First reported 24 Jul 2024•Latest report 30 Mar 2026
Definition
What this concern includes
Includes failures in dedicated paediatric or NHS abdominal-pain pathways, including pathway design, symptom discrimination, clinical assessment, escalation, referral, imaging or specialist involvement where these directly affect recognition and management of possible appendicitis or other time-critical abdominal conditions.
Not included
Excludes generic clinical assessment, staffing, training or documentation deficiencies unless they directly impair an abdominal-pain pathway.
Excludes condition-specific pathways for bowel obstruction, suspected meningitis or other named conditions when that condition provides the more specific supported boundary.
Excludes diagnostic, treatment or referral failures occurring after an abdominal-pain pathway has reliably identified and escalated the patient's risk.
Excludes generic hospital admission or emergency-department delays where no abdominal-pain pathway deficiency is identified.
Reports
4
Distinct published reports
Individual concerns
7
A report can raise multiple concerns
Date range
2024–2026
First to latest report issue date
Stated actions
17
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.
NHS England3
Royal College of General Practitioners2
East Kent Hospitals University NHS Foundation Trust1
George Eliot Hospital NHS Trust1
National Institute for Health and Care Excellence1
Royal College of Paediatrics and Child Health1
Royal College of Radiologists1
Royal College of Surgeons of England1
St George'S University Hospitals NHS Foundation Trust1
Executive non-departmental public body3
NHS trust3
Health professional body2
Professional body1
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.
Warwickshire
Concerns raised1
Failure of the paediatric abdominal pain pathway to align with GIRFT structure and escalation principles
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 concerns
Each 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.5
Action
Embed the GIRFT paediatric abdominal pain pathway into clinical practice.
Stated by George Eliot Hospital NHS TrustStated in progressThe respondent said that this action was in progress when they made their response on 25 June 2026.
Action
Share GIRFT paediatric abdominal pain guidance with Emergency and Paediatric Department staff.
Stated by George Eliot Hospital NHS TrustStated completedThe respondent said that this action was complete when they made their response on 25 June 2026.
Action
Deliver and repeat targeted abdominal pain teaching for the Paediatric Team.
Stated by George Eliot Hospital NHS TrustStated in progressThe respondent said that this action was in progress when they made their response on 25 June 2026.
Action
Run monthly multidisciplinary simulation sessions covering paediatric abdominal pain, neurodivergence, communication and escalation.
Stated by George Eliot Hospital NHS TrustStated in progressThe respondent said that this action was in progress when they made their response on 25 June 2026.
Action
Review GIRFT guidance and compile a compliant Standard Operating Procedure for paediatric abdominal pain.
Stated by George Eliot Hospital NHS TrustStated plannedThe respondent said that this action was planned when they made their response on 25 June 2026.
Inner South London
Concerns raised3
Inadequate training of doctors to consider appendicitis as a differential diagnosis for generalised abdominal pain
Failure to consider appendicitis in patients with abdominal pain
Failure to use bedside or departmental ultrasound scanning for abdominal pain
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 concerns
Each 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.9
Action
Run regular courses developing safe, comprehensive history-taking and triage skills for telephone consultations.
Stated by Royal College of General PractitionersStated completedThe respondent said that this action was complete when they made their response on 8 November 2024.
Action
Embed telephone consultation, triage, and urgent-care knowledge and skills within the GP Curriculum, training, and clinical topic guides.
Stated by Royal College of General PractitionersStated completedThe respondent said that this action was complete when they made their response on 8 November 2024.
Action
Continue supporting educational resources on appendicitis and managing diagnostic uncertainty through the GP Curriculum and continuing professional development.
Stated by Royal College of General PractitionersStated in progressThe respondent said that this action was in progress when they made their response on 8 November 2024.
Action
Signpost members to the Best Practice Pathway Resource for paediatric acute abdominal pain and appendicectomy.
Stated by Royal College of Paediatrics and Child HealthStated plannedThe respondent said that this action was planned when they made their response on 8 November 2024.
Action
Share the report with Specialty Advisory Committee Chairs for consideration in upcoming curriculum reviews.
Stated by Royal College of Surgeons of EnglandStated completedThe respondent said that this action was complete when they made their response on 8 November 2024.
Action
Review CCRISP course content to determine whether it should explicitly refer to retrocaecal appendicitis.
Stated by Royal College of Surgeons of EnglandStated in progressThe respondent said that this action was in progress when they made their response on 8 November 2024.
Action
Launch the updated CCRISP course version incorporating the completed content review.
Stated by Royal College of Surgeons of EnglandStated plannedThe respondent said that this action was planned when they made their response on 8 November 2024.
Action
Redevelop the Clinical Skills in Emergency Surgery course while reviewing whether to explicitly refer to retrocaecal appendicitis.
Stated by Royal College of Surgeons of EnglandStated in progressThe respondent said that this action was in progress when they made their response on 8 November 2024.
Action
Publish an anonymised educational Surgical Safety vignette about the case in the specified surgical journals and disseminate it to a wide surgical audience.
Stated by Royal College of Surgeons of EnglandStated plannedThe respondent said that this action was planned when they made their response on 8 November 2024.
Respondent positions A position is what a respondent says about the concern when they do not describe a specific action.1
Position
Current surgical curricula adequately cover retrocaecal appendicitis, so no additional curriculum change is considered necessary beyond ongoing review.
Stated by Royal College of Surgeons of EnglandExisting arrangements considered sufficientThe respondent said that existing arrangements were sufficient, so no further action was needed.
Inner West London
Concerns raised1
Inadequate safety-netting for apparently benign abdominal conditions
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 concerns
Each statement is shown once, even when linked to more than one concern.
No linked response statements
No respondent-stated action or position is linked to these concerns in the published data.
Central and South East Kent
Concerns raised2
Lack of clinical staff knowledge of the Acute Abdominal Pain Pathway
Failure of the Acute Abdominal Pain Pathway documentation to provide sufficient clarity
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 concerns
Each 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.3
Action
Continue joint Emergency Medicine and Surgical teaching sessions reinforcing the Acute Abdominal Pain Pathway.
Stated by East Kent Hospitals University NHS Foundation TrustStated in progressThe respondent said that this action was in progress when they made their response on 30 September 2024.
Action
Require completion of the Acute Abdominal Pain Pathway for Emergency Department admissions involving abdominal pain.
Stated by East Kent Hospitals University NHS Foundation TrustStated completedThe respondent said that this action was complete when they made their response on 30 September 2024.
Action
Add the Acute Abdominal Pain Pathway to the My ED App for clinician access.
Stated by East Kent Hospitals University NHS Foundation TrustStated completedThe respondent said that this action was complete when they made their response on 30 September 2024.
Respondent positions A position is what a respondent says about the concern when they do not describe a specific action.4
Position
The current training regime is considered sufficient to ensure staff understand the emergency management process for adult abdominal pain.
Stated by East Kent Hospitals University NHS Foundation TrustExisting arrangements considered sufficientThe respondent said that existing arrangements were sufficient, so no further action was needed.
Position
No actions by NICE are considered necessary to address the issues raised in the report.
Stated by National Institute for Health and Care ExcellenceNo action considered necessaryThe respondent said that no further action was needed.
Position
The concerns are local Trust issues outside NHS England’s remit.
Stated by NHS EnglandOutside remitThe respondent said that this matter was outside its role or authority.
Position
East Kent Hospitals University NHS Foundation Trust should respond to and address the concerns.
Stated by NHS EnglandRedirects responsibilityThe respondent said that another organisation was responsible for deciding or taking action.
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Includes failures in dedicated paediatric or NHS abdominal-pain pathways, including pathway design, symptom discrimination, clinical assessment, escalation, referral, imaging or specialist involvement where these directly affect recognition and management of possible appendicitis or other time-critical abdominal conditions.
