In 2022/23, Gloucestershire Hospitals NHS Foundation Trust was facing severe operational pressure. More than 250 patients were ready to be discharged but were still occupying hospital beds. Patients were having to wait in the back of ambulances for an average of more than 80 minutes.

These delays at the front door were contributing to risks for patients and placing increasing strain on staff. Staff morale was low, with significantly fewer colleagues recommending the trust as a place to receive care than in previous years.

In response, the trust launched its Clinical Vision of Flow, a clinically led programme to improve patient flow and reduce harm caused by delays. The work focused on 4 areas: emergency departments, short-stay units, specialist wards and frailty services.

Rather than concentrating only on targets, the programme set out to tackle the points in the patient journey where long waits were creating the greatest risk.

It led to improvements in several important measures:

• ambulance delays fell from 3,343 hours per month in 2023 to 1,106 in 2025
• the number of patients ready for discharge but still in hospital fell by 30%, from 169 in 2023 to 118 in 2026

The trust’s mortality indicator has also improved over the past 14 months. It remains focussed on further reducing corridor care, through sustained clinical leadership, strong system working and a sharp focus on patient safety.

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