Recurring concern
Failure to escalate significant clinical concerns to appropriately senior clinicians
- Reports that mention this concern
- 72
- Times this concern has been raised
- 81
- Stated actions linked to this concern
- 103
What this concern includes
Includes failures of clinical escalation for significant patient concerns, abnormal findings, changing clinical conditions or treatment problems where escalation to an appropriately senior clinician is required, including obstetric escalation and escalation by junior staff during busy shifts.
What is not included
- Excludes generic organisational governance failures where no clinical concern requiring senior clinical review is identified.
- Excludes failures of escalation in non-clinical operational, safeguarding, complaints or emergency-control-room processes.
- Excludes delays in senior review where the failure is solely lack of consultant availability and no escalation deficiency is identified.
- Excludes failures limited to documentation, communication or training unless they directly constitute or undermine escalation of a significant clinical concern.
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.
Reports and published responses 72 reports
See individual reports that have raised this concern, and the actions taken in response
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Concerns raised1
Failure to escalate concerning patient presentations to a doctor
This report raised 6 other concerns. They are not shown here because they do not form part of this recurring concern.
No linked response statementsNo respondent-stated action or position is linked to these concerns in the published data.
-
Concerns raised1
Failure to escalate post-PEG patient concerns to a senior doctor for consideration of possible bleeding
This report raised 1 other concern. They are not shown here because they do not form part of this recurring concern.
No linked response statementsNo respondent-stated action or position is linked to these concerns in the published data.
-
Concerns raised1
Failure to alert senior clinicians to unexpected patient deterioration
This report raised 14 other concerns. They are not shown here because they do not form part of this recurring concern.
Linked response
- Spire Healthcare Limited
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
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Spire Healthcare Limited
Provide NEWS refresher training to relevant colleagues and conduct regular audits of NEWS compliance.
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Spire Healthcare Limited
Deliver training to RMOs on recognising deteriorating patients and signs of gastric perforation.
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Spire Healthcare Limited
Introduce deteriorating-patient stickers for clinical use.
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Concerns raised1
Failure to escalate eligible emergency department patients for consultant review
This report raised 4 other concerns. They are not shown here because they do not form part of this recurring concern.
Linked response
- University Hospitals Birmingham 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
-
University Hospitals Birmingham NHS Foundation Trust
Implement a policy empowering any multiprofessional team member to escalate delayed assessment or transfer to the consultant on call.
-
University Hospitals Birmingham NHS Foundation Trust
Deliver an education programme on escalation for delayed assessment or transfer from August 2023.
-
University Hospitals Birmingham NHS Foundation Trust
Deliver direct teaching and display laminated posters in acute surgical areas at all acute sites by 31 October 2023.
Respondent positions A position is what a respondent says about the concern when they do not describe a specific action.1
-
University Hospitals Birmingham NHS Foundation Trust
Responsibility for addressing emergency department patient volume rests with the Department of Health and Social Care.
-
Concerns raised1
Delay in calling the ITU team during critical emergencies
This report raised 5 other concerns. They are not shown here because they do not form part of this recurring concern.
No linked response statementsNo respondent-stated action or position is linked to these concerns in the published data.
-
Concerns raised1
Failure to share iliac artery aneurysm information to trigger Consultant Vascular Surgeon advice
This report raised 4 other concerns. They are not shown here because they do not form part of this recurring concern.
Linked response
- East Kent Hospitals University 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.1
-
East Kent Hospitals University NHS Foundation Trust
Communicate the requirement for accurate information in clinician referrals through clinical directors and regular team training.
-
Concerns raised1
Failure to escalate critical A&E blood-test abnormalities to the senior clinician
This report raised 9 other concerns. They are not shown here because they do not form part of this recurring concern.
No linked response statementsNo respondent-stated action or position is linked to these concerns in the published data.
-
Concerns raised1
Failure of junior staff to seek senior advice about anticoagulation interactions before administration
This report raised 6 other concerns. They are not shown here because they do not form part of this recurring concern.
No linked response statementsNo respondent-stated action or position is linked to these concerns in the published data.
-
Concerns raised1
Failure to contact the respiratory on-call consultant on repeat presentation
This report raised 19 other concerns. They are not shown here because they do not form part of this recurring concern.
Linked response
- Norfolk and Norwich University Hospitals 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.1
-
Norfolk and Norwich University Hospitals NHS Foundation Trust
Hold daily multidisciplinary morning report meetings to discuss cases and make appropriate specialty referrals.
Respondent positions A position is what a respondent says about the concern when they do not describe a specific action.1
-
Norfolk and Norwich University Hospitals NHS Foundation Trust
A further respiratory referral was not considered necessary because the patient had the same symptoms only two days earlier.
-
Concerns raised1
Failure of systems to provide supervision and escalation of complex cases involving junior doctors
This report raised 7 other concerns. They are not shown here because they do not form part of this recurring concern.
Linked response
- Barking, Havering and Redbridge University Hospitals NHS 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
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Barking, Havering and Redbridge University Hospitals NHS Trust
Use Care Flow to require consultant sign-off for specified patients and senior review before learning-disability patient discharge.
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Barking, Havering and Redbridge University Hospitals NHS Trust
Deliver teaching on diagnostic overshadowing and senior escalation, and add safeguarding and diagnostic overshadowing to the induction pack.
Actions and positions describe what organisations say in published responses. Implementation is not independently verified.
Data last updated 7 September 2026