Corridor care ‘endemic’ in UK, doctors say as study reveals scale of problem

Corridor care is “endemic” in the UK, doctors have said, as a major study found one in five patients were treated in hallways, offices and cupboards.

Millions of patients are enduring undignified and unsafe care, with almost every A&E department in the country deploying the approach routinely, contravening national guidance, research reveals.

Amid mass overcrowding and long delays for treatment in hospitals, short-term use of temporary “escalation area” care has been reported to be widespread. But until now there was no high-quality evidence on its prevalence.

The study, by the Royal College of Emergency Medicine’s (RCEM) trainee emergency research network (Tern), analysed five snapshots taken from 165 A&E departments in March this year.

It found 17.7% of patients were receiving care in escalation areas, classed as anywhere not routinely used for care unless capacity in emergency departments is breached.

This included corridors, waiting rooms, doubled-up cubicles, offices, cupboards and ambulances waiting outside to offload for more than 15 minutes.

Writing in the medical journal Emergency Medicine, the researchers said: “National guidance states escalation area use is not acceptable; this research demonstrates it is routine.” It also posed “a significant patient safety issue”, they added.

Dr Ian Higginson, the president of the RCEM, said the study “reinforces that the shameful practice of corridor care is endemic in emergency departments in the UK”.

He added: “The stark picture this paper paints reflects the stories we hear from our members nationwide – the volume of which are growing as we head into winter. Just this week, one member told us of a patient having to wait two days for a bed in their department.

“It’s important to note that these patients may be elderly, vulnerable, have mental health issues, or be children. They have been failed by successive governments.”
In October, the Guardian reported how almost 150,000 people aged 90 and over in England were forced to wait longer than 12 hours in A&E every year, with some experiencing “truly shocking” waits of several days stuck in corridors.

Older people were also being left in their own excrement and wet beds for hours, denied pain relief and forced to watch and hear other patients die next to them because they end up waiting so long for care.

Higginson said it was “worrying” that the snapshots for the new study were taken in March and not at the height of winter, which “shows that corridor care is an issue all year round”.

“We are very concerned about the harm associated with long waits in emergency departments and how it puts patients’ lives at risk – for every 72 patients who wait between eight and 12 hours before admission, there is one excess death,” he added. “This should not be happening in a wealthy country.”

Higginson also said it was “abundantly clear” that the crisis had not been given the priority it deserved by the government. “It can’t be blamed on hiccups or flu,” he added. “We fear this winter we will see gridlock.”

Last week the health secretary, Wes Streeting, promised to end corridor care in hospitals by the next general election “if not sooner”.

The Department of Health and Social Care said corridor care was unacceptable, undignified and had no place in the NHS.

“That is why we will be publishing corridor waiting figures for the first time, so we can take the steps needed to eradicate it from our health service,” a spokesperson said. “Sunlight is the best disinfectant.”

It would “take time” to “turn around the shocking situation we inherited”, but there were already some “green shoots of recovery,” the spokesperson added.