New definition of corridor care is step forward but ‘not perfect’, says RCN

A new definition of corridor care has been established by NHS England (NHSE) to help collect and analyse data on the scale of the situation across the country.

Published on 4 March, the definition states that for general and acute beds, corridor care relates to the number of patients who are receiving care for more than 45 minutes on a ward outside of a bed space.

For emergency departments (EDs), it said corridor care is the number of patients who received care in an ED corridor for more than 45 minutes within the previous 24-hour reporting period. This includes patients receiving treatment, waiting for admissions, or transfer.

The definition comes after calls for greater transparency and mandatory reporting of data for more than a year from the Royal College of Nursing (RCN) following warnings that several NHS trusts in England had declared critical incidents amid dangerously high demand.

Concerns were also expressed by the RCN about shortages in community nursing, GP access and social care fuelling hospital overcrowding and forcing treatment into unsafe corridor spaces.

NHSE has also confirmed that the 30 NHS trusts worst affected by corridor care are now ‘rapidly developing’ to make progress on the issue, which the RCN says reflect suggestions put forward by the ‘corridor care coalition’ which includes the college and 15 other key health care and patient organisations.

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This included sending a letter to health secretary Wes Streeting and chief executive of NHSE Amanda Pritchard in January last year, urging the UK Government to ‘commit to transparency on the true extent of the issue by publishing data on all incidences of care delivered in inappropriate places’.

Professor Nicola Ranger, RCN general secretary and chief executive, said the new definition is by ‘no means perfect’ but will help determine the ‘scale of the crisis’.

‘The brave testimony of nursing staff and determined campaigning of the RCN-led coalition has resulted in these commitments,’ she said.

‘We’re pleased that NHSE has engaged and agreed to some of the actions put forward by the corridor care coalition.

‘Together we need to start resetting the standards in our hospitals. These actions rightly place new expectations on trust leaders to own the corridor care crisis, put in place measures within their control to ease pressure, and recognise it as a risk to patients and staff by formally recording and reporting corridor care.’

However, Professor Ranger added that though the definition ‘marks progress’, there is a need for ‘bigger and bolder’ steps to address to address the issue.

She said: ‘As we’ve made clear, the solutions include investment to expand capacity across the system and particularly in community services and nursing roles, as well as improving discharge processes and removing red tape that prevents the effective use of social care capacity.

‘That’s how you keep people healthy, ease pressures on hospitals and prevent this unconscionable practice taking place in our NHS.’

The Royal College of Emergency Medicine (RCEM) was also part of the corridor care coalition and has welcomed NHSE’s ‘commitment to focus on the issue’.

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RCEM’s president Dr Ian Higginson said: ‘Corridor care is dangerous, undignified, and a source of national shame.

‘We absolutely welcome NHSE’s commitment to focus on this issue. We also welcome the intention behind the definition on corridor care. This has been promised since early last year.’

However, Dr Higginson expressed concerns that the definition will be effective, stating patients waiting in areas not specifically designated as ED will not be included.

He said: ‘The definition will not include, for instance, patients waiting for admission in areas not designated as being part of the ED, waiting in spaces designed for rapid assessment, or potentially on chairs in waiting rooms.

‘These patients may still experience harmful long waits in inappropriate spaces. Secondly, the 45-minute threshold is hard to justify.

‘We are concerned that the definition, as it stands, will encourage manipulation of figures to make things look better than they are. Sadly, we have seen this happen so often we are expecting to see it again.’