Winter Flow Project 2016/17

In 2015 we launched the ‘Winter Flow Project’ in an effort to highlight the difficulties facing an NHS struggling with unprecedented financial difficulties and insufficient resources.

The project looked at patient flow within Emergency Departments over the winter. It was great success because of the generosity of its contributors, with over 50 NHS Trusts and Health boards from across the UK submitting data over a six month period. This data helped to provide a better understanding system pressures and 4 hour standard performance. 

This enabled the RCEM to broaden the debate around emergency medicine beyond the usual narrow focus on the 4 hour standard, and meant that providers, commissioners, the national press, and Governments in each of the nations of the UK were better informed about the challenges you face.

Given the success of the project, the College has decided to repeat ‘Winter Flow’ for 2016/17. As was the case for 2015/16, the project will collect the following data points on a weekly basis:

  • Type one 4 hour standard performance
  • The number of acute beds in service
  • The number of cancelled elective operations
  • The number of patients in their trust for whom hospitalisation in an acute trust is no longer medically required.

The project will run from the beginning of October 2016 to the end of March 2017. All information submitted will be anonymised and aggregated to provide a system wide picture while avoiding unhelpful scrutiny of individual sites. Moreover, the data will only be discussed and published in aggregate form.

At present we have 60 Trusts signed. For further information on the project, please contact Dr Simon Howes, RCEM's Policy Research Manager at

Documents and Releases

Final report:

Halfway report:

Weekly reports and figures:

Winter Flow Project 2015-16

We launched our first Winter Flow Project in October 2015, to look at system-wide pressures impacting on the emergency care system over the winter of 2015/16. The purpose of the work was to suggest that hospitals' performance against the four hour standard should not be seen in isolation but seen alongside other important metrics such as:

  • how many acute beds are available in the hospital
  • how many elective operations had to be cancelled
  • how many patients were subject to delayed transfers of care.
We collected this data from 50 Trusts/health boards from October 2015 to March 2016, who provided us with figures on the metrics above. The data collected helped to shed light on the pressures our emergency departments over the winter period.

Winter Flow Project 2015-16 Final Report

This report details the overall performance of the Trust/Boards participating in the project over the course of the project. It also includes RCEM's analysis and conclusions from that collected data.

Documents and Releases

Weekly reports and figures:

Press release launching the project.