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Supporting the A&E 4 hour target at Luton and Dunstable NHS Trust

Since 2017, Luton & Dunstable NHS Trust have consistently been between 2% and 4% better than the 4 hour A&E waiting time target. How are they doing it?

Streams and hubs

Luton found that the traditional method of managing all patient flow within the A&E department wasn’t getting the results they wanted. Efficiencies were created through the introduction of multiple streams, each with their own staff teams, to flow patients into more specialised areas that could meet their needs quickly and effectively.

Operations Centre

Situated between A&E and the Emergency Admissions Unit is Luton’s first-class Operations Centre (OC). Similar in execution to the Clinical Coordination Centre concept set out in the Future Hospitals report, Luton’s OC is the operational command facility for the whole organisation.

Staffed 24 hours a day, 7 days a week, the OC steers the hospital through the management of hundreds of emergency attendances each day. Paper-based processes are kept at a minimum; real-time data is key to the running of the OC, giving staff chance to change course as necessary to keep the hospital running efficiently. The Flow solution and access to views of CAMS (Ambulance Service systems) allows the OC to monitor capacity and demand, not only in A&E but also throughout the hospital.

“We take a proactive approach to ensure that the flow of patients across the hospital is smooth, directing them to the right place first time. Flow is like an extra member of our team supporting this process.”

Martin Jagedo, Deputy Director of Operations, Luton and Dunstable NHS Trust


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