Recurring concern
Unreliable complex case management
- Reports that mention this concern
- 8
- Times this concern has been raised
- 9
- Stated actions linked to this concern
- 12
What this concern includes
Includes failures in explicitly complex case-management arrangements, including inadequate progress, under-use of enhanced case-management systems, absence or unclear allocation of a designated case manager, insufficient monitoring and liaison, and failure to convene or use dedicated complex-case coordination arrangements where these are intended to manage complex or uncertain cases.
What is not included
- Excludes generic delays, staffing, communication or documentation deficiencies where complex case management is not the identified unsafe condition.
- Excludes ordinary case management for routine or non-complex cases.
- Excludes failures belonging to a separately named pathway, safeguarding system, placement process or clinical condition when that named concern provides the more specific supported boundary.
- Excludes general multi-agency ownership or care-coordination failures that do not specifically concern complex case management.
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 8 reports
See individual reports that have raised this concern, and the actions taken in response
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Concerns raised1
Insufficient managerial oversight of complex District Nursing cases
This report raised 4 other concerns. They are not shown here because they do not form part of this recurring concern.
Linked response
- Tameside and Glossop Integrated 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.4
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Tameside and Glossop Integrated Care NHS Foundation Trust
Introduce Team Leader of the Day and Coordinator of the Day roles to provide senior support and clear escalation routes.
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Tameside and Glossop Integrated Care NHS Foundation Trust
Increase caseload reviews and triage to prioritise patients with complex, frail, end-of-life or changing clinical needs.
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Tameside and Glossop Integrated Care NHS Foundation Trust
Recruit and introduce a senior District Nursing Caseload Facilitator role to strengthen caseload oversight, patient flow and care planning.
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Tameside and Glossop Integrated Care NHS Foundation Trust
Establish a District Nursing Improvement Group to lead work on triage, caseload management, documentation, escalation and monthly audited assurance reporting.
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Concerns raised1
Lack of a mechanism for multidisciplinary medical coordination under a single practitioner
Linked responses
- NHS England
- NHS Greater Manchester Integrated Care 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
-
NHS Greater Manchester Integrated Care Board
Continue progressing the appointment of care coordinators for patients with complex medical needs.
Respondent positions A position is what a respondent says about the concern when they do not describe a specific action.1
-
NHS England
Processes for managing complex patients across Greater Manchester specialties are better addressed by the Greater Manchester Integrated Care Board.
-
Concerns raised1
Insufficient progress with complex case management
This report raised 2 other concerns. They are not shown here because they do not form part of this recurring concern.
Linked response
- Nottinghamshire Healthcare 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
-
Nottinghamshire Healthcare NHS Foundation Trust
Establish weekday multidisciplinary daily triage meetings across Adult Mental Health and Local Mental Health Teams for complex referral decisions.
-
Concerns raised1
Lack of national-level complex case forums
This report raised 10 other concerns. They are not shown here because they do not form part of this recurring concern.
Linked response
- Home Office
Respondent positions A position is what a respondent says about the concern when they do not describe a specific action.1
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Home Office
The current MARAC model provides an effective, flexible forum for agencies to manage domestic abuse safeguarding risks without statutory duties.
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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.
-
Concerns raised1
Failure to identify complex cases early and assign them to an appropriately qualified psychiatrist
This report raised 7 other concerns. They are not shown here because they do not form part of this recurring concern.
Linked response
- Greater Manchester Mental Health 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
-
Greater Manchester Mental Health NHS Foundation Trust
Develop forensic in-reach support for high-risk community patients, including timely advice, risk management and second opinions.
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Greater Manchester Mental Health NHS Foundation Trust
Complete caseload reviews covering patient numbers and complexity within the enhanced community model.
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Concerns raised2
Failure to provide robust, effective and event-responsive complex case planning
Under-utilisation of enhanced case management for complex prisoners
This report raised 4 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
Lack of a designated clinical case manager for complex and uncertain cases
This report raised 1 other concern. They are not shown here because they do not form part of this recurring concern.
Linked responses
- Department of Health and Social Care
- Leeds Teaching 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
-
Leeds Teaching Hospitals NHS Trust
Fill clinical nurse specialist posts to support cancer care coordination.
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Leeds Teaching Hospitals NHS Trust
Assign a clinical nurse specialist to follow the case and provide communication for every patient attending clinics with a possible cancer diagnosis.
Respondent positions A position is what a respondent says about the concern when they do not describe a specific action.1
-
Department of Health and Social Care
The local Trust is responsible for addressing whether a clinical case manager role is needed in this case.
Actions and positions describe what organisations say in published responses. Implementation is not independently verified.
Data last updated 7 September 2026