Urgent care pathways
Deficiencies in urgent care pathways for serious but non-immediately life-threatening conditions, leading to delays and poor outcomes.
Strongest theme matches
Mixed across source types and ranked by classifier confidence plus text match strength.
Committee recommendation
86match
#3 - Clearly set out causes of urgent care performance variation and initiatives to improve standards.
The quality of patients’ access to urgent and emergency care depends too much on where they live, particularly with wide variation in ambulance response times. There is significant regional variation in the performance of services for urgent and emergency care. For example, in 2021–22, average ambulance response times for the most serious incidents varied from six minutes 51...
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terms: care, urgent
PPO recommendation
81match
The Head of Healthcare
The Head of Healthcare should ensure that there is: • Adequate training for nurses responsible for assessing the clinical condition and appropriate treatment pathways for prisoners, and • At least one nurse trained in advanced clinical assessment skills during all day shifts within one year and that nurses should be trained to this level before answering Urgent Assessment...
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terms: care, pathway, urgent
PFD report
77match
June Parkes
Significant delays occurred in urgent endoscopies due to inadequate protocols for 'in-hours' care and re-bleeds, and a lack of 'out-of-hours' emergency endoscopy/surgery. Concerns also include poor record-keeping, NEWS compliance, and doctor presence during critical transfers.
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terms: care, urgent
PFD report
77match
Teresa Dennett
Absence of a clear pathway for life-saving neurosurgery referral, issues with diagnostic imaging, and insufficient input from stroke physicians were identified as critical concerns. A lack of defined protocols risked delayed treatment for patients needing urgent surgery.
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terms: pathway, urgent
Committee recommendation
74match
#1 - Evidence taken from DHSC and NHS England on access to unplanned or urgent care.
On the basis of a report by the Comptroller and Auditor General, we took evidence from the Department of Health & Social Care (the Department) and NHS England about access to unplanned or urgent care.1
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terms: care, urgent
PFD report
73match
Vanessa Dadswell
Mental health services lacked an intermediate referral option between 4-hour A&E assessment and 5-day appointments, preventing timely intervention for patients requiring urgent but not emergency care.
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terms: care, urgent
PFD report
73match
Harry Gill
The NHS 111 vomiting pathways were not robust, leading to inappropriate responses in most calls and failing to ensure adequate patient care.
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terms: care, pathway
PFD report
69match
Dorothy Townley
Significant communication breakdowns between District Nurses and the GP, inadequate burns treatment knowledge and training, and unclear procedures for urgent blood tests compromised patient care.
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terms: care, urgent
PFD report
69match
Jacqueline Allwood
The urgent care center lacked an agreed protocol for DVT management, and a consulting GP failed to meet normative practice standards for diagnosis, risking future missed DVT cases.
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terms: care, urgent
PFD report
69match
Christine McNamara
There is a lack of clear pathways for post-ERCP patients with complications, and out-of-hours radiography is hampered by the absence of a Maidstone surgical consultant for urgent referrals.
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terms: pathway, urgent
PFD report
69match
Imad Hassan
There is no formal backup plan for PCI procedures when primary hospitals lack capacity, and no agreed pathways for accessing critical care beds outside Wales or for unconscious STEMI patients.
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terms: care, pathway
Committee recommendation
69match
#4 - Ensure all FGM survivors access timely, essential support and specialist care nationwide
The Government should ensure that all FGM survivors can access the essential support and care they need in a timely manner. While some variation in service provision may be necessary to reflect local prevalence rates, higher-prevalence areas should offer funded multidisciplinary services that allow quick access to specialist care. In lower-prevalence areas, there must be clear referral pathways...
Matched on
terms: care, pathway
PFD report
65match
Keith Martin
Systemic delays in A&E assessment, diagnostics, senior review, and treatment for chest pain, combined with unclear protocols and poor documentation, resulted in critical care failures.
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terms: care
PFD report
65match
Caroline Robey
Community healthcare providers failed to use a sepsis screening tool or adopt the national sepsis clinical toolkit, leading to missed diagnosis opportunities and delayed emergency admission.
Matched on
terms: care
PFD report
65match
Frederick Bevan
A poor handover practice led to paramedics receiving an inaccurate incident history from a non-witnessing nurse instead of the witnessing carer, risking detrimental effects on treatment.
Matched on
terms: care
CQC action
65match
Kettering General Hospital
The service should continue to explore how it improves speciality response times in the urgent and emergency care department.
Matched on
terms: care, urgent
HSSIB recommendation
65match
Provision of mental health care to patients presenting at the emergency department
It is recommended that NHS England ensures there is a sustainable funding model to support 24/7 urgent and emergency mental health liaison services in acute general hospitals with emergency departments.
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terms: care, urgent
IOPC learning recommendation
64match
Investigation into police contact with a man following a report into his behaviour and welfare - Merseyside Police,...
The IOPC recommends that Merseyside Police ensures that there is a robust agreement in place between the force and North West Ambulance Service NHS Trust in relation to people who come into contact with the police and require urgent medical attention’, including people showing signs of Acute Behavioural Disturbance (ABD). This agreement must ensure that the ambulance service...
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terms: care, urgent
CQC action
62match
Humber Primary Care
Continue to review the amount of patients attending accident and emergency.
Matched on
terms: care
PFD report
61match
Chloe Grace Flavell
The reception area management, prior to triage, creates significant and dangerous delays in providing immediate care and treatment, particularly for children.
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terms: care
PFD report
61match
Patricia Chapman
Revised training for community hospital staff lacks provision for obtaining emergency expert medical advice from acute hospitals, potentially delaying critical guidance in urgent situations.
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terms: urgent
PFD report
61match
Sally Ellison
There was a significant delay in conducting diagnostic tests for severe pneumonia, specifically Legionella, hindering confirmed diagnosis and potentially delaying optimal treatment. A rapid testing and reporting service is urgently needed.
Matched on
terms: urgent
PFD report
61match
George Boulton
Delays in emergency stroke care arose from the GP failing to escalate, a bed bureau lacking emergency re-routing, and ambulance services not classifying a stroke as an immediate emergency, risking critical treatment windows.
Matched on
terms: care
PFD report
61match
Leslie Summerfield
The withdrawal of urgent endoscopy services at a hospital, despite available resources, forces critically ill patients to be transported, causing unnecessary discomfort and potentially aggravating their conditions.
Matched on
terms: urgent
PFD report
61match
David Mostari
Urgent diagnostic tests were critically delayed over a weekend due to the hospital lacking a robust system for ensuring timely imaging, particularly for patients admitted outside of weekdays.
Matched on
terms: urgent
PFD report
61match
Sandra Wood
The NHS Trust's lack of routine weekend CT scan facilities led to a critical delay in an urgent scan, proving too late for the patient.
Matched on
terms: urgent
PFD report
61match
Marilyn Anson
Delays in urgent 'hot foot' clinic referrals, coupled with inadequate patient prioritisation and resource allocation, led to patient deterioration and death.
Matched on
terms: urgent
PFD report
61match
Terence Millington
Inadequate arrangements for on-call doctors, including a senior doctor's failure to ensure availability and a consultant's distant location, delayed prompt emergency care and a blood product request was incorrectly met.
Matched on
terms: care
PFD report
61match
Derek Turnbull
There was an hour-long delay in calling an ambulance for a patient with a head injury and known fall risk, despite clear need for immediate hospital transfer, indicating a failure in protocols for urgent escalation.
Matched on
terms: urgent
HSSIB recommendation
61match
HSIB’s local investigation pilot: shared learning for local healthcare systems
HSIB national investigation ‘Harm caused by delays in transferring patients to the right place of care .’
Matched on
terms: care
PFD report
57match
Barnabas Newlyn
Road transfer times for time-sensitive critical care, particularly neurosurgical emergencies, are too long, necessitating earlier consideration and use of air transfer services.
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terms: care
PFD report
57match
Thomas Smith
Critical issues include incomplete handovers, slow response times for children, lack of ambulance transfer, outdated national guidance on pre-hospital antibiotics for meningitis, and fragmented hospital care with unaddressed nursing concerns.
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terms: care
PFD report
57match
Mikey Hornby
The out-of-hours service repeatedly failed to appreciate the seriousness of an infant's condition, delaying hospital admission and critical antibiotic treatment. The GP surgery also lacked essential diagnostic facilities.
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classifier match
PFD report
57match
Robert Hogg
NHS Pathways' toddler/child assessment tools are failing to identify very sick children, a persistent and unaddressed risk despite prior investigations.
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terms: pathway
PFD report
57match
Michael Valentine
Inadequate communication and administrative procedures led to a GP not being informed about the rejection of an urgent mental health assessment, as rejected applications were not marked urgent nor accompanied by a phone call.
Matched on
terms: urgent
PFD report
57match
David Moran
The Trust's referral urgency guidance was imprecise, lacking a default to urgent in cases of doubt or absent screening. Communication between administrative, nursing, and clinical staff also appeared ineffective.
Matched on
terms: urgent
PPO recommendation
57match
The Governor and Head of Healthcare
The Governor and Head of Healthcare should ensure that all staff are fully aware of and understand their responsibilities in a medical emergency, including the use of an emergency response code if a prisoner has chest pains and documenting incidents.
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terms: care
HSSIB recommendation
57match
Variations in the delivery of palliative care services to adults
Support collaboration between health and care organisations to define clear routes of support for people in and out of normal working hours to ensure they know how to access help for palliative care and end of life needs.
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terms: care
Committee recommendation
56match
#31 - Unacceptable patient uncertainty accessing first-contact care through new NHS organisations.
Primary Care Networks and Integrated Care Systems offer an opportunity to better integrate care around people. It should not be the case that patients face so much uncertainty about where to turn to if they have a new or urgent care need and it is particularly unacceptable if the number of different organisations involved in providing first-contact services...
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terms: care, urgent
PFD report
53match
Andrew John Fallon
Emergency Department staffing levels were critically insufficient, causing excessive delays for seriously ill patients as staff were overwhelmed by patient volume, including minor complaints.
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classifier match
PFD report
53match
Stephen Bedford
Ambulance staff training and assessment for life support standards are inconsistent, leading to inappropriate crew deployment for critical patients and inadequate communication of crew capabilities.
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classifier match
PFD report
53match
Noel Jones
Delays in patient acceptance by the hospital and the absence of out-of-hours vascular surgery or interventional radiology services likely contributed to the deceased's death.
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classifier match
Committee recommendation
53match
#10 - Establish a 24/7 Neighbourhood Mental Health Centre in every community.
We believe there should be a 24/7 Neighbourhood Mental Health Centre in every community. (Recommendation, Paragraph 92)
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terms: care
HSSIB recommendation
53match
Management of acute onset testicular pain
It is recommended that NHS England/Improvement works with relevant stakeholders to develop guidance for handling telephone advice/triage in primary medical care settings.
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terms: care
HSSIB recommendation
53match
Clinical decision making: diagnosis of pulmonary embolism in emergency departments
It may be beneficial for emergency departments and same-day emergency care units to have rapid access to recommended imaging for patients who require it for the diagnosis of pulmonary embolism.
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terms: care
HSSIB recommendation
53match
Nutrition management of acutely unwell patients in acute medical units
NHS trusts can improve patient safety by reviewing policies, processes, and procedures in acute medical units to ensure they provide clear and easily accessible pathways to refer patients to dietetics or speech and language services.
Matched on
terms: pathway
CQC action
53match
Royal Shrewsbury Hospital
The trust must ensure patients can access care and treatment in a timely way. This includes ambulance handover times and patient waiting times for treatment and arrangements to admit, treat and discharge patients.
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terms: care
Inquiry recommendation
53match
MAI-149 - Healthcare provision under Protect Duty
The Home Office should consider whether the requirement for adequate healthcare provision at events is a topic that should also be addressed by the Protect Duty.
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terms: care
Committee recommendation
53match
#27 - Second Report - Delivering core NHS and care services during the pandemic and beyond
We welcome the news that the Government and NHSE/I are piloting a ‘111 dial first’ scheme to support the triaging of patients before they attend A&E departments. The introduction of an expectation that a patient will call first before walking into an A&E department is a sensible change to support A&E departments during the pandemic, and has much...
Matched on
terms: care
HSSIB recommendation
53match
Patient care in temporary care environments
Does your organisation have aligned processes across different departments, including the availability of specialty services to help facilitate the movement of patients to the right place of care as soon as possible?
Matched on
terms: care