More than 90% of respondents to a survey from the Royal College of Nursing say that patient safety is being compromised by care in what the NHS calls “temporary escalation spaces”.
More than two-thirds of respondents to a new Royal College of Nursing (RCN) survey said they’re delivering care in over-crowded or unsuitable places – such as corridors, converted cupboards and even car parks – on a daily basis.
What has become the normalisation of medical care in British hospitals is under the spotlight again.
In a statement to the Commons earlier this week (15 January), health secretary Wes Streeting emphasised that he wanted to end the “undignified” practice.
“I want to be clear, I will never accept or tolerate patients being treated in corridors. It is unsafe, undignified, a cruel consequence of 14 years of failure on the NHS and I am determined to consign it to the history books,” he said.
But he was unwilling to put a time frame on it.
“I cannot and will not promise that there won’t be patients treated in corridors next year,” he said.
As Healthcare Today reported at the beginning of January, sign of the normalisation of corridor care has come from the much-criticised guidance from NHS England which details how patients can be safely treated in corridors.
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”.
Patient safety is compromised
The scale of the problem comes through clearly in the RCN survey and more than 90.8% of respondents said that patient safety is being compromised.
Nursing staff report caring for as many as 40 patients in a single corridor, unable to access oxygen, cardiac monitors, suction and other lifesaving equipment. They report female patients miscarrying in corridors, while others said they cannot provide adequate or timely emergency resuscitation to patients having heart attacks.
“This devastating testimony from frontline nursing staff shows patients are coming to harm every day, forced to endure unsafe treatment in corridors, toilets and even rooms usually reserved for families to visit deceased relatives,” said RCN general secretary and chief executive Nicola Ranger.
“Vulnerable people are being stripped of their dignity and nursing staff are being denied access to vital lifesaving equipment. We can now categorically say patients are dying in this situation,” she continued.
The findings of the survey are confirmed by others in the profession who tell stories, for example, of the physiotherapy gym taken over for extra bed spaces and describe corridors as “full to the brim”.
“Physicians tell us that they are being asked to provide more and more care in corridors and in other temporary environments, such as treating additional patients on wards, over and above agreed numbers. This is unacceptable and must end,” said Royal College of Physicians clinical vice president John Dean.
“Doctors, and now our nursing colleagues, are almost beyond despair as they struggle with the impossible task of trying vainly to look after scores of sick and dying people, left for hours on end in unsanitary and unacceptable conditions,” said BMA chair of council Philip Banfield.
A broad coalition
In mid-January, a joint letter from the RCN and 15 healthcare and patient organisations including the Patients Association, the British Medical Association, Age UK, Marie Curie, John’s Campaign, the Faculty of Intensive Care Medicine, the Royal Pharmaceutical Society and the Royal College of Emergency Medicine was sent to Streeting and NHS chief executive Amanda Pritchard which outlined the impact of corridor care on patients and staff, and demonstrated that the issue of corridor care is a priority for multiple organisations.
This is the first time a broad coalition has urged the government to take action on corridor care.
“For staff, this means being forced to deliver compromised care, unable to access oxygen, suction or even plug sockets. This causes moral distress and ultimately, moral injury,” the letter said.
“Health and social care professionals and patients, their relatives and carers, are rightly worried about what the coming weeks and months may bring… we are clear that treating patients in corridors, on chairs and other inappropriate spaces is in no way acceptable and must end,” the letter continued.
NHS England has indicated that it will begin to report a count on the number of patients who receive care within temporary escalation spaces later this month.
