Recurring concern
Unreliable return-from-hospital arrangements
- Reports that mention this concern
- 8
- Times this concern has been raised
- 8
- Stated actions linked to this concern
- 10
What this concern includes
Includes failures of the dedicated return-from-hospital process, including governing forms and protocols, communication with receiving care providers, confirmation of return, post-return evaluation or assessment, and related handover controls needed to resume safe care.
What is not included
- Excludes general hospital discharge planning, discharge summaries, medication transfer or onward-care placement failures when they do not specifically concern the return-from-hospital process.
- Excludes failures limited to the quality of hospital treatment before return or ongoing care after a reliable return process has been completed.
- Excludes generic documentation, communication or assessment deficiencies unless they directly impair safe return from hospital.
- Excludes transport availability or transport safety failures where the concern is conveyance itself rather than safe receipt and follow-up after return.
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
Failure to require notification of safe return to the hospital or care company
This report raised 3 other concerns. They are not shown here because they do not form part of this recurring concern.
Linked response
- the Dudley Group NHS Foundation Trust
Respondent positions A position is what a respondent says about the concern when they do not describe a specific action.1
-
the Dudley Group NHS Foundation Trust
Some patient transport safety actions fall outside the Trust’s scope.
-
Concerns raised1
Failure to conduct further risk assessments after a resident’s return from hospital
This report raised 10 other concerns. They are not shown here because they do not form part of this recurring concern.
Linked response
- Hibiscus Housing Association 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.1
-
Hibiscus Housing Association Limited
Reassess tenants returning from hospital, including Care Manager risk assessment, ongoing observation and recording outcomes in tenant files and Birdie.
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Concerns raised1
Inadequate protocols for return from hospital forms
This report raised 15 other concerns. They are not shown here because they do not form part of this recurring concern.
Linked response
- Hill Care Group
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
-
Hill Care Group
Train nurses and shift leaders on documentation, care plans, wound management, assessments, body maps, consent forms and hospital-return documentation.
Respondent positions A position is what a respondent says about the concern when they do not describe a specific action.1
-
Hill Care Group
Existing protocols for wound management and required care documentation are considered sufficient, with compliance monitored through regular audits.
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Concerns raised1
Failure to evaluate a patient’s situation and required action after return to the ward
This report raised 13 other concerns. They are not shown here because they do not form part of this recurring concern.
Linked response
- Leeds and York Partnership 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
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Leeds and York Partnership NHS Foundation Trust
Implement return interviews after unauthorised leave and use the information to guide care plans and future leave decisions.
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Leeds and York Partnership NHS Foundation Trust
Audit compliance with the revised procedure’s return-interview requirements.
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Concerns raised1
Failure to evaluate patients after return
This report raised 3 other concerns. They are not shown here because they do not form part of this recurring concern.
Linked response
- Hc-One 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.6
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Hc-One Limited
Apply the falls prevention and post-fall protocol, including prompt assessment, incident recording, investigation and review of care plans and risk assessments.
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Hc-One Limited
Increase Area Director and Quality Regulation Manager scrutiny of falls assessments and evaluations during visits and inspections.
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Hc-One Limited
Discuss falls trends and share learning through quarterly Quality Governance Group meetings, with follow-up actions reviewed monthly.
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Hc-One Limited
Share sample falls risk assessments with staff to clarify assessment and post-fall evaluation requirements.
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Hc-One Limited
Implement a falls flow chart at Sunnyside Care Home to guide post-fall actions.
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Hc-One Limited
Implement 24-hour post-incident observation records and senior clinical walk-rounds, with operational and internal inspection audits.
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Concerns raised1
Lack of guidance for managing children returning to their local area after out-of-area psychiatric inpatient care
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
Inadequate communication and liaison between hospital and community care providers after discharge
This report raised 2 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 reassess and update care plans and falls risks after hospital return
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.
Actions and positions describe what organisations say in published responses. Implementation is not independently verified.
Data last updated 7 September 2026