Emergency care leaders have warned MPs that seriously ill patients are being left "tucked away" in waiting rooms on plastic chairs so they do not count towards corridor care statistics, amid concerns that medics are "gaming" the system since Labour launched a crackdown on corridor care this year.
Corridor care became widespread throughout the NHS under the Conservatives following the Covid-19 pandemic, with patients being treated in non-clinical spaces such as corridors. The fresh warning suggests the true scale of the problem could be considerably worse than official figures indicate.
Cancer patient left in storeroom for 48 hours
Healthwatch recorded more than 280,000 cases of corridor care over the summer, driven by record heatwaves and an average of 2,300 daily cases in July. A series of deeply troubling accounts of lengthy A&E waits have emerged, including that of an 81-year-old woman with terminal cancer who was left lying on plastic chairs in an A&E storeroom for 48 hours.
Pam Smith, who has stage 4 cancer, went into Royal Gwent Hospital in south Wales suffering from a fever following chemotherapy treatment, only to be told there were no beds available. There is no suggestion the Royal Gwent was gaming the statistics.
Definition 'open to gaming'
The Labour government has pledged to eliminate corridor care and is the first administration to begin monitoring it. NHS England launched its inaugural national definition of corridor care in March, describing it as a patient remaining for at least 45 minutes in a clinically unsuitable section of an emergency department.
Dr Ian Higginson, president of the Royal College of Emergency Medicine, welcomed this development but cautioned the definition is "open to gaming". He explained: "It does not count patients who are in ambulances, or waiting to come into hospital, and those can be used by some organisations as pseudo cubicles."
"It does not count patients who are potentially in waiting rooms, waiting on our plastic chairs, or in what are called 'off the clock' units, waiting on hard plastic chairs for admission. There are some anecdotal reports to suggest that counting corridor care is driving an increase in the number of patients who are being tucked away in that sort of environment."
Patient describes feeling 'abandoned'
Retired teacher Pam Smith received a cancer diagnosis in August, having spread from her bowel to her stomach and liver. A month afterwards, the grandmother-of-seven was receiving chemotherapy but developed a high temperature and was instructed by medical staff to attend hospital.
She initially waited on a chair in a public area at the Royal Gwent Hospital in Newport, but after her family raised concerns about the risk of infection due to her being immunosuppressed, she was relocated to a storeroom. Pam, who is now receiving palliative care, said she felt "abandoned" by the NHS throughout her two-day ordeal, telling ITV News: "We had three plastic chairs. I was tired so we set them out so I could lie down and sleep. There was just no one there for me at that point in time."
Her daughter Rebekah said: "It was very, very upsetting. No one at that age when they feel that ill should be lying on a chair for hours, especially when going through cancer and being on chemo. It can rapidly go downhill and become life-threatening."
One in five patients in unsuitable spaces
New polling from the Royal College of Emergency Medicine, published this week, suggests that one in five A&E patients are being treated in unsuitable spaces such as corridors and storage cupboards. Its survey of clinical leads across 119 hospitals revealed that two-thirds believe pressures are already greater than at the same point last year.
Dr Higginson told MPs: "What makes emergency departments unsafe is where you have patients absolutely everywhere and you cannot do your job properly. If you describe a typical shift... in the old days, my job was to answer questions from less experienced practitioners, go and see patients with them, teach, support and supervise. My job now is essentially traffic control and risk management."
"So we're trying to find spaces for the next patient," he added. "Resuscitationary [rooms] might be full. We're trying to work out which patients we need to prioritise if we've got very long waits. I might be going to the waiting room to apologise to our poor patients who have been waiting there for hours."
Matthew Hopkins, director of acute and ambulance services at the NHS Alliance, stated that pressures were no longer easing during warmer months, saying: "So our membership are very much saying that given the challenges during the summer, given the demand, there is now no longer a kind of summer lull."
NHS England says it is measuring corridor care
Dr Emma Rowland, executive director of performance at NHS England, told the committee that the solution was tied to improving social care and discharging patients promptly once they were well enough to leave hospital. "We have called out corridor care and we now measure it," she said. "I completely accept that there are questions around the definition of how one measures it, but for the first time, we are measuring it."
"The second thing is, we are clearly stating that we wish to eradicate it. That is our intent for exactly the [reasons] everybody's alluded to - it causes increased harm, increased length of stay and it has no dignity to it."
Karin Smyth, minister for secondary care, said: "Don't underestimate [that] for the staff at the front end dealing with this... it's very pressured. We don't shy away from the fact that this is a pressurised system and clinical colleagues are feeling that very much at the front end. But I would say that we are grasping it and making improvements."
Corridor care became widespread prior to Labour taking office in 2024, following a decade of rising A&E and 999 waiting times. The Mirror previously disclosed that the practice was quietly introduced across the NHS in England in 2022 to get ambulances queuing outside A&Es back on the road more swiftly.
A spokesperson for Aneurin Bevan University Health Board, which operates Royal Gwent Hospital, said: "We are truly sorry for Mrs Smith's experience and the distress this caused her and her family. Our services are caring for very high numbers of patients and are under significant pressure. However, this is not a standard of care that we accept - no patient who needs a bed should have to spend time in such uncomfortable conditions."
They continued: "As soon as this was brought to our attention, we contacted the family, apologised for their experience and we are grateful that they shared their concerns with us. As a result, we have taken immediate steps to increase the availability of recliner chairs and other comfort items, including pillows, at the Royal Gwent Hospital."
"We would like to thank Mrs Smith and her family for their constructive engagement with the Health Board. We also recognise the comments they have made about the kindness and professionalism shown by staff, who continue to provide compassionate care in exceptionally challenging circumstances."
