The battle to end 'indignity' of hospital corridor care

Hospital corridors lined with patients on beds used to be a seasonal problem, linked to winter pressures such as flu. In recent years, though, such scenes have become a year-round issue across the UK.

In Liverpool, nurses and doctors have treated more than 24,000 people in corridors over the past year, in what the NHS describes as "clinically inappropriate spaces".

It says such care should happen only in "exceptional circumstances".

Across the UK, about 90,000 people a month are now treated in this way.

Although some Liverpool hospitals have seen a "significant reduction" in corridor care, families affected by it say the upset caused by the experience remains.

Harry Lyness had hardly ever been in hospital, according to his son John. The former Royal and Merchant Navy serviceman was 95 when he was admitted to the Royal Liverpool Hospital after a fall at his Wavertree care home in 2023.

"It was so overcrowded. They just couldn't fit him in," John said.

"He was on this big long corridor, and all along it were plugs for the staff to plug in the medical equipment they needed to use to treat people.

"The corridor looked about 30 or 40 yards long, and it was bed-to-bed all along the corridor, and just a massive big queue of trolleys.

"It looked to me like what you'd expect to see if there had been a major incident, a fire or an explosion."

As the hours passed, John repeatedly asked staff when his father might be moved to a room, but, he said, nobody could tell him.

John, now 65, told the BBC the memory still upsets him. More than anything, it was the "indignity" his father endured.

"I was there overnight, sitting next to him on a little fold-down chair," he said. "There was no privacy for him if he needed to go to the toilet. They brought one of these screens to pull round him so he could have a wee."

The NHS agrees corridor care is unacceptable.

"We are committed to the total eradication of corridor care, recognising it as a clinical and moral imperative," the NHS said in 2024.

"NHS England considers the delivery of corridor care in departments or wards experiencing patient crowding to be unacceptable and should never be considered standard.

"Patients should only be placed in corridors in extremis and for the shortest possible duration."

Harry spent about 30 hours on a corridor at the Royal Liverpool.

The NHS says corridor care leads to "worse clinical outcomes and poorer experiences for patients, their loved ones, and healthcare staff". Hospitals were urged to collect and report data on the practice.

A report by University Hospitals Liverpool Group (UHLG), due before a Liverpool City Council scrutiny committee later, sets out the problem in stark terms.

The UHLG report says corridor care, once associated mainly with winter pressures, has become "a year-round issue" because of a national 12% to 15% increase in emergency department attendances.

At the Royal site, it says, there are "issues with limited ward beds and the ability to expand in response to surges in activity".

Yet rising admissions are not a new problem. More than a decade ago, the National Audit Office warned that emergency admissions were increasing partly because of the slow development of alternatives to hospital care.

It said the rise was dominated by patients staying fewer than two days and by "an increasingly elderly frail population" more likely to attend A&E and be admitted.

Thirteen years later, NHS data still points to the challenge posed by an ageing population. People aged over 65 account for about 40% of hospital admissions and about 60% of all hospital bed days.

At the same time, delayed discharges have risen sharply. In 2015, 2.7 million bed days were lost to discharge delays. By last year, the figure had exceeded 6.75 million.

Charities including Age UK have pointed to failures to put care packages in place quickly enough for people ready to leave hospital, as well as disputes between councils and the NHS over funding.

The result is that patients who no longer need hospital treatment remain in beds, making it harder to admit others, including elderly patients such as Harry.

The UHLG report states that "corridor care is a visible consequence of system flow failure".

Its data shows that:

• The number of patients at the Royal Liverpool who no longer need to be there is "persistently" about 136 (22.7%)
• At Aintree hospital, the number is 146 (20.3%)
• At Broad Green hospital it is 47 (39%)
• The national average is 11% – 13%

The report says increasing demand, an ageing population, deprivation-related health inequalities and pressure on community services can lengthen hospital stays and reduce bed availability.

"This creates a bottleneck throughout the patient flow pathway, leading to emergency department overcrowding, delayed ambulance handovers and an increased risk of corridor care," it says.

These patients are classed as having NMCR, or No Medical Criteria to Reside. They are often referred to as "bed blockers", a phrase Age UK has said is "tinged with ageism" and should "never be used again", stressing it is not the fault of patients that they remain in hospital.

UHLG says "no single organisation can resolve corridor care in isolation", adding that "community services, mental health providers, housing services and the wider care system all have a role in ensuring patients receive the right care in the right place at the right time".

UK-wide figures from 2023 showed roughly a quarter of patients staying in hospital longer than necessary were waiting for home care support, while about 16% were waiting for a care home place.

About 10,000 people in Liverpool receive long-term adult social care support each year. BBC figures obtained earlier this year showed the cost of providing home care packages has risen from £29m to almost £40m over the past three years.

Liverpool City Council says it has teams based in hospitals to help ensure people are discharged as quickly and safely as possible. However, it recognises many people remain in hospital longer than necessary and is also working to help residents remain independent and avoid hospital admissions.

Housing providers are also becoming involved. The Prima Group has approached more than 200 tenants in Wavertree and Picton, asking them to join a scheme allowing housing information to be shared with Mersey Care NHS Foundation Trust.

The aim is to identify changes that could help people stay healthy at home, such as improved ventilation for those with respiratory conditions or extra grab rails for people unsteady on their feet.

Housing manager Lisa Caldwell said: "Living conditions play a major role in people's health so it is vital that housing and health professionals work together.

"This pilot brings GPs, Integrated Care Teams and neighbourhood housing officers together to better understand tenants' living situations and improve their health and wellbeing.

"This will help us provide early interventions allowing people to stay healthy at home and avoid hospital visits so they are not adding to the high demand for beds."

The NHS Cheshire and Merseyside said: "Corridor care is not the standard of care we want for people in Cheshire and Merseyside."

It said tackling the problem remains a priority and pointed to initiatives including urgent community response teams, virtual wards and neighbourhood-based care aimed at reducing avoidable admissions and improving discharge.

In the end, John Lyness drove his father back to his care home himself rather than wait for an ambulance. Harry died three months later, aged 95.

Since then, the government has committed to increasing health and social care funding by about £2.3bn a year, while Prime Minister Andy Burnham has signalled a major overhaul of adult social care.

For John, the experience reinforced his belief that the NHS needs more funding.

"The hospital staff, you could not fault them," he said. "But he was frail, he was tired, he was upset. For a man of my dad's age, there was just no dignity.

"It was shocking. Shameful, really."

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