Corridor care guidance needs to move beyond what “should” happen and grapple honestly with why it isn’t (a blog by Claire Cox)

Summary

Corridor care is a term used to describe the practice of providing medical attention to patients in hallways or other non-designated clinical areas due to overcrowding or resource shortages. In a series of blogs on the hub, we have been highlighting some of the key patient safety issues surrounding corridor care.

On the 11 December 2025, NHS England published new guidance Principles for providing patient care in corridors. This replaced the previous guidance published last September, which spoke about providing safe and good quality care in “temporary escalation spaces”. The new guidance aims to support point-of-care staff in delivering the safest possible care when corridor care has been deemed unavoidable.

In this blog, Patient Safety Learning’s Associate Director and nurse, Claire Cox reflects on this guidance and sets out the need for national action to tackle this persistent problem.

Content

At the very least, we should welcome the retirement of that Orwellian phrase “temporary escalation space”. This was a linguistic sleight of hand that softened the reality of what was actually happening. Calling it corridor care is more honest, even if honesty alone does not make it safer.

The new guidance also includes some welcome elements:

• It explicitly states that corridor care is unacceptable and must not be normalised.
• It recognises the risk of harm and references analyses from the Royal College of Nursing and Royal College of Emergency Medicine. They have been clear for some time about the dangers to patients and staff alike.
• It talks about dignity, safety, leadership oversight, escalation, and governance.

However, despite these positive additions, this guidance is a near-perfect example of “work as imagined rather than work as done”.

It is full of “shoulds”. Care should be to the same standard as on wards. Corridor care should only ever be used in absolute emergencies. Boards should have oversight. Staff should be supported. Patient safety should be paramount.

Of course it should. No one working in the NHS disagrees with any of that.

The problem is that what is being described simply does not reflect reality.

The gap between policy and practice

The guidance features a list of patient groups who must never be cared for in a corridor, including but not limited to:

• Patients who are severely frail.
• Patients with physical disabilities.
• Patients who have dementia, confusion or delirium.
• Any patient with a high National Early Warning Score (NEWS) scores. NEWS is a standardised tool for recording and score changes to acutely ill patients.

However, many patients who fall into these groups are often the core demographic of emergency departments (EDs).

EDs are full of elderly, frail, confused, high-acuity patients. To say they must never be in corridors is to fundamentally misunderstand the pressure profile of modern emergency care.

The new guidance also states that corridor care should only ever be used in “absolute emergencies”. If you speak to frontline staff working in EDs in England currently, that description has applied almost every day for the past 18 months. When the exceptional becomes routine, the language collapses under the weight of reality.

The guidance insists that corridor care must not be normalised. Staff already know this. They have known it for years. They don’t need to be told again that this is unsafe, undignified, and wrong. They live that truth every shift.

What they need is help to stop it happening.

Standards without means are not solutions

The document includes a number of principles for “ensuring patients receive the same standard of care as those in allocated in clinical spaces”. However, by its very nature, asking staff to deliver ward-level standards of care in these environments is intrinsically impossible. Privacy, infection control, observation, documentation, safe staffing, patient dignity - all of these are harder, and some are fundamentally compromised, in corridors by design.

Yes, more can always be done locally to mitigate harm. But this guidance does not meaningfully explain how to fix the problem. There is nothing substantial on capacity, flow, delayed discharges, social care failure, or the structural mismatch between demand and beds.

There is no roadmap, no accountability for system-level causes, and no recognition that corridor care is not a behavioural failure by trusts or staff, but a predictable outcome of prolonged system saturation.

Instead, the centre appears to be “doing something” by issuing guidance. Setting expectations that cannot be fully met, while the risk and moral burden remain with staff providing frontline services and their organisational leaders.

The risk of moral injury

There is a real danger here. When guidance describes an idealised version of care that staff cannot deliver despite their best efforts, it doesn’t improve safety - it deepens moral injury. It tells people they are failing, even when the system has already failed them and their patients.

Being clear that corridor care is unacceptable is important. Being honest about harm is important.

But clarity without solutions is not leadership.

Naming the problem is not the same as fixing It

Retiring the temporary escalation space label is progress. Acknowledging patient harm is progress. But progress stops short when there is no serious engagement with the underlying causes. Or a credible plan to eliminate corridor care rather than simply restate that it should not exist.

Corridor care is not happening because staff don’t understand the principles. It is happening because the system has run out of space, time, and slack.

To have a significant impact, guidance such as this needs to move beyond what should happen and grapple honestly with why it isn’t.

Otherwise documents like this will remain well-intentioned, rhetorically correct - but offer little practical help to staff working on the frontline.

What meaningful national action could look like

If corridor care is truly unacceptable, national action must go beyond issuing guidance that simply restates what is already well understood. Corridor care is not a local failure of standards or leadership; it is the predictable consequence of a system that has been operating beyond capacity for years.

Meaningful action requires honesty about the underlying causes: insufficient staffed beds, delayed discharge, fragile social care, and blocked patient flow.

It also means aligning regulation with operational reality, rather than condemning corridor care while tacitly accepting the conditions that make it inevitable.

Above all, this requires decisive action on capacity across acute beds, primary care, community provision, social care, the independent sector, and ambulance services, combined with genuine collaboration and co-design across the whole system - including Integrated Care Boards, trusts, providers, and the public. Local leaders must work together to share effective approaches for mitigating risk, reducing the need for corridor care, and designing services that are safe, responsive, and sustainable.

Guidance can describe what good looks like. Only national leadership, working in partnership with local systems, primary care, ambulance trusts, the independent sector, and the public, can create the conditions in which it may be possible.

(Photo is a head and shoulders image of Claire Cox looking at the camera, wearing her nursing uniform)

Related reading

• How corridor care in the NHS is affecting safety culture (A blog by Claire Cox, 27 January 2025)
• The crisis of corridor care in the NHS: patient safety concerns and incident reporting (A blog by Clare Wade, 6 February 2025)
• Corridor care: are the health and safety risks being addressed? (A blog by Claire Cox, 24 April 2025)

Share your experience

Do you have experience of corridor care either as a patient or a healthcare professional?

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