The crisis of corridor care in the NHS: patient safety concerns and incident reporting

Summary

In this blog, Patient Safety Learning’s Director Clare Wade reflects on the challenges that growing prevalence of corridor care poses to reporting and acting on patient safety concerns in the NHS.

Content

As highlighted by Lord Darzi’s independent investigation into the state of the NHS in September, the health service in the UK is currently facing unsustainable pressure accompanied by a range of critical challenges.[1] One of the most alarming indicators of this pressure is the rise and growing prevalence of 'corridor care'.

Corridor care refers to patients receiving treatment in hospital corridors, cupboards and other unsuitable spaces due to bed shortages and overwhelming demand. These are referred to formally by NHS England as ‘temporary escalation spaces’.[2] While this practice aims to provide some level of care amidst resource constraints, it raises significant concerns about patient safety, dignity and quality of care.

Recent reports have highlighted how corridor care is becoming increasingly common. In On the frontline of the UK’s corridor care crisis published last month, the Royal College of Nursing (RCN) highlighted from a survey of its members that nearly 70% of nursing staff deliver care in unsuitable spaces such as corridors, and over 90% believe this compromises patient safety.[3] Some hospitals, including Whittington Hospital in North London, have even advertised for 'corridor nurses' to manage patients in these overflow areas, where basic amenities like oxygen and power outlets are hastily installed.[4]

Implications for patient safety

As we set out in more detail in a blog published last month on the extent of corridor care in the UK,[5] this practice of corridor care poses numerous patient risks, including:

• Delayed treatment: Patients in corridors often face delays in receiving timely interventions as these areas lack proper infrastructure for urgent care.
• Inadequate monitoring: Without essential monitoring equipment and privacy, the early detection of patient deterioration is less likely.
• Compromised infection control: Corridors are high-traffic zones, making it harder to maintain proper hygiene and prevent hospital-acquired infections.

The systemic and operational challenges posed by corridor care can also significantly undermine safety culture at an organisation, as set out in more detail in a recent blog by my colleague Claire Cox.[6]

Patient safety incident reporting in the NHS

In the face of such risks, it is essential that we have robust systems for reporting events or situations that potentially harm, or could harm, patients while they are receiving care.  

NHS England has recently introduced a new service for recording and analysing patient safety incidents in England. The Learn from Patient Safety Events (LfPSE) service replaces the previous National Reporting and Learning System and is intended to improve patient safety incident reporting in the NHS. Stating how it will do this, NHS England says that when it is fully functional it will:

• Make it easier for staff across all healthcare settings to record safety events, with automated uploads from local systems to save time and effort, and introduce new tools for non-hospital care where reporting levels have historically been lower.
• Collect information that is better suited to learning for improvement than what is currently gathered by existing systems.
• Make data on safety events easier to access, to support local and specialty-specific improvement work.
• Utilise new technology to support higher quality and more timely data, machine learning, and provide better feedback for staff and organisations.[7]

LfPSE has now been rolled out across most of the NHS. However, the way in which this system works, coupled with the conditions created by corridor care, can present significant challenges to reporting and learning from patient safety risks associated with corridor care.

Reporting rates

At Patient Safety Learning we have heard concerns from frontline staff that significant time pressures can deter them from submitting incident reports. When working in less than ideal conditions such as delivering corridor care, this is further exacerbated. Staff who face significant additional time pressures that accompany monitoring and caring for patients in non-standard spaces can simply have less time and capacity to report incidents.

Focus on digital systems

LfPSE depends heavily on digital tools for incident reporting. For some organisations this can still be a barrier to their use as they continue to work with outdated IT infrastructure. These infrastructure limitations impact in a range of areas, one of which can be the accessibility and ability to capture incidents comprehensively using the new LfPSE service. This is another issue amplified when working in overcrowded and chaotic environments like corridors, where staff may not have easy access to appropriate IT.

Lack of timely feedback

Some healthcare staff told us that feedback from LfPSE can be delayed or absent altogether. Without timely insights, the potential for learning and improvement diminishes, and staff may be less likely to report issues if they don’t see evidence of concerns being acted on.

Sharing learning

Sharing learning from patient safety incidents is a fundamental component of improving patient safety and delivering safe care. However, at Patient Safety Learning we have concerns that LfPSE lacks effective mechanisms for disseminating the learning derived from reported incidents. Currently, LfPSE data is not made readily available for analysis. Trusts can see reports of their own data (which they already have access to) but not system-wide information to help them assess risk or engage with others. 

This can create a siloed approach where individual trusts or departments may benefit from their data but fail to contribute to a wider culture of safety improvement. For example, in the context of corridor care, incidents such as missed deteriorations or infection outbreaks may provide valuable lessons but, without NHS-wide sharing of this information, other organisations are unable to implement preventive measures.

Underrepresentation of corridor care data

Many corridor care incidents may be unreported or under-reported, as they often occur in makeshift spaces outside formal wards or departments. This creates a gap in the data and limits the system’s ability to address specific risks associated with such practices. At present, there appears to be no formalised mechanism to capture data from healthcare providers specifically highlighting ‘corridor care’ as a contributory factor to an increased risk of or actual patient harm.

NHS England have recently announced that they will now require trusts to report on the number of patients who receive care in ‘temporary escalation spaces’.[4] To date, this data has not been made available so we are unaware of the true frequency of corridor care, where the ‘hot spots’ are or how long patients are being cared for in a corridor/escalation area.

Cultural barriers

There is a significant body of evidence, ranging from staff survey results to whistleblower testimonies, highlighting the wider problem of the persistence of blame cultures and a fear of speaking up in parts of the NHS.[8] [9] This is particularly true in high-pressure settings like corridors, where staff may feel they are being judged for circumstances beyond their control. Given the significant media focus on this issue, staff may feel reluctant to speak up, fearing a negative response from the trust worried about the reputational impact of reported concerns.

Addressing the challenges

There are clearly a number of challenges associated with reporting, learning from and acting on patient safety risks and incidents associated with corridor care.

Reporting corridor care incidents needs to improve, which could involve introducing specific reporting categories to help identify and address systemic issues more effectively. Also, actively encouraging staff to share their insights to enable trusts and the wider healthcare system to better understand the nature and scale of risk to patient’s safety would be beneficial.

There are also a number of wider system issues that need to be considered:

• Improved sharing of learning: The NHS must establish robust mechanisms for sharing insights from LfPSE data, ensuring that safety lessons from one trust are accessible more widely across the organisation. National safety alerts or learning forums could support this initiative.
• Support for staff and patients/families: Equipping staff/patients/families with the skills and confidence to report incidents without fear of blame is essential.
• Investment in IT infrastructure: Upgrading digital systems across NHS trusts will ensure the LfPSE is accessible and efficient, allowing staff providing corridor care to easily use the IT to report to LfPSE.
• Real-time feedback mechanisms: Providing timely analysis and feedback to staff will reinforce the value of reporting and enable immediate improvements.
• Using the safety science tools being promoted in PSIRF: Undertaking thematic analysis and observations of corridor care to identify the reality of ‘work as done’, including:
  – the risks of unsafe care
  – the contributory factors to these risks (task, environment, process factors, etc)
  – the potential opportunities for immediate improvement
  – sharing these insights across the healthcare system as a matter of urgency. Trusts should be made aware of colleagues who are developing good practice to mitigate risks to patients and to enable them to implement in their environments.
• Focus on systemic solutions: Policy reforms must address resource allocation, especially around primary care, bed management and alternative care pathways to reduce reliance on corridor care.

The combination of corridor care and the limitations of the LfPSE underscores the urgent need for systemic change within the NHS. While the LfPSE is a promising tool for learning from safety events, its full potential will only be realised if these shortcomings are addressed. By prioritising the sharing of learning, fostering a culture of transparency, investing in resources and refining reporting systems, the NHS can take a vital step towards safeguarding patient safety and dignity in even the most challenging circumstances.

References

1. The Rt Hon. Professor the Lord Darzi of Denham. Independent Investigation of the National Health Service in England, 12 September 2024.
2. NHS England. Principles for providing safe and good quality care in temporary escalation spaces, 17 September 2024.
3. Royal College of Nursing. On the frontline of the UK’s corridor care crisis, 16 January 2025.
4. Lintern S, Wheeler C. Hospital advertises for ‘corridor care’ nurses to ease NHS crisis. The Times, 11 January 2025.
5. Patient Safety Learning. Response to RCN report: on the frontline of the UK’s corridor care crisis, 17 January 2025.
6. Claire Cox. How corridor care in the NHS is affecting safety culture: A blog by Claire Cox. Patient Safety Learning, 27 January 2025.
7. NHS England. Learn from patient safety events (LFPSE) service, Last accessed 27 January 2025.
8. Patient Safety Learning. We are not getting safer: Patient safety and the NHS staff survey results, 26 March 2024.
9. Peter Duffy and Helen Hughes. Speaking up for patient safety: A new interview series about raising concerns and whistleblowing. Patient Safety Learning, 15 January 2025.