Recurring concern
Failure to escalate significant clinical concerns to appropriately senior clinicians
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Request correctionFirst reported 23 Aug 2013•Latest report 27 May 2026
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.
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.
- Reports
- 72
- Individual concerns
- 81
- Date range
- 2013–2026
- Stated actions
- 103
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 to conduct renal or urological consultations through appropriately senior clinicians
This report raised 6 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 obtain appropriate senior medical review or support when deterioration is identified
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 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 ensure that the responsible consultant is made aware of worsening symptoms after discharge
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 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
Recirculate the medical escalation flow chart to CHITT and inpatient staff to clarify escalation routes for risk concerns.
Stated by Black Country Healthcare NHS Foundation Trust
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Concerns raised1
Failure to refer patients to the Critical Care Outreach Team at required NEWS thresholds
This report raised 8 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 inform the consultant of the patient and imminent self-discharge before discharge
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.
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
Notify consultants within 12 hours when their patient self-discharges from hospital.
Stated by The Trust
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Concerns raised1
Failure to seek early senior review
This report raised 6 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 escalate to a consultant
This report raised 6 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 raised3
Failure to escalate unresolved clinical review access problems to senior staff
Failure of junior staff to escalate clinical concerns to senior staff
Failure to calculate EDD scores accurately and trigger required Doctor review
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.4
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Action
Establish a 24-hour Central Hub with patient tracking, referral and bleep management, workload oversight, handover, task allocation, escalation and senior-manager staffing.
Stated by Frimley Health NHS Foundation Trust -
Action
Implement policy requiring independent verification of deteriorating-adult EDOD score calculations.
Stated by Frimley Health NHS Foundation Trust -
Action
Audit compliance with accurate EDOD score calculation and appropriate algorithm use.
Stated by Frimley Health NHS Foundation Trust
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Action
Introduce electronic MSS calculation of EDOD scores in the Emergency Department.
Stated by Frimley Health NHS Foundation Trust
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Concerns raised1
Failure of senior clinical review to recognise seriousness and plan urgent treatment
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 raised2
Failure to contact a consultant when Early Warning Scores indicate clinical deterioration
Failure to refer patients to consultant level when Early Warning Scores indicate escalation
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 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.
Data last updated 7 September 2026