SAFER patient flow bundle


These resources will help you implement the SAFER patient flow bundle.

The SAFER patient flow bundle blends five elements of best practice. It’s important to implement all five together for cumulative benefits and it works particularly well when you use it with the ‘Red2Green days’ approach. 

Tailor this guidance to your local circumstances, to support engagement and continuous improvement.

The five elements of the SAFER patient flow bundle are:

S – Senior review. All patients will have a senior review before midday by a clinician able to make management and discharge decisions.

A – All patients will have an expected discharge date and clinical criteria for discharge. This is set assuming ideal recovery and assuming no unnecessary waiting.

F – Flow of patients will commence at the earliest opportunity from assessment units to inpatient wards. Wards that routinely receive patients from assessment units will ensure the first patient arrives on the ward by 10 am.

E – Early discharge. 33% of patients will be discharged from base inpatient wards before midday.

R – Review. A systematic multi-disciplinary team review of patients with extended lengths of stay (>7 days – ‘stranded patients’) with a clear ‘home first’ mindset.

To get started use our practical SAFER patient flow bundle rapid improvement guide to introduce best practice and reduce delays for your patients.


Safer patient flow bundle slide set PPTX, 16.4 MB

These SAFER patient flow bundle slides are useful for introducing the bundle to your teams. You can adapt them for local use and training.

SAFER patient flow bundle implementation checklist DOCX, 76.5 KB

An example implementation checklist that you can adapt for local use.

Many aspects of the SAFER patient flow bundle aren't new to ward teams; some teams find a baseline assessment is a good place to start.

This tool was co-designed by a ward and improvement team members. It can help you gain a clear picture of your current practice, before you attempt to implement the SAFER patient flow bundle. 

Case studies

Many providers have successfully implemented the SAFER patient flow bundle. These case studies show good practice and how the providers have benefited. 

You can find more case studies on The Academy of Fabulous Stuff website. 


Use these videos in your training and launch events.

This patient story shows why we need to improve flow through our services.

This video from Nottingham University Hospitals NHS Trust clearly explains why patient flow is everyone’s business.

This poem commissioned by NHS England raises awareness of why we respect patients’ time and dignity in their last 1,000 days.

Our elective care team has also produced these useful videos


For webinars covering the key principles of Safer, faster, better and how to apply them in your systems, visit our Safer, faster, better webinar page

Find out more

Some providers have dedicated webpages of resources to support their improving flow programmes and implementation of the SAFER patient flow bundle. Gloucestershire Hospitals NHS Foundation Trust’s website is a great example.

The SAFER patient flow bundle is best implemented with Red2Green days; find out more and use the resources on the Red2Green campaign page

For the latest improvements arising from the SAFER patient flow bundle and Red2Green days see FacebookTwitterThe Academy of Fabulous Stuff and The Edge.

You can also follow these hashtags on Twitter for highlights of the latest achievements across the country.

Share your improvement stories and resources with colleagues across the NHS by submitting them to our Improvement Hub.

Related content

You can also access all our rapid improvement guides to support improvements in urgent and emergency care at rapid improvement guides

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