Matter for Discussion: Corridor care

CHANGED to Resolution: That this meeting of Congress asks Council to lobby the government to completely abolish corridor care and ensure that the respect and dignity of patients is upheld.

This resolution passed.

The term ‘corridor care’ is caring for patients in inappropriate places such as corridors and non-clinical areas, and not within a defined hospital bed space.

Since December 2012, the NHS has not been able to consistently meet the four-hour target in accident and emergency (A&E) departments, due to the influx in patient care (The King’s Fund, 2022). 

Corridor care has become the ‘new norm’ where emergency departments and hospitals continue to see an increase in demand for care (Royal College of Nursing, 2020). This forces patients into inappropriate places within the hospital such as corridors, the middle of bays and rooms that don’t support patient care. 

In the summer of 2022, NHS in England promised the brutal flow model, which actively encouraged corridor care. While there are reports that focus on a patient’s perspective around corridor care, there aren’t so many that focus on a nurse’s perspective and the impact it has on their wellbeing, morale, and accountability. 

Some trusts are implementing initiatives such as the ‘1 upping’ or not taking handover in the A&E department, forcing ambulance crews to wait until a bed is available. However, the nurses who are providing care in these areas are experiencing moral injury and distress, knowing that they are providing suboptimal care to their patients and families. 

Across England, Wales, Scotland and Northern Ireland, there are areas for improvement, including patient privacy and dignity, where corridors and lounge areas are overcrowded. 

In March 2022, the RCN Northern Ireland Emergency Nurse Network wrote to the Minister for Health, the Health and Safety Executive for Northern Ireland and nursing leaders in Northern Ireland to escalate members’ concerns over unsustainable pressures in emergency departments. 

This letter referenced a lack of safe access to exits, infection control issues arising from overcrowding, the associated threat to the physical and mental health and wellbeing of staff, increased incidences of violence and aggression towards staff, and the moral distress of nursing staff not being able to provide high levels of patient care.

In Scotland, the RCN has repeatedly called on the Scottish government and health boards to take action to retain and recruit nursing staff. Over a quarter (26%) of Scottish respondents to the College’s Last Shift survey reported that they were treating patients in inappropriate settings, compromising their care, and potentially making it unsafe. In its review of the NHS in Scotland 2022, Audit Scotland acknowledged that workforce capacity is the biggest risk to NHS recovery.  

In Wales, the focus has moved to a whole systems approach for unscheduled care with the Welsh government focusing its attention on transforming access to urgent and emergency care.

The aim of this discussion is to share and highlight best practice and initiatives in relation to caring for patients in inappropriate locations such as hospital corridors and the impact it has on nursing staff and their wellbeing.

The RCN has produced resources to support RCN members dealing with unsustainable service pressures which can be found here.

Reading list for this debate available at rcn.libguides.com/congress2023.

References 

Audit Scotland (2023) NHS in Scotland 2022. Available at: https://www.audit-scotland.gov.uk/publications/nhs-in-scotland-2022 (Accessed 15 March 2023) 

The King’s Fund (2022) What’s going on with A&E waiting times? Available at: https://www.kingsfund.org.uk/projects/urgent-emergency-care/urgent-and-emergency-care-mythbusters (Accessed 15 March 2023) 

The Royal College of Nursing (2020) ‘Corridor care’ in hospitals becoming the new norm warns RCN. Available at: https://www.rcn.org.uk/news-and-events/Press-Releases/corridor-care-in-hospitals-becoming-the-new-norm-warns-rcn (Accessed 15 March 2023) 

The Royal College of Nursing (2023) RCN Scotland responds to First Ministers briefing on the NHS and winter pressures. Available at: https://www.rcn.org.uk/news-and-events/news/first-ministers-briefing-on-the-nhs-and-winter-pressures-090122 (Accessed 15 March 2023)