Repeated warnings
Each dot is 1% of the 1,360 links found between reports
99%
dimmed: the later report does not cite the earlier one
85%
ringed: the later report came from a different coroner
A link shows that a similar concern was raised again, not why.
Start here
Six clear examples, picked because they are easy to follow. This is not a ranking.
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666 chains, most recent report first. The order is by date only; there is no ranking of organisations.
- Missed opportunity for appropriate VTE risk management
Worcestershire Acute Hospitals NHS Trust · NHS body
2 reports · 2 coronersClosely relatedConfidence 0.90 · highNo published response to an earlier report - Insufficient social care provision leading to discharge delays
Department of Health and Social Care · National body
8 reports · 3 coronersClosely relatedConfidence 0.90 · highNo published response to an earlier report - Lack of follow-up on mental health history and drug overdose
Practice Plus Group · Company or provider
2 reports · 1 coronerClosely relatedConfidence 0.90 · high - Lack of transport suitability assessment for changing patient conditions
Barts Health NHS Trust · NHS body
2 reports · 2 coronersClosely relatedConfidence 0.90 · high - Disjointed clinical information system leading to data loss risk
Tameside and Glossop Integrated Care NHS Foundation Trust · NHS body
2 reports · 1 coronerClosely relatedConfidence 0.90 · high - Communication failures and information sharing problems across trust
Mid and South Essex NHS Foundation Trust · NHS body
2 reports · 2 coronersClosely relatedConfidence 0.90 · high - 2 reports · 2 coronersIdentical hazardConfidence 0.95 · high
- Missing person coordinator absent weekends and insufficient 24/7 PolSA coverage
College of Policing · National body
2 reports · 2 coronersClosely relatedConfidence 0.80 · moderateNo published response to an earlier report - 2 reports · 2 coronersClosely relatedConfidence 0.90 · high
- Standing water on road leading to hydroplaning
National Highways · National body
5 reports · 5 coronersClosely relatedConfidence 0.80 · moderateNo published response to an earlier report - Obscured observation panels hinder monitoring
His Majesty's Prison and Probation Service · National body
3 reports · 3 coronersIdentical hazardConfidence 0.90 · high - Inaccurate and inconsistent care plan entries and record keeping
Care Quality Commission · National body
10 reports · 9 coronersClosely relatedConfidence 0.85 · high - Excessive speeding near school crossing
Dorset County Council · Local authority
2 reports · 2 coronersClosely relatedConfidence 0.90 · high - Lack of national guidance for antenatal fetal monitoring
Royal College of Obstetricians and Gynaecologists · National body
2 reports · 2 coronersClosely relatedConfidence 0.85 · highNo published response to an earlier report - 2 reports · 2 coronersClosely relatedConfidence 0.85 · highNo published response to an earlier report
- Overcrowded emergency department increases patient mortality
Department of Health and Social Care · National body
5 reports · 4 coronersClosely relatedConfidence 0.87 · high - 2 reports · 2 coronersClosely relatedConfidence 0.90 · highNo published response to an earlier report
- 55 reports · 32 coronersClosely relatedConfidence 0.80 · moderateNo published response to an earlier report
- Antibiotic prescribing without joint discussion or swallow assessment
Tameside General Hospital · NHS body
2 reports · 2 coronersClosely relatedConfidence 0.80 · moderate - Delayed referral for neurosurgical care
NHS England · National body
2 reports · 2 coronersClosely relatedConfidence 0.90 · high