Corridor Care Now 'Inevitable' in NHS Hospitals as A&Es Face Critical Overcrowding
Corridor care has become an unavoidable reality in NHS hospitals across England, with emergency departments now dangerously overcrowded and patients facing waits of up to 16 days for a bed on a ward. This alarming situation has been revealed through a snapshot survey conducted by the Royal College of Emergency Medicine (RCEM), which highlights a systemic crisis in urgent and emergency care.
Critical Patient-to-Space Ratio in Emergency Departments
The RCEM's survey of clinical leads working in 81 A&Es on January 12 found there were 7,400 patients present but only 2,970 permanent treatment spaces. This creates a patient-to-space ratio of 2.5 to 1, meaning most patients were waiting on chairs or trolleys in corridors, waiting rooms, or other non-designated areas. On that single day, the average longest wait for admission across the surveyed departments exceeded 48 hours, with one mental health patient waiting 16 days for an inpatient bed and several others waiting seven or more days.
Unacceptable Conditions and Patient Harm
Dr Ian Higginson, president of the Royal College of Emergency Medicine, stated that patients are being made to wait in A&E in 'unacceptable conditions' for hours or even days. The survey found that only 11 per cent of clinical leads reported all their patients were accommodated in proper treatment areas that day. Furthermore, 93 per cent believed patients were coming to harm due to the conditions in their departments.
The Royal College of Nursing has previously warned about the dangerous and undignified nature of corridor care, where staff must discuss personal medical matters and conduct physical examinations surrounded by other patients. The noise and bright lights can disrupt patients' rest, while essential equipment like call bells, emergency suction, and oxygen tubes are not immediately accessible next to trolleys.
Staff Morale at 'All-Time Low'
Clinical leads who responded to the RCEM poll provided written testimonies that paint a grim picture of working conditions. One stated: 'Morale is at an all-time low with several staff off sick with stress or burnout. Hard to quantify harm in terms of numbers, though harm is without doubt being done as crowding eats into efficiency and is resulting in inevitable delays in care.' Another revealed: 'In the past we would be in the corridor occasionally, but now it is every day.' A third admitted they were 'unable to keep patients safe' under these circumstances.
Root Causes of Overcrowding
The survey identified the primary reasons for this dangerous overcrowding:
- 93 per cent cited difficulties discharging patients who are medically fit to leave, largely due to trouble arranging social and community care.
- 84 per cent pointed to organisational delays affecting discharge.
- 74 per cent highlighted a lack of alternatives to admission for patients.
- 56 per cent mentioned disruptions due to weekends or holidays.
Notably, high numbers of patients with less serious conditions or injuries was only cited by 36 per cent of respondents, indicating that the crisis stems from systemic issues rather than inappropriate A&E use.
Alarming Statistics and Historical Context
The survey found that occupancy levels for patients awaiting admission to a ward alone would still be 103.3 per cent, and overall, 16 per cent of patients present in these A&Es were subject to corridor care. Previous analysis by the College suggested there were more than 16,600 deaths associated with long A&E waits before admission to a ward in England in 2024. Additionally, over 1.8 million patients had to wait 12 hours or more to be admitted, transferred, or discharged from A&E in England in 2024/25, against a target of 4 hours.
Calls for Systemic Solutions
Dr Higginson emphasised: 'These findings are further evidence that our EDs are struggling, to say the least. Every day in EDs across the country, patients are stuck waiting in corridors in unacceptable conditions for hours or days. These patients are waiting for a hospital bed – but we can't get them into one.' He noted that recent NHS figures show bed occupancy this month has been over 94 per cent, well above the 'safe' level of 85 per cent, with thousands of beds occupied by people medically fit to leave but unable to be discharged due to lack of social care provision.
The RCEM warned: 'There are many more patients than there are designated spaces for them in emergency departments, making corridor care an inevitability.' While acknowledging that the Secretary of State for Health and Social Care and NHS England leaders have been engaging on the issue, the College stressed the need for 'a clear long-term plan for fixing Urgent and Emergency Care or things will not get better.'
Government Response and Immediate Actions
A Department of Health and Social Care spokesperson stated: 'No one should receive care in a corridor – the situation we inherited is unacceptable and undignified, and we are determined to end it. We recognise staff are under immense pressure and thank them for their dedication in keeping patients safe.' The Department highlighted immediate actions including:
- Investing £450 million to expand urgent and emergency care services.
- Building 40 new same day emergency care centres and 15 mental health crisis centres.
- Preparing for winter earlier than ever before.
The spokesperson added that NHS England is working closely with trusts to reduce discharge delays alongside social care colleagues, and will soon publish data on corridor care, noting that 'sunlight is the best disinfectant.'
