First reported 13 Dec 2013•Latest report 24 Nov 2025
Definition
What this concern includes
Includes delays or unreliable operation of the end-to-end hospital admission process, including emergency-department handover, patient flow, bed availability, escalation or active management, when these directly prevent or delay admission.
Not included
Excludes delays in a specific treatment or procedure after admission unless they are themselves part of the admission process.
Excludes deficiencies in admission documentation, assessment, communication or review when they do not directly concern whether admission is provided promptly.
Excludes generic staffing, resource or policy deficiencies that are not directly tied to unsafe delay or failure in hospital admission.
Excludes delays or failures in non-hospital placements unless they directly determine whether required hospital admission is provided.
Reports
47
Distinct published reports
Individual concerns
53
A report can raise multiple concerns
Date range
2013–2025
First to latest report issue date
Stated actions
176
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 Care23
Betsi Cadwaladr University LHB10
Welsh Ambulance Services NHS Trust9
NHS England8
Care Quality Commission3
Greater Manchester Health and Social Care Partnership3
Welsh Government3
Ysbyty Gwynedd3
Conwy County Borough Council2
Cwm Taf Morgannwg University Local Health Board2
Denbighshire County Council2
Flintshire County Council2
Greater Manchester Mental Health NHS Foundation Trust2
Health Services Safety Investigations Body2
NHS Greater Manchester Integrated Care Board2
Ministerial department23
NHS trust19
Local health board13
Executive non-departmental public body10
Healthcare site8
Health-system partnership5
Integrated care board4
Devolved government3
Health and social care service regulator3
Private limited company3
Devolved legislature2
Welsh county borough council2
Welsh county council2
Coronial office1
Education sector body1
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 transfer emergency department patients to hospital wards when clinically indicated
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
Maintain the uplift of 5,000 staffed, permanent hospital beds delivered through the urgent and emergency care plan.
Stated by Department of Health and Social CareStated completedThe respondent said that this action was complete when they made their response on 3 April 2024.
Action
Invest an additional £1 billion through the Discharge Fund to support timely and effective hospital 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 3 April 2024.
Action
Ensure every acute hospital has access to a care transfer hub supporting complex discharges and early planning.
Stated by Department of Health and Social CareStated completedThe respondent said that this action was complete when they made their response on 3 April 2024.
Suffolk
Concerns raised1
Insufficient bed capacity for informal mental health inpatient admissions
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
Invest more than £400 million to replace mental health dormitories with ensuite bedrooms, with more than 600 beds already replaced across 34 sites.
Stated by Department of Health and Social CareStated in progressThe respondent said that this action was in progress when they made their response on 14 March 2024.
Swansea and Neath Port Talbot
Concerns raised1
Delays in offloading patients into hospital
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.2
Action
Work with the Welsh Ambulance Service to develop use of pressure-relieving equipment during ambulance transport and delayed handover situations.
Stated by Swansea Bay University Local Health BoardStated in progressThe respondent said that this action was in progress when they made their response on 14 March 2024.
Action
Apply a zero-tolerance threshold to ambulance off-load delays exceeding 10 hours as part of improving handover times.
Stated by Swansea Bay University Local Health BoardStated completedThe respondent said that this action was complete when they made their response on 14 March 2024.
Respondent positions A position is what a respondent says about the concern when they do not describe a specific action.3
Position
Existing plans, resource measures and organisational monitoring are considered sufficient, so no further action is proposed on ambulance and hospital delays.
Stated by Welsh Ambulance Services OfficeExisting arrangements considered sufficientThe respondent said that existing arrangements were sufficient, so no further action was needed.
Position
REACT assessments largely prevent significant harm during delayed ambulance handovers by identifying patient risks and enabling immediate treatment or prevention.
Stated by Swansea Bay University Local Health BoardExisting arrangements considered sufficientThe respondent said that existing arrangements were sufficient, so no further action was needed.
Position
Use of pressure-relieving ambulance equipment depends on the Welsh Ambulance Service accepting the Health Board’s existing offer of equipment.
Stated by Swansea Bay University Local Health BoardRedirects responsibilityThe respondent said that another organisation was responsible for deciding or taking action.
Inner North London
Concerns raised1
Unavailability of suitable psychiatric hospital bed spaces in a timely way
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
Increase timely access to psychiatric hospital beds and provide earlier identification, treatment and support for people in custody who need mental healthcare.
Stated by NHS EnglandStated in progressThe respondent said that this action was in progress when they made their response on 14 February 2024.
Action
Address concerns and lessons identified in the HMIP review of delays transferring mentally unwell prisoners.
Stated by NHS EnglandStated in progressThe respondent said that this action was in progress when they made their response on 14 February 2024.
Cornwall and Isles of Scilly
Concerns raised1
Unavailability of hospital beds for informal admission
This report raised 8 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.
Respondent positions A position is what a respondent says about the concern when they do not describe a specific action.3
Position
The ICB considers its commissioned mental health bed capacity appropriate because it matches the national median per 100,000 population.
Stated by Department of Health and Social CareDisputes the concernThe respondent disagreed with part of the concern or the basis for it.
Position
The ICB relies on alternative solutions to mitigate the impact of closed mental health beds.
Stated by Department of Health and Social CareExisting arrangements considered sufficientThe respondent said that existing arrangements were sufficient, so no further action was needed.
Position
Closed acute and rehabilitation beds cannot be reinstated because of environmental issues being challenged through the provider’s contract.
Stated by Department of Health and Social CareUnable to actThe respondent said that a constraint prevented them from taking the relevant action.
North Wales (East and Central)
Concerns raised1
Failure to admit ambulance patients promptly and return ambulances to active duty
This report raised 11 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.7
Action
Communicate annual priorities requiring health boards to improve ambulance handovers and patient flow.
Stated by Welsh GovernmentStated completedThe respondent said that this action was complete when they made their response on 28 December 2023.
Action
Establish a national urgent and emergency care improvement programme and direct health boards to develop local improvement plans.
Stated by Welsh GovernmentStated completedThe respondent said that this action was complete when they made their response on 28 December 2023.
Action
Direct the Chief Ambulance Services Commissioner to monitor improvement plans through Emergency Ambulance Services Committee governance.
Stated by Welsh GovernmentStated in progressThe respondent said that this action was in progress when they made their response on 28 December 2023.
Action
Implement an NHS Wales ambulance patient handover improvement plan for winter 2023/2024.
Stated by Welsh GovernmentStated completedThe respondent said that this action was complete when they made their response on 28 December 2023.
Action
Hold health board chairs accountable for ambulance handover improvements and seek collective assurance through regular national meetings.
Stated by Welsh GovernmentStated in progressThe respondent said that this action was in progress when they made their response on 28 December 2023.
Action
Use monthly integrated quality, planning and delivery meetings and six-monthly Joint Executive Team meetings to monitor and challenge ambulance handover performance.
Stated by Welsh GovernmentStated in progressThe respondent said that this action was in progress when they made their response on 28 December 2023.
Action
Scope and formalise additional Emergency Department capacity, including a dedicated speciality waiting area.
Stated by Betsi Cadwaladr University LHBStated in progressThe respondent said that this action was in progress when they made their response on 28 December 2023.
Respondent positions A position is what a respondent says about the concern when they do not describe a specific action.1
Position
Responsibility for delivering health services, including ambulance handover improvements, rests with the health board rather than Welsh Ministers.
Stated by Welsh GovernmentRedirects responsibilityThe respondent said that another organisation was responsible for deciding or taking action.
Inner North London
Concerns raised1
Failure to re-admit patients to hospital when indicated
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
Update the acute mental health patient-flow and bed-management policy to guide inpatient admission decisions.
Stated by Oxleas NHS Foundation TrustStated completedThe respondent said that this action was complete when they made their response on 6 December 2023.
Action
Train clinicians to document medication and medical-review discussions, decisions, participants, timings and outcomes.
Stated by Oxleas NHS Foundation TrustStated completedThe respondent said that this action was complete when they made their response on 6 December 2023.
Norfolk
Concerns raised1
Delays in admission to Accident and 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.5
Action
Publish the delivery plan for recovering 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 5 October 2023.
Action
Deliver 5,000 more staffed, permanent hospital beds than planned for 2022/23.
Stated by Department of Health and Social CareStated completedThe respondent said that this action was complete when they made their response on 5 October 2023.
Action
Maintain the increased staffed, permanent hospital bed capacity in 2024/25.
Stated by Department of Health and Social CareStated plannedThe respondent said that this action was planned when they made their response on 5 October 2023.
Action
Scale up virtual ward capacity beyond 10,000 beds, with over 11,000 beds available nationally.
Stated by Department of Health and Social CareStated completedThe respondent said that this action was complete when they made their response on 5 October 2023.
Action
Provide £1.6 billion over two years to support timely and effective hospital discharge.
Stated by Department of Health and Social CareStated completedThe respondent said that this action was complete when they made their response on 5 October 2023.
North Wales (East and Central)
Concerns raised1
Delays in ambulance handover at hospitals
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.
No linked response statements
No respondent-stated action or position is linked to these concerns in the published data.
Manchester South
Concerns raised1
Insufficient hospital bed capacity
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.2
Action
Deliver 5,000 additional staffed, permanent hospital beds to increase capacity and improve patient flow.
Stated by Department of Health and Social CareStated completedThe respondent said that this action was complete when they made their response on 20 February 2023.
Action
Make £1.6 billion available over two years to support timely hospital discharge and free beds.
Stated by Department of Health and Social CareStated completedThe respondent said that this action was complete when they made their response on 20 February 2023.
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Includes delays or unreliable operation of the end-to-end hospital admission process, including emergency-department handover, patient flow, bed availability, escalation or active management, when these directly prevent or delay admission.
