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THE PRESSURE POINT: 92.5% general and acute bed occupancy in Q4 2025/26 – with 94,737 of 102,423 beds occupied.
92.5% general and acute bed occupancy in Q4 2025/26. 94,737 of 102,423 beds occupied. 95.7% adult general and acute bed occupancy in the first week of January 2026. 75% of A&E patients admitted, transferred or discharged within four hours in August 2026, against a 78% operational target. 140,000+ A&E patients waiting more than 12 hours in the same month. 13,815 patients medically fit for discharge but still in hospital in January 2025. 6.1 days average delay per patient. Around 324,000 lost bed days in one month.
The numbers, at a glance:
Metric | Figure |
General and acute bed occupancy (Q4 2025/26) | 92.5% |
Beds occupied | 94,737 / 102,423 |
Adult G&A bed occupancy (first week of Jan 2026) | 95.7% |
A&E patients seen within 4 hours (Aug 2026) | 75% (target 78%) |
A&E patients waiting 12+ hours (Aug 2026) | 140,000+ |
Medically fit for discharge, still in hospital (Jan 2025) | 13,815 |
Average delay per patient | 6.1 days |
Lost bed days in one month | ~324,000 |
NHS App registered users | 39M+ |
NHS App monthly logins | 62.3M |
Secondary-care appointment views per month | ~13M |
Meanwhile, the NHS App had 39M+ registered users, 62.3M monthly logins and around 13M secondary-care appointment views each month, showing the scale at which digital access is already part of the patient journey.
The direction of travel is clear. The NHS 10 Year Health Plan for England is built around three major shifts: hospital to community, analogue to digital, and sickness to prevention. For acute trusts, this means patient flow cannot be managed only inside the ED or wards. It requires better links between A&E, SDEC, inpatient teams, discharge teams, community services, virtual wards, primary care and patients themselves. Patient flow and bed management in acute care therefore needs connected data, real-time visibility and digital tools that support the whole pathway rather than isolated departments.
When an ED is full, the problem is rarely just a lack of beds.
An ambulance handover may be delayed because there is no capacity in the ED. Patients may then wait in corridors. Admissions can queue because there are no staffed ward beds. Ward teams can struggle to discharge patients because community or social care support is not ready. That delays the next admission. The cycle continues.
This is why patient flow and bed management in acute care has to look beyond bed numbers.
The NHS has maintained general and acute bed occupancy above 90% continuously since September 2021. Sustained occupancy above 92% is already regarded as a pressure point for safe and effective flow, yet actual demand continues to push beyond this level.
Delayed discharge makes the problem worse. In 2025, around 12,906 patients per day were reported as medically fit for discharge but remained in hospital. Delays can arise from the availability of social care, rehabilitation, reablement, community services, equipment, assessments or suitable accommodation.
For acute trusts, every delayed discharge has a knock-on effect:
A bed that cannot be released cannot be used for the next patient → A patient waiting for admission occupies ED capacity → ED crowding increases ambulance delays → Staff spend more time coordinating information manually → Clinical teams have less visibility of what is happening elsewhere in the pathway
The result is not simply an operational problem. It becomes a patient-safety issue.
The NHS 10 Year Health Plan places greater emphasis on hospital-to-community care, neighbourhood health services, virtual wards, same-day emergency care and better discharge pathways.
The Urgent and Emergency Care Plan 2025/26 reinforces this direction through the Home First and discharge-to-assess approach. Acute trusts are expected to improve daily discharge performance, including Pathway 0 discharges, while working with local authorities and community services across Pathways 1–3.
This changes what an acute-care digital system needs to deliver.
A PAS or EPR cannot operate as a standalone repository of patient information. It needs to support the movement of patients through the system.
That means connecting:
This is where Cellma fits.
Cellma is an AI-powered EHR and HIMS designed to connect clinical, operational and administrative processes across healthcare settings.
For acute providers, the value is not simply having another digital record. It is having one connected environment through which patient information, activity and workflows can move with the patient.
Cellma brings together capabilities across PAS, EMR, scheduling, referrals, clinical documentation, e-prescribing, pharmacy, communications, billing, document management, business intelligence and patient-facing services.
This creates a stronger foundation for patient flow and bed management in acute care, because teams can work from connected information instead of relying on separate systems, phone calls, spreadsheets, paper notes or repeated data entry.
A patient journey can involve multiple teams within a short period.
The patient may arrive through ED, move to SDEC or an inpatient ward, require investigations, receive treatment, transfer between teams and eventually move to community or home-based care.
Cellma supports this journey through connected PAS and clinical functionality.
Teams can access relevant patient information, record activity, manage appointments and referrals, document clinical care and support discharge processes within the same wider ecosystem.
This matters on the ground:
Role | What They Need |
Bed manager | To know what beds are available |
Ward team | To know which patients are ready for discharge |
ED team | Visibility of admission capacity |
Discharge coordinator | To know whether the next step is home, rehabilitation, reablement, community care or another service |
Clinician | The right clinical information at the point of decision-making |
Connected information helps these teams work from the same picture.
No acute trust operates through one system alone.
A modern EPR needs to exchange information with the wider NHS digital landscape and with existing trust systems.
Cellma supports interoperability through established standards, APIs and integration capabilities.
Its integration approach can align with the requirements surrounding:
For acute care, this interoperability is important because patient flow does not stop at the hospital boundary.
A patient discharged from an acute ward may need community nursing, rehabilitation, primary care follow-up, medicines, diagnostics or virtual ward support. Information needs to follow the patient rather than becoming trapped inside one department or system.
Patient-facing digital access is becoming an increasingly important part of the wider flow model.
The NHS App already provides a major national digital route for patients. By December 2025, more than 39 million people were registered, while monthly logins reached 62.3 million in November 2025. Secondary-care appointment views were reaching around 13 million per month.
The NHS App is therefore not simply an information channel.
It can become part of the wider operational pathway when connected appropriately with provider systems.
Cellma’s patient-facing capabilities, including CellmaPatientPortal, can support digital access to relevant patient information and services while integration with the wider NHS digital ecosystem helps connect provider-level activity with national services.
For acute care, this can support areas such as appointment visibility, communication, patient information and access to relevant records.
The objective is not to make patients manage the hospital’s operational burden. It is to give patients appropriate digital access while giving healthcare teams better-connected information to support the pathway around them.
One of the biggest weaknesses in traditional flow management is delayed visibility.
A bed may technically exist but not be clinically available.
Another bed may be occupied by a patient who is medically fit for discharge but waiting for community support.
Another patient may be ready to transfer but the receiving team does not yet have the required information.
A static bed list cannot capture all of this.
Patient flow and bed management in acute care requires a more complete operational picture.
Cellma’s PAS, scheduling, clinical documentation and analytics capabilities can support the collection and presentation of information needed by operational teams.
This creates opportunities to understand:
✓ Current admissions
✓ Transfers
✓ Bed availability
✓ Patient location
✓ Appointment activity
✓ Discharge activity
✓ Referral status
✓ Clinical activity
✓ Outstanding actions
✓ Patient movement across services
✓ Operational trends
The objective is to give teams information they can act on, rather than data that only explains what happened yesterday.
Acute flow does not begin and end with inpatient beds.
Same Day Emergency Care (SDEC) and wider ambulatory models are increasingly important to managing demand without unnecessary admission.
SDEC allows appropriate patients to receive assessment, diagnosis and treatment without automatically becoming an overnight inpatient.
For this model to work, teams need fast access to patient information, diagnostics, referrals, clinical documentation and follow-up arrangements.
Cellma can support this connected workflow across the patient journey.
The same principle applies to ambulatory services more broadly. Patients may move between urgent care, specialist services, diagnostics, community care and follow-up without requiring a traditional inpatient stay.
A connected EPR helps maintain continuity across these transitions.
Discharge is one of the biggest pressure points in the acute pathway.
The answer is not simply to tell wards to discharge more patients.
Teams need the information, coordination and visibility to identify patients who can leave, understand what is preventing discharge and coordinate the next step.
This is where Home First, Discharge to Assess (D2A) and Pathways 0–3 become operationally important.
Cellma can support the information flows behind these processes by connecting clinical documentation, referrals, communications, scheduling and patient information.
For example, where a patient requires further community support, relevant information can be captured and shared through connected workflows rather than relying solely on manual handovers.
This supports a more coordinated transition from hospital to home or community care.
The aim is straightforward:
Do not keep the patient in hospital because the information needed for the next step is stuck somewhere else.
Acute care involves constant handovers.
ED to ward → Ward to ward → Clinician to clinician → Hospital to community → Acute care to primary care
Poor handovers create risk.
Missing information can result in repeated assessments, delayed decisions, duplicated documentation and unnecessary calls between teams.
Cellma provides a connected EHR environment where relevant patient information can be available across appropriate clinical and operational workflows.
Role-based access controls help ensure users access information according to their responsibilities, while audit trails provide visibility of activity.
This is particularly important in a high-pressure environment where teams need information quickly but governance cannot be compromised.
Acute systems must operate within a highly regulated environment.
Cellma’s approach to NHS digital requirements considers standards and frameworks including:
✓ Data Security and Protection Toolkit (DSPT)
✓ Cyber Essentials Plus
✓ ISO 27001
✓ UK GDPR and Data Protection Act
✓ Role-Based Access Control (RBAC)
✓ Multi-Factor Authentication (MFA)
✓ Audit trails
✓ DCB0129 and DCB0160
✓ DTAC
✓ Relevant NHS interoperability and clinical coding standards
These are not simply compliance checkboxes. They underpin the trust required to share information across clinical, operational and patient-facing environments.
The NHS is collecting huge volumes of operational data.
The challenge is turning that data into something useful at the point of care and operational decision-making.
CellmaAnalytics can support this through reporting and business intelligence capabilities that help organisations examine activity and operational trends.
For acute teams, analytics can contribute to understanding areas such as:
This creates a stronger evidence base for identifying pressure points and planning capacity.
It also supports the wider NHS direction towards population-level and system-wide management rather than treating every hospital episode in isolation.
The pressure on acute care is not temporary.
Bed occupancy has remained above 90% for years. Delayed discharges continue to consume capacity. A&E waits remain under pressure. Corridor care has become a recognised patient-safety concern. Workforce constraints make manual coordination even harder.
At the same time, the NHS is moving towards neighbourhood care, virtual wards, SDEC, Home First, integrated discharge pathways and greater digital access.
These two realities meet at one point: connected information.
A modern EPR must therefore do more than store clinical records.
It needs to connect people, processes, services and information across the patient journey.
That is the role Cellma is positioned to play.
Effective patient flow and bed management in acute care depends on knowing what is happening, where it is happening and what needs to happen next.
Cellma brings PAS, EHR, clinical workflows, referrals, scheduling, communications, analytics and patient-facing capabilities into a connected ecosystem.
It can help acute organisations move from isolated information to connected workflows, from delayed visibility to more timely information, and from department-level coordination to a broader view of the patient journey.
The NHS 10 Year Health Plan has set the direction: move care closer to communities, increase digital integration and reduce avoidable pressure on hospitals.
For acute trusts, the next step is putting that direction into day-to-day operations.
Cellma provides the digital foundation to help make that connection possible.
Ready to Strengthen Acute Patient Flow?
Discover how Cellma can support connected admissions, bed management, SDEC, discharge planning, referrals, clinical communication and patient-facing digital services across the acute-care pathway.
Connect the pathway. Connect the teams. Connect the patient journey with Cellma.
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