As winter has set in, ITV reports have been predictably focused on the proliferation of “corridor care” in England’s NHS. Health Secretary Wes Streeting has wrung his hands and ensured NHS England and his Department of Health and Social Care state their opposition to corridor care.
But the promise to solve this problem by 2029 comes as less convincing after warnings from Age Concern last October that corridor care had increased 525-fold since 2015/16.
Part of the pressure on emergency services has been patients waiting outside hospitals in ambulances, but now new evidence suggests that attempts to improve ambulance handover times have worsened the problem of corridor care.
There has been success in reducing ambulance handover. Streeting welcomed the 14-minute average reduction, with dramatic improvements at some trusts. Although the HSJ report highlighted 21 Trusts with longer handovers—nine increased by more than a minute and 14 remained below the England average—almost 100 Trusts maintained or reduced their times. Twenty-four Trusts cut over 15 minutes, 17 reduced more than 30 minutes, and six more cut over an hour, with reductions of 67-77%. Great Western Hospitals reduced handovers from over 2 hours to 27 minutes, and University Hospitals Plymouth from 2 hours 24 minutes to just under 34 minutes.
However, as a new report from the Health Services Safety Investigations Body (HSSIB) reveals, this dramatic change came after NHS England changed the rules last autumn, to shift the delays in treatment from the backs of queuing ambulances into the Emergency Departments (and all the surrounding areas).
The new guidance from NHS England introduced the W45 (“withdraw at 45 minutes”) standard. This says that the handover of patients from ambulance to hospital staff should be completed within 15 minutes, but no later than 45 minutes. At that point ambulance staff should leave their patients in the Emergency Department, and make themselves available for other calls. So the saved time makes ambulance services appear more efficient, while the hospitals are left to struggle.
The impetus of W45 was to get people into the hospital, which is not wrong, especially when they have been brought across town by blue light ambulances. But it was not backed up by any additional beds to put them in, or staff to care for them (numerous trusts are looking to cut staffing levels in a desperate effort to balance their books).
Rise in corridor care
As a result, hospitals are reporting a greater use of ‘temporary care environments’ (AKA corridor care) since the introduction of W45. Trusts told the HSSIB investigation that W45 had “improved ambulance response times in the community” – but at a cost in terms of much more corridor care.
One trust told the investigation of the problems this can cause:
“On occasion patients are identified in non-clinical areas (receptions etc) that have seemingly been left by their paramedic crew at the 45 minute mark, but without communicating to our team with any sort of handover. On occasion the local team did not even know the patient was in the department at all.”
The use of additional spaces to store patients waiting for beds when Emergency Departments are full has become a problem year-round, but is more pronounced in winter as the weather worsens.
ITV features have exposed the situation in at Queen’s Hospital in Romford in early December, and in the (brand new) Royal Liverpool University Hospital on January 8.
The safety issues involved have also been highlighted by the HSSB report. It is based on investigations in 13 hospitals that spanned from August to December 2025, “recognising pressures around patient flow are constant and that temporary care environments are used throughout the year and not just during ‘winter pressures’.”
‘Temporary care environments’ were being used when patient demand exceeded the capacity of the hospital.
The HSSIB notes many common problems in the use of corridors and other improvised non-clinical spaces for trolley patients, not least the lack of any privacy; problems in accessing toilet facilities; and the lack of nearby power sockets, oxygen supplies, and emergency call bells. There can be problems getting water, hot drinks and food for patients in corridors for prolonged periods. Fire escapes can be blocked by trolleys. And it is much harder to properly monitor patients on trolleys that are likely to be out of sight of any nursing station. The spaces used include a Costa coffee area in one Kent hospital.
A senior sister told the investigators:
“I have had a patient collapse on me and been unable to pull an emergency buzzer as there are none. I had to shout and wait until someone heard me. Every second in that situation feels like a lifetime managing the situation alone, and the sense of relief when someone hears you is immense.” (HSSIB p36)
The report states many doctors and nurses told researchers that using temporary care environments was the “best worse” option, while “Leaving people at home, in ambulances or unseen in waiting rooms were the worst options.”
However, it’s unfortunate that the news report in Healthcare Management on the HSSIB investigation chose to headline that corridor care was the ‘best worst option,’ rather than highlight the many dangers that make it so much worse than proper provision of beds and settled care on a ward. Indeed the HSSIB report itself lacks any clear call for the extra resources needed to end the need for corridor care, instead focusing on “mitigations” to lessen the damage.
It’s not as if the revelations in the HSSIB report are especially new or surprising. Almost two years ago, a blog on the Health Foundation website urged health staff not to get too comfortable with corridor care – “because we can be sure patients won’t.” The blog explains:
“The increasing frequency of corridor care is alarming – both for patient safety and staff morale, and because it risks normalising substandard care delivery. […]
“For staff, there is consistent evidence that this practice leads to lower morale and poorer mental health outcomes in the workplace. It also impacts their ability to care for patients, as staff working in corridors don’t have direct access to – or room to use – routine equipment such as observation machines and patient hoists. […]
“For patients and their families, the experience can be traumatising. Patients can feel invisible out of the sight of staff. The physical environment is distressing, with harsh lighting, little to no privacy and difficulty accessing basic needs such as water or even a toilet. As such spaces are not designed to accommodate people for long periods of time, families are left standing for hours, unable to leave their relative due to fears they will be alone or forgotten.”
Becoming normalised
All of this has been well-known for a long time, as has the year-round pressure that hospitals now lack the capacity to handle. An All-Party Parliamentary Group survey of Emergency Department Clinical Leads in summer 2025 found that almost one in five ED patients were being cared for in corridors, and that this was:
“… disproportionally putting the most clinically vulnerable patients in conditions that nobody should be forced to endure. […] Corridor care has become the most visible sign of system-wide undercapacity in the NHS. It is unsafe for patients, damaging to staff, financially wasteful, and erodes public trust in emergency care.”
The Royal College of Nursing warned last year that patients on corridors were dying because of increasingly routine use of corridor care.
The Royal College of Emergency Medicine (RCEM) has also campaigned long and hard to challenge the flawed system that puts lives at increased risk for lack of front-line capacity. Its response to the HSSIB report was to say:
“What’s most alarming is that there is nothing shocking about the findings. … Corridor care has become so normalised that even the recommendations contained in this report are primarily based on mitigation, not eradication.”
“We struggle to move patients into wards because there’s no available beds. People then become stuck in ED, waiting hours, sometimes days for a bed. And this is where the harm lies – in 2024, the deaths of more than16,600 people were associated with long waits.”
The Royal College of Physicians responded to the HSSIB report by pointing out that:
“In our recent member survey, 94% of physicians who provided care in these temporary spaces over the summer months said that patients’ privacy and dignity were compromised. Physicians are seeing patients without access to the basics like food, water and privacy, while they themselves are experiencing moral injury and very real emotional trauma as they are often unable to provide basic care in these spaces.
“It is heartbreaking to see patients showing such stoicism in these unacceptable conditions because they are conscious of staffing and health service pressures.”
The RCEM has also argued that freeing up the beds to reduce occupancy levels and eliminate corridor care is by no means an impossible pipedream, although more resources would be needed for social care and community health services:
An extra 8,000 beds are needed to reduce occupancy levels to 85%, but:
“this could be achieved without opening new beds. So far on average in 2025, 13,000 beds (13% of the total bed base) were occupied by patients medically fit for discharge …. Freeing just 60% of these beds would bring occupancy to safer levels and ease pressure on EDs.”
There is no doubt that the substantial improvement in most ambulance handover times does reflect a determined effort by staff to speed up the treatment of the most serious emergency cases. In some areas, a local initiative to expand joint working with social care has succeeded in reducing the number of long-stay patients and freeing up beds.
But until ministers get to grips with the scale and impact of 14 years of austerity and underfunding of NHS and social care up to July 24 these issues will remain as an albatross around the necks of most health workers, preventing staff from delivering the standard of service they have been trained to provide.
Dear Reader,
If you like our content please support our campaigning journalism to protect health care for all.
Our goal is to inform people, hold our politicians to account and help to build change through evidence based ideas.
Everyone should have access to comprehensive healthcare, but our NHS needs support. You can help us to continue to counter bad policy, battle neglect of the NHS and correct dangerous mis-infomation.
Supporters of the NHS are crucial in sustaining our health service and with your help we will be able to engage more people in securing its future.
Please donate to help support our campaigning NHS research and journalism.
