Ambulances struggling to offload patients into hospitals as corridor care returns

Dangerous crowding and corridor care has returned to Emergency Departments in England.

NHS England Performance figures for October 2020 show that patients waiting for treatment on trollies has increased by 50%, with patients waiting longer than 12 hours from decision to admission having quadrupled from September 2020.

The data also shows:

• patients waiting longer than 12 hours (from decision to admit) has nearly doubled from the same month last year
• the proportion of patients attending A&E who require admission is up by 3 percentage points on last year
• the number of ambulances dispatched by NHS111 is higher than last month
• ambulances response times are up on last month and the same month last year
• Performance of the four-hour target is down by 4.1 percentage points in type 1 Emergency Departments from last month, with nearly 1 in 4 patients waiting longer than four hours to be seen

Dr Katherine Henderson, President of the Royal College of Emergency Medicine, said: “I am appalled and alarmed; the data is massively worrying.

“Despite our repeated calls for action, crowding and corridor care is back and it has to stop. It is a dangerous and unsafe situation that puts enormous pressure on staff and departments and now increases the risk of hospital acquired infection to patients.

“We simply cannot leave patients for hours in crowded corridors without social distancing, making infection prevention control measures impossible; potentially exposing them to infections.

“Hospitals and trusts must, as a necessity, implement and follow strict IPC guidance ensuring staff are using the right PPE and are trained in how to fit it correctly to maximise safety for themselves and their patients. We welcome the news that there will be regular staff tests and look forward to hear how this will be operationalised. We need patients to be confident they are not being seen by staff who might be carrying the virus.

“But this only tackles part of the problem. To function as it should and provide the best care possible for patients, the Emergency Care system must have good flow. Without it ambulances are stuck waiting to offload patients and paramedics are unable to return to the community; waiting times increase across the board and patients suffer.

“The recent rise in covid infections in the community and a rise in general hospital admissions means there has been an increase in the number of patients in hospital. We already had a bed base far smaller than required, and the consequence of too few staffed beds is that patients are becoming stranded in EDs, putting them unnecessarily at risk. Hospitals need to be given guidance about how to prioritise the multiple demands they are trying to balance.

“Winter has only just begun and with the rise in community covid transmission it is only likely to get worse. We must stop crowding and corridor care now, we must ensure patients and staff are safe, we must ensure there is good flow so ambulances can admit patients into EDs quickly and waiting times are reduced. If these practices continue and we do not act I dread to think of the suffering this winter will bring.”