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Data show thousands of elective care operations cancelled, amid crisis in urgent and emergency care

7 December 2021

Data from The Royal College of Emergency Medicine’s Winter Flow Project 2021/22 reveals that in November 2021 6,726 elective care operations were cancelled and in October 2021 6,335 elective care operations were cancelled.

Dr Adrian Boyle, Vice-President of the Royal College of Emergency Medicine, said:

“In its first week of reporting, the Royal College’s Winter Flow project 2021/22 has a stark warning for the months ahead. Nearly 7,000 elective care operations were cancelled at reporting sites in November alone. This data comes as the National Audit Office, in their latest report, predict that the elective care waiting list could reach 12 million by March 2025.

“Data show 12-hour stays are twice as high as the same time last year; four-hour performance remains incredibly low averaging at 62% in November; long hospital stays have increased 13% since the beginning of October. Urgent and Emergency Care is verging on crisis and it is impacting and derailing elective care, meaning surgery for patients with serious conditions is delayed.

“The situation is unsustainable; we must see a willingness to address these crises and tackle the problems. The core of the issue is poor patient flow throughout the hospital and exit block caused by difficulties in discharging patients. These blockages cause ambulance handover delays, crowding and corridor care.

“Capacity must be expanded to avoid a hard-hitting impact on elective care. While it is crucial that social care is resourced to enable a timely and supported discharge of patients. In the long-term, restoring bed capacity to pre-pandemic levels and publishing a long-term workforce plan are vital to ensuring no parts of the system are compromised or derailed; to promoting good flow throughout the system; and keeping patients safe.” 


Notes to Editor

Winter Flow data for November 2021 also show:

  • There were 275,596 attendances
  • 20,169 patients spent 12 hours or more in an Emergency Department from time of arrival; this is equal to 7.3% of attendances
  • 48,154 patients spent seven days or more in hospital from admission

Winter Flow is an annual project run by the Royal College of Emergency Medicine since 2015. It is now in its seventh year. The Winter Flow Project runs from October 2021 to March 2022. Anonymised data from 40 sites across the UK will be published on a weekly basis.

The project collects a wider range of data to explore the other factors that affect Emergency Departments and patient ‘flow’. Trusts are asked to submit on a weekly basis data on:

  • The number of acute beds in service
  • Four-hour performance
  • The number of unplanned attendances at Emergency Departments
  • The number of patients spending more than 12 hours in an Emergency Department from arrival to departure
  • The number of patients spending greater than seven days in hospital from admission
  • The number of cancelled elective operations
  • Ambulance handover delays and hours lost

Weekly reports for 2021/2022 will be published at

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