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RCEM Winter Flow data shows nearly 1 in 20 patients is waiting 12 hours or more to be admitted

12 January 2020

In the fifth week of December 2,614 patients waited for longer than 12 hours in the Emergency Departments of 32 Trusts and Boards across the UK. This represents 4.77% of all attendances – the highest weekly total in the project so far.

From the beginning of October 2020 26,806 patients have waited longer than 12 hours to be admitted to a bed at the sampled sites across the UK – yet data from NHS England alone reports that  since December 2010, in England, a total of only 30,344 patients stayed longer than 12 hours measuring from decision to admit to admission. This highlights why RCEM believes it is important for NHS England to report the full picture1.

The data for December Week 5 (28 December 2020 – 3 January 2021) also shows:

  • 4-hour standard performance dropped to 71.87%
    • Meaning nearly 3 in 10 patients were waiting more than 4 hours to be admitted.
    • This figure marks the worst performance for this project, October 2020 – March 2021, and is also marginally lower than the previous year (72.03%, December Week 5 2019).
  • Capacity increased by 1.08%, or by 254 beds, on the previous week.
  • Attendances increased by 4.42% increase, or 2,320 patients, on the previous week.

Dr Katherine Henderson, President of the Royal College of Emergency Medicine, said: “We recognise that we are in the middle of a pandemic but the number of patients waiting more than 12 hours prior to admission to a hospital ward is so worrying.

“We went into the pandemic with the NHS struggling with beds and workforce. This pandemic has further exposed the core shortages of essential staff, beds and resources.

“Our emergency doctors and other healthcare workers are working relentlessly hard. They are doing their best to keep up with the number of patients requiring admission. They are making sure that social distancing and infection prevention control measures are in place, but the demand makes this an extremely difficult challenge.

“It is a dire situation to be in. Our departments are crowded, with many places having no choice but to administer care in corridors – as shown by the number of patients waiting 12 hours or longer. Not only is this dangerous in of itself but it increases the risk of nosocomial infection which we cannot allow in the middle of a pandemic. It also makes it more difficult to get patients offloaded from ambulances and our great paramedic crews back out to help the next person who needs them.

“In the short term we must do all we can to maintain flow through our hospitals, while we deal with the third wave. But in order to eliminate the long-term problem of 12 hours waits, we must first measure them properly. NHS England have announced the consultation on the Clinical Review of Standards, and we want to see the new measures implemented as soon as possible.

“New metrics will help us better understand the problems EDs face and enable us to take better preventative action to stop dangerous crowding and corridor care.”


Notes to Editor

The Winter Flow Project runs from October 2020 to March 2021. Anonymised data from 35 sites across the UK will be published on a weekly basis.

In addition to four-hour performance – a metric the College believes is an invaluable system indicator, but not the whole story – the project collects a wider range of data to explore the other factors that affect Emergency Departments and patient ‘flow’.

In addition to type one four-hour performance figures, Trusts are asked to submit on a weekly basis data on:

  • the number of acute beds in service
  • the number of cancelled elective operations
  • the number of patients in their trust who no longer medically need to be in hospital
  • the number of unplanned attendances at EDs
  • the number of patients spending more than 12 hours in an Emergency Department from arrival to departure

The full 2019/20 report and data, along with weekly reports for 2020/2021, is published at

1. Northern Ireland, Scotland and Wales record 12-hour waits from arrival to discharge.

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