By John Tingle, Associate Professor, Birmingham Law School, University of Birmingham
The NHS faces a ‘perfect storm’ in trying to balance its books and at same time look after the health of the nation. It faces an infinite demand for finite resources despite record government funding over the years. Media stories abound of waiting lists, delays in getting GP appointments, long waits in A & E and now ‘corridor care.’
Corridor Care
The issue of corridor care in the NHS is a major national concern and one which has attracted considerable media attention and continues to do so. It is an issue of intense political debate raising patient safety , legal, and many other issues.
NHS England Framework: Corridor Care
NHS England provide framework guidance to support staff when TES (Temporary Escalation Spaces) are used. It is stated in the guidance that care delivery in TES spaces such as corridors or chairs and so on due to overcrowding is not acceptable and should not be considered as standard. Core principles are given by NHS England which include assessment of risk, escalation, quality of care.
Some argue that the title of the NHS framework guidance is contradictory.
Sheather and Phillips state:
“The title is a contradiction. Its basic premises are at loggerheads. Safe and good quality care cannot co-exist with treatment in corridors.”
The theory, practice gap
The patient safety guidance offered by NHS England on corridor care seems on first reading to provide a reasonable patient safety baseline. However, the everyday practical workplace reality of corridor care paints a very different and alarming picture. This can be seen in a recently published RCN survey of nurses, patients experiences of corridor care.
Has corridor care become normalised?
There are reports of job advertisement for corridor care nurses and structural changes to corridors. The addition of call bells and so on in corridors to facilitate treatment and care. Many nurse respondents to the RCN survey, pointed to what are seemingly permanent changes to accommodate corridor care:
“Corridor nursing is a daily occurrence in my department. So much so that we have put in safety measures with call bells and a crash trolley in the corridor” (p.13).
Also, there are structural changes taking place:
“They then opened the DTA corridor which involves 17 beds built into what was formerly a narrow corridor connecting the three units mentioned above. There were curtains built into the ceiling which are no wider than the beds themselves, therefore when attempting to deliver care you are literally sticking out of the curtains. The beds have no space between them, and patients have their feet touching the next person’s head. This means nobody has any dignity” (p.85).
The temporary nature of corridor care in the NHS can be seriously challenged by the above.
Legal perspective
Whether corridor care is normalised or not maintains important legal implications for any clinical negligence actions brought by patients. Patients arguing that they have suffered negligently caused harm because they were treated in a corridor as opposed to a well-equipped ward or treatment room. In terms of establishing breach of duty, a court may factor into its assessment of the standard of care to be exercised, the fact that battlefield, crisis, care conditions prevailed at the time. Concluding that the hospital, doctor, nurse acted reasonably in the circumstances of the case and that there was no breach of duty. The court’s assessment of the standard of care being possibly different if more normal, less busier care conditions prevailed.
The case of Mullholland v Medway NHS Foundation Trust [2015] EWHC 268 (QB) is instructive to the corridor care crisis. Herring states:
“The court will take into account the situation in which professionals find themselves.” (p.123)
Does normalisation subsume a battlefield, crisis focus ?Herring also states:
“It is unclear the extent to which lack of resources will be a defence to a claim in negligence (p.123).”
The case of Garcia v St Mary’s NHS Trust [2006] EWHC 2314 (QB) is quoted by Herring. The case is useful for its discussion on the organisations of care departments and staffing. The key watchwords here are what is reasonable and foreseeable.
RCN Survey: chronic patient safety issues identified.
The RCN survey was based on the responses of 5,408 nursing staff across the UK from 18th December 2024 to 11th January 2025:
– 66.81% responded saying they had delivered care daily in an inappropriate setting not designed for patient care.
-90.82% said that patient care and safety was compromised.
Extracts from the survey include:
“No dignity, Unsafe-no access to suction or oxygen. No curtains for privacy. Care given in public” (p.246).
“I had to change an incontinent, frail patient with dementia on the corridor, by the vending machine. It was undignifying , felt so bad at the same time it was my duty to deliver care “(p.5)
Factor more the legal perspective in debates, discussions.
The legal aspects of corridor care do need to be factored into debates and discussions more as it does seem to be missing from many of these. It should not be forgotten that injured patients may be able to bring clinical negligence claims. Also, that many nurses featured in the reports appear to be suffering or have suffered from workplace stress and that this also has legal implications. Important issues of tort law are also raised.
This blog is based on my column submitted to the British Journal of Nursing
https://www.britishjournalofnursing.com/authors/john-tingle/