation

    Failure to ensure all 111 service providers understand the limitations of the BT service for disclosing data sensitive information

    Wider context from the report

    “2. BT’s evidence was that they have given further advice and information to blue light service providers (namely Fire, Police, Ambulance, Coastguard) but as they do not know of the identity of all 111 providers it is very possible that other 111 providers may not understand the limitations of the BT service for disclosing data sensitive information and therefore, so that this issue can be considered and lessons learnt therefrom the Department of Health ought to consider sharing this information with all other 111 service providers throughout the country to reduce the risk of similar fatalities in the future. A copy of the full Regulation 28 report addressed to North East Ambulance Service Trust is attached. ”

    Source location

    Gary William Million · Prevention of Future Deaths report
    Page 2 · concerns

    Open source report

Actions and positions describe what organisations say in published responses. Implementation is not independently verified.

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Data last updated 7 September 2026