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Patients are collapsing in hospitals unseen by staff because overcrowding means they are stranded out of sight on corridors, the NHS’s safety watchdog has revealed.
Using corridors, storerooms and gyms as extra care areas poses serious risks to patients, including falls, infections and a lack of oxygen, the Health Services Safety Investigations Body (HSSIB) said.
NHS staff told investigators that some patients who end up on a trolley or bed in overflow areas have not been assessed or started treatment “and so may be at increased risk of deterioration, which may go unnoticed or be detected late in a temporary care environment,” HSSIB’s report said.
It highlighted that patients in these areas are at risk of not getting prompt attention if they deteriorate and suffer a medical emergency.
“Several nurses shared a patient safety concern around calling for help and responding to a medical emergency in temporary care environments,” the report said.
“They said this was because the patient may be at the end of a corridor and in many cases out of the line of sight of the central part of the emergency department.
“A few incidents where patients had collapsed in a temporary care environment were reported to the investigation,” said HSSIB. While their presence in an overflow area did not affect their outcome, “there were concerns about the impact it had on the timeliness of the emergency response.”
The Royal College of Nursing, which warned last year that patients on corridors were dying, said the report was “a damning indictment” of what HSSIB says is increasingly routine use of corridor care.
Some hospitals are so worried about the potential for harm that they have installed emergency call bells in overflow areas so patients and staff can raise the alarm in an emergency, HSSIB said.
Installing call bells, plug sockets to power medical equipment and mini nursing stations in overflow areas makes them “calmer” and more organised for patients and staff, HSSIB said.
But other hospitals are not taking those steps because they do not want care in such areas – which can also include offices and family rooms – to become “normalised”, it added.
HSSIB also found that while some hospitals try to ensure that patients spend only an hour or less in a temporary care environment, that can become several days, because of a lack of beds.
The Royal College of Emergency Medicine, which represents A&E doctors, estimates that more than 16,600 people died in England last year as a direct result of delays in finding them a bed after arriving at A&E.
NHS England says that corridor care is “unacceptable and should never be considered standard”. Wes Streeting, the health secretary, has pledged to end the practice by 2029, though NHS staff groups are sceptical he will do so.
A Department of Health and Social Care spokesperson said: “No one should receive care in a corridor.
“The situation we inherited is unacceptable and undignified, and we are determined to end it. That is why NHS England is working closely with trusts to reduce variation, tackle inconsistencies, improve data collection and reduce discharge delays, alongside social care colleagues.
“Staff are under immense pressure, and this report highlights the dedication and professionalism of those who are keeping patients safe and delivering the best care they can.”
