First reported 19 Feb 2015•Latest report 18 Jun 2026
Definition
What this concern includes
Includes failures in the end-to-end hospital patient-flow process, including ambulance-to-Emergency-Department transfer, Emergency Department admission and throughput, movement into wards, bed and resource coordination, discharge-related flow constraints and associated escalation or coordination controls where these directly leave patients waiting or obstruct safe movement through hospital care.
Not included
Excludes generic ambulance response delays, clinical treatment delays or hospital handover failures when they are not part of a wider hospital patient-flow problem.
Excludes the underlying shortage of a specific resource, bed type or care package when no resulting hospital patient-flow failure is asserted.
Excludes failures confined to a separately named process such as hospital bed-management systems, Emergency Department triage, discharge planning or social-care provision when that narrower process is the shared unsafe condition.
Excludes routine patient-flow descriptions or isolated delays without a continuing or system-level unsafe condition.
Reports
33
Distinct published reports
Individual concerns
37
A report can raise multiple concerns
Date range
2015–2026
First to latest report issue date
Stated actions
115
Described in published responses
Reports over time
Reports over time
Reports about this concern issued each year.
* 2026 is projected from reports observed to 7 Sep 2026.
Most frequent recipients
Most frequent recipients
Reports about this concern sent to each recipient.
Department of Health and Social Care15
Welsh Ambulance Services NHS Trust9
Betsi Cadwaladr University LHB7
Ysbyty Gwynedd3
Care Quality Commission2
NHS England2
Aneurin Bevan University LHB1
Barking, Havering and Redbridge University Hospitals NHS Trust1
Conwy County Borough Council1
Denbighshire County Council1
East Midlands Ambulance Service NHS Trust1
East Riding of Yorkshire Council1
Flintshire County Council1
Greater Manchester Health and Social Care Partnership1
Greater Manchester Mental Health NHS Foundation Trust1
NHS trust17
Ministerial department15
Local health board8
Healthcare site4
Executive non-departmental public body2
Health and social care service regulator2
Devolved legislature1
English unitary authority1
Health-system partnership1
Integrated care board1
NHS provider group1
Nursing home1
Welsh county borough council1
Welsh county council1
Type not available1
Concerns and responses across reports
Only concerns grouped under this recurring concern are included. Select any concern, action or position to view the source wording.
Cornwall and Isles of Scilly
Concerns raised1
Failure to maintain emergency department capacity and timely patient flow
This report raised 3 other concerns. They are not shown here because they do not form part of this recurring concern.
Responses linked to these concerns
Each statement is shown once, even when linked to more than one concern.
Actions described in response An action is something a respondent says it has done, is doing, or plans to do in response to the concern raised.3
Action
Invest over £450 million to expand urgent and emergency care capacity through the 2025/26 delivery plan.
Stated by Department of Health and Social CareStated completedThe respondent said that this action was complete when they made their response on 3 September 2026.
Action
Publish national clinical standards for emergency departments, acute pathways and discharge to improve flow and safer emergency care.
Stated by Department of Health and Social CareStated completedThe respondent said that this action was complete when they made their response on 3 September 2026.
Action
Work with health and care partners to improve discharge arrangements, strengthen service integration and ensure safe, timely and appropriate care.
Stated by Department of Health and Social CareStated in progressThe respondent said that this action was in progress when they made their response on 3 September 2026.
Buckinghamshire
Concerns raised1
Inconsistent operation of daily patient flow meetings
This report raised 10 other concerns. They are not shown here because they do not form part of this recurring concern.
Responses linked to these concerns
Each statement is shown once, even when linked to more than one concern.
No linked response statements
No respondent-stated action or position is linked to these concerns in the published data.
Blackpool and the Fylde
Concerns raised1
Delays in transferring unwell patients from ambulances to the emergency department
This report raised 2 other concerns. They are not shown here because they do not form part of this recurring concern.
Responses linked to these concerns
Each statement is shown once, even when linked to more than one concern.
Actions described in response An action is something a respondent says it has done, is doing, or plans to do in response to the concern raised.6
Action
Publish national urgent and emergency care, medium-term planning, and 10-year health plans setting priorities for ambulance response, handovers, flow, discharge, and urgent care access.
Stated by Department of Health and Social CareStated completedThe respondent said that this action was complete when they made their response on 12 February 2026.
Action
Mandate the Release to Rescue approach, requiring ambulance handover to begin at 30 minutes and finish within 45 minutes.
Stated by Department of Health and Social CareStated completedThe respondent said that this action was complete when they made their response on 12 February 2026.
Action
Continue working with integrated care boards, acute trusts, and ambulance services to deliver the 45-minute handover limit, strengthen urgent community care, and improve hospital flow and discharge.
Stated by Department of Health and Social CareStated in progressThe respondent said that this action was in progress when they made their response on 12 February 2026.
Action
Re-emphasise safe clinical escalation processes for patients awaiting ambulance offload, including when clinical staff should attend patients outside the department.
Stated by Care Quality CommissionStated plannedThe respondent said that this action was planned when they made their response on 12 February 2026.
Action
Continue monitoring ambulance handover delays and their impact on patient safety through regulatory activity and evidence from patients, staff, ambulance services and system partners.
Stated by Care Quality CommissionStated in progressThe respondent said that this action was in progress when they made their response on 12 February 2026.
Action
Continue using regulatory powers to ensure the trust maintains systems identifying deteriorating patients, including those waiting outside the department, and manages emergency-care pathway risks.
Stated by Care Quality CommissionStated in progressThe respondent said that this action was in progress when they made their response on 12 February 2026.
Respondent positions A position is what a respondent says about the concern when they do not describe a specific action.1
Position
The Care Quality Commission will provide a separate response to the concerns.
Stated by Department of Health and Social CareRedirects responsibilityThe respondent said that another organisation was responsible for deciding or taking action.
East Riding and Hull
Concerns raised1
Failure to move people requiring ward-based care out of the emergency department
This report raised 1 other concern. They are not shown here because they do not form part of this recurring concern.
Responses linked to these concerns
Each statement is shown once, even when linked to more than one concern.
Actions described in response An action is something a respondent says it has done, is doing, or plans to do in response to the concern raised.1
Action
Model beds, review discharge processes, and work with community partners to improve specialist and acute bed flow.
Stated by Hull University Teaching Hospitals NHS TrustStated in progressThe respondent said that this action was in progress when they made their response on 7 November 2025.
Northamptonshire
Concerns raised2
Delays in transferring patients from the Emergency Department into wards
Delays in transferring ambulance patients into the Emergency Department
This report raised 5 other concerns. They are not shown here because they do not form part of this recurring concern.
Responses linked to these concerns
Each statement is shown once, even when linked to more than one concern.
Actions described in response An action is something a respondent says it has done, is doing, or plans to do in response to the concern raised.12
Action
Implement a standardised Transfer of Care form across the organisation to improve discharge-hub referrals.
Stated by University Hospitals of Northamptonshire NHS GroupStated completedThe respondent said that this action was complete when they made their response on 31 October 2025.
Action
Reopen Sir Thomas Moore Ward as a 24/7 discharge lounge, adding 14 bed spaces and eight chairs.
Stated by University Hospitals of Northamptonshire NHS GroupStated completedThe respondent said that this action was complete when they made their response on 31 October 2025.
Action
Hold twice-weekly system-partner escalation calls to support complex discharges.
Stated by University Hospitals of Northamptonshire NHS GroupStated completedThe respondent said that this action was complete when they made their response on 31 October 2025.
Action
Improve hospital patient flow, increase four-hour emergency-department performance to 78%, reduce 12-hour waits and tackle discharge delays.
Stated by Department of Health and Social CareStated plannedThe respondent said that this action was planned when they made their response on 31 October 2025.
Action
Implement additional winter surge capacity across urgent and emergency care services.
Stated by Department of Health and Social CareStated completedThe respondent said that this action was complete when they made their response on 31 October 2025.
Action
Increase staffing to mitigate seasonal urgent and emergency care pressures.
Stated by Department of Health and Social CareStated completedThe respondent said that this action was complete when they made their response on 31 October 2025.
Action
Formalise direct ambulance pathways to Same Day Emergency Care and extend operating hours.
Stated by University Hospitals of Northamptonshire NHS GroupStated completedThe respondent said that this action was complete when they made their response on 31 October 2025.
Action
Launch Rapid Assessment and Acute Assessment Units to expand ambulance handover capacity and stream patients directly into acute assessment.
Stated by University Hospitals of Northamptonshire NHS GroupStated completedThe respondent said that this action was complete when they made their response on 31 October 2025.
Action
Introduce a NerveCentre pre-arrival screen using ambulance clinical histories to prepare handovers before arrival.
Stated by University Hospitals of Northamptonshire NHS GroupStated completedThe respondent said that this action was complete when they made their response on 31 October 2025.
Action
Commission eight additional Rapid Assessment Unit trolley spaces at Northampton General Hospital for primary assessment and faster handover.
Stated by University Hospitals of Northamptonshire NHS GroupStated completedThe respondent said that this action was complete when they made their response on 31 October 2025.
Action
Continue working with system partners to reduce delay impacts and implement the national 45-minute maximum ambulance handover standard.
Stated by University Hospitals of Northamptonshire NHS GroupStated in progressThe respondent said that this action was in progress when they made their response on 31 October 2025.
Action
Enable ambulance services to convey patients directly to non-emergency-department facilities, including same-day emergency care services.
Stated by Department of Health and Social CareStated plannedThe respondent said that this action was planned when they made their response on 31 October 2025.
Cornwall and Isles of Scilly
Concerns raised1
ED crowding delaying patient access to surgery or specialist treatment
This report raised 2 other concerns. They are not shown here because they do not form part of this recurring concern.
Responses linked to these concerns
Each statement is shown once, even when linked to more than one concern.
Actions described in response An action is something a respondent says it has done, is doing, or plans to do in response to the concern raised.6
Action
Publish the 2025 mandate to NHS England, prioritising improvements to A&E and ambulance waiting times.
Stated by Department of Health and Social CareStated completedThe respondent said that this action was complete when they made their response on 11 April 2025.
Action
Strengthen NHS and social care partnerships to tackle delayed discharges, reduce hospital stays and free beds.
Stated by Department of Health and Social CareStated in progressThe respondent said that this action was in progress when they made their response on 11 April 2025.
Action
Ask local systems to implement six neighbourhood-health components, including measures to reduce hospital discharge delays.
Stated by Department of Health and Social CareStated in progressThe respondent said that this action was in progress when they made their response on 11 April 2025.
Action
Publish the new £9 billion Better Care Fund policy framework establishing joint NHS and local-authority accountability for reducing discharge delays.
Stated by Department of Health and Social CareStated completedThe respondent said that this action was complete when they made their response on 11 April 2025.
Action
Set out lessons learned from winter urgent and emergency care pressures.
Stated by Department of Health and Social CareStated plannedThe respondent said that this action was planned when they made their response on 11 April 2025.
Action
Put improvements in place to further improve urgent and emergency care services during 2025/26.
Stated by Department of Health and Social CareStated plannedThe respondent said that this action was planned when they made their response on 11 April 2025.
Manchester South
Concerns raised2
Prolonged waits in Emergency Departments for ward beds
Recurring prolonged waits in Emergency Departments for ward beds
This report raised 6 other concerns. They are not shown here because they do not form part of this recurring concern.
Responses linked to these concerns
Each statement is shown once, even when linked to more than one concern.
Actions described in response An action is something a respondent says it has done, is doing, or plans to do in response to the concern raised.2
Action
Publish the 2025 NHS mandate and planning guidance containing urgent-care delivery priorities and implementation targets.
Stated by Department of Health and Social CareStated completedThe respondent said that this action was complete when they made their response on 21 February 2025.
Action
Continue improving urgent and emergency care services to improve access and restore constitutional waiting-time performance.
Stated by Department of Health and Social CareStated in progressThe respondent said that this action was in progress when they made their response on 21 February 2025.
East Riding and Hull
Concerns raised1
Inability to hand over emergency ambulance patients into the emergency department at Hull Royal Infirmary
This report raised 4 other concerns. They are not shown here because they do not form part of this recurring concern.
Responses linked to these concerns
Each statement is shown once, even when linked to more than one concern.
Actions described in response An action is something a respondent says it has done, is doing, or plans to do in response to the concern raised.15
Action
Implement the phased 045 Handover Plan to reduce ambulance handover times toward a 45-minute target.
Stated by NHS Humber Health PartnershipStated completedThe respondent said that this action was complete when they made their response on 2 December 2024.
Action
Activate the Ambulance Delay Protocol, including site escalation, rapid patient transfers, and prioritisation of suitable patients.
Stated by NHS Humber Health PartnershipStated completedThe respondent said that this action was complete when they made their response on 2 December 2024.
Action
Revise the operating procedure to offload up to eight ambulances hourly and transfer ten patients from the Emergency Department to inpatient wards.
Stated by NHS Humber Health PartnershipStated in progressThe respondent said that this action was in progress when they made their response on 2 December 2024.
Action
Implement Pull for Safety to maintain regular patient flow from the Emergency Department to assessment areas and wards.
Stated by NHS Humber Health PartnershipStated completedThe respondent said that this action was complete when they made their response on 2 December 2024.
Action
Use escalation areas and reverse boarding protocols to create immediate capacity for arriving patients.
Stated by NHS Humber Health PartnershipStated completedThe respondent said that this action was complete when they made their response on 2 December 2024.
Action
Implement the Temporary Escalation Space and Boarding SOP to manage capacity challenges, patient boarding, and timely Emergency Department handovers.
Stated by NHS Humber Health PartnershipStated completedThe respondent said that this action was complete when they made their response on 2 December 2024.
Action
Open and operate a 54-bed NCTR unit to accommodate patients awaiting discharge and reduce reliance on acute beds.
Stated by NHS Humber Health PartnershipStated completedThe respondent said that this action was complete when they made their response on 2 December 2024.
Action
Implement updated discharge protocols covering local-authority coordination, family and carer involvement, and care transfer hubs.
Stated by NHS Humber Health PartnershipStated completedThe respondent said that this action was complete when they made their response on 2 December 2024.
Action
Conduct board rounds and huddles to identify discharges early and meet ward discharge targets of 30% by noon and 70% by 17:00.
Stated by NHS Humber Health PartnershipStated completedThe respondent said that this action was complete when they made their response on 2 December 2024.
Action
Enforce maximum stays of 24 hours in AMU and 12 hours in the Emergency Department to maintain patient flow.
Stated by NHS Humber Health PartnershipStated completedThe respondent said that this action was complete when they made their response on 2 December 2024.
Action
Monitor ambulance arrivals and Emergency Department capacity in real time and escalate boarding or discharge issues through clinical and senior leadership.
Stated by NHS Humber Health PartnershipStated completedThe respondent said that this action was complete when they made their response on 2 December 2024.
Action
Continue working with trusts and services facing significant ambulance handover challenges.
Stated by NHS EnglandStated in progressThe respondent said that this action was in progress when they made their response on 2 December 2024.
Action
Prioritise improving length of stay for admitted patients, particularly emergency admissions lasting at least one day.
Stated by NHS EnglandStated plannedThe respondent said that this action was planned when they made their response on 2 December 2024.
Action
Prioritise reducing delays in urgent and emergency care pathways.
Stated by NHS EnglandStated plannedThe respondent said that this action was planned when they made their response on 2 December 2024.
Action
Prioritise improving length of stay in NHS-commissioned community beds.
Stated by NHS EnglandStated plannedThe respondent said that this action was planned when they made their response on 2 December 2024.
Respondent positions A position is what a respondent says about the concern when they do not describe a specific action.2
Position
Local and system concerns fall outside NHS England’s national policy and programme remit.
Stated by NHS EnglandOutside remitThe respondent said that this matter was outside its role or authority.
Position
Local organisations should address the local and system concerns raised in the report.
Stated by NHS EnglandRedirects responsibilityThe respondent said that another organisation was responsible for deciding or taking action.
Manchester South
Concerns raised1
Failure to move patients from emergency departments onto wards in a timely manner due to capacity constraints
This report raised 1 other concern. They are not shown here because they do not form part of this recurring concern.
Responses linked to these concerns
Each statement is shown once, even when linked to more than one concern.
Respondent positions A position is what a respondent says about the concern when they do not describe a specific action.2
Position
The reported emergency-department corridor wait caused by capacity pressures falls outside the regulator’s remit.
Stated by Care Quality CommissionOutside remitThe respondent said that this matter was outside its role or authority.
Position
Responsibility for addressing the emergency-department corridor wait is directed to the Secretary of State for Health and Social Care.
Stated by Care Quality CommissionRedirects responsibilityThe respondent said that another organisation was responsible for deciding or taking action.
Cornwall and Isles of Scilly
Concerns raised1
Delays in moving patients from the ED after a decision that they are ready to discharge
Responses linked to these concerns
Each statement is shown once, even when linked to more than one concern.
Actions described in response An action is something a respondent says it has done, is doing, or plans to do in response to the concern raised.2
Action
Return to safe operational waiting-time standards set out in the NHS Constitution.
Stated by Department of Health and Social CareStated plannedThe respondent said that this action was planned when they made their response on 8 August 2024.
Action
Develop local NHS-social care partnerships to reduce delayed discharges and prevent hospital departments being blocked.
Stated by Department of Health and Social CareStated plannedThe respondent said that this action was planned when they made their response on 8 August 2024.
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Includes failures in the end-to-end hospital patient-flow process, including ambulance-to-Emergency-Department transfer, Emergency Department admission and throughput, movement into wards, bed and resource coordination, discharge-related flow constraints and associated escalation or coordination controls where these directly leave patients waiting or obstruct safe movement through hospital care.
