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“This winter is already far worse than last winter”, RCEM President says

The latest data from The Royal College of Emergency Medicine’s Winter Flow Project 2021/22 show that since the beginning of October 2021 there have been 56,096 patients delayed by 12 hours or more from time of arrival in Emergency Departments.

In comparison, last year’s Winter Flow Project 2020/21 didn’t record over 50,000 12 hour stays from time of arrival in Emergency Departments until February Week 3.

Data also show that in December 2021 Week 2, four-hour performance fell to 56.3%, the lowest ever recorded.

Dr Katherine Henderson, President of the Royal College of Emergency Medicine, said:

“The data show a deepening crisis. We’ve now reached 50,000 12-hour delays, a figure we didn’t reach until February last winter.

“It is hard to communicate the enormous strain NHS staff are under and how deeply the pressures affect patient care. The latest Winter Flow Project report details some of the harrowing conditions patients find themselves in and conditions in which staff are delivering care. This winter is already far worse than last winter, with the coming weeks set to take us deeper into crisis.

“Trusts are already doing all they can, opening every last bed where safely possible. The government must ensure adequate support is given to social care, as difficulties in discharging patients following their treatment has knock-on effects throughout the system and causes exit block in Emergency Departments, ambulances handover delays, and prevents ambulance crews from returning to the community and responding to emergencies.

“The public must be cautious and sensible over the Christmas period and take care of themselves and those around them. Using facemasks, washing hands, avoiding spending long periods of time in very crowded places, getting tested if you develop Covid symptoms, and getting boosted – all these practices will make a real difference in the coming weeks.”


Notes to Editor

Winter Flow data for December Week 2 2021 show:

  • There were 70,214 attendances
  • 6,497 patients stayed in an Emergency Department for 12-hours or more from time of arrival
    • This is equal to nearly one in 10 attendances
  • Four-hour performance fell to the lowest ever on record, 56.3%
  • There were 1,721 cancelled electives
  • There were 1,619 hours lost from ambulance handovers
  • 12,529 patients spent seven or more days in hospital from admission
  • There were 22,270 active beds in service

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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