The Royal College of Emergency Medicine and Royal College of Nursing have hit out at the normalisation of medical care in corridors.
The Royal College of Emergency Medicine (RCEM) has hit out at guidance from NHS England which details how patients can be safely treated in corridors. Adrian Boyle, president of the independent professional association calls it the “normalisation of the unacceptable and dangerous”.
In mid-September, NHS England published a guidance paper on how to treat patients in what it euphemistically calls “temporary escalation spaces”.
Although it admits that this kind of treatment is “never acceptable when caring for children”, it says that the current healthcare landscape means that “some providers are using temporary escalation spaces more regularly” and that “this use is no longer in extremis”.
NHS England’s six-point plan was developed to provide what it calls “the safest, most effective and highest quality care possible” when treatment in corridors has been deemed necessary.
Never safe
In an open letter Boyle and RCEM vice president Ian Higginson state simply that: “it is not possible to provide safe and good quality care in temporary escalation spaces, such as corridors”.
They refer to an academic study in the Emergency Medical Journal which shows that extreme long waits in A&E departments before patients are admitted are linked to excess mortality.
They also accuse those who draw up such guidance as being “out of touch” with what is happening in Emergency Departments.
This is backed up by a survey published in late November from the RCEM which found that almost nine out of 10 British A&E clinicians said that they aren’t confident that their departments will cope well this winter and 94% think that patients are being put at risk due to the pressures currently being experienced.
More to the point, 83% of respondents from 83 hospitals across the country, said that they had patients being cared for in corridors.
At the time, Boyle called the findings “a stark warning” from those on the front line. “Clinicians are worried, and patients are unsafe,” he said.
Undignified and unacceptable
This is not a new concern.
In a policy report published in June, the Royal College of Nursing (RCN) called corridor care “undignified” and “unacceptable”.
“There’s nothing about corridor care that resembles caring. Patients left on trolleys or chairs for hours on end, often soiled, in pain and suffering – it’s tantamount to torture. There’s no part of our society that should consider this acceptable. So why are we accepting it?” wrote Nicola Ranger, the RCN’s general secretary and chief executive, in the introduction to the report.
It is also an issue of which the government is aware.
In a speech on the NHS at the King’s Fund in September this year, prime minister Keir Starmer, railed against waiting times in A&E departments. “That phrase avoidable deaths should always be chilling,” he said.
But with what Stephen Powis, NHS national medical director calls the current “tidal wave” of flu infections and a 70% increase in hospital cases in the second week of December, the warning from RCEM is timely.
“Our patients need a firm commitment from our politicians, and NHS leaders not to accept the unacceptable,” says Boyle. “Rather than advising how to deal with overcrowding, all effort should be focused on preventing it.”
