Reducing the waits in emergency departments is important for patients and is a government priority. In order to reduce waits the whole system must be considered. The flow of patients before arrival at the emergency department determines the workload of the department. The staffing, resources and systems within the emergency department are key to providing high quality timely care. The flow of patients after leaving the emergency department until their return home will determine whether they can be discharged from the department in a timely manner. Despite the present focus on emergency care in the NHS there have been no reviews of the literature to inform the present changes to reduce waits.