A north London hospital has sparked conversation following advertising for a corridor nurse.
The corridor nurse would be responsible for caring for patients waiting for space in a room to be available.
This practice is not new, but with the busiest winter flu season on record according to NHS England, hospital care has been under dangerously high pressure.
Reports have shown patients are being treated along corridors and even by fire exits.
In response to the attention that this recent job advertisement has been getting, the Royal College of Nursing wrote an open letter to the Secretary of State for Health and Social Care of the UK, Wes Streeting.
The joint letter with organisations like the British Medical Association emphasised the negative effects of this emergency practice and called for transparency.
The letter stated:
“For staff, this means being forced to deliver compromised care, unable to access oxygen, suction or even plug sockets. This causes moral distress and ultimately, moral injury.”
“For patients, it puts them in danger, out of the sight of staff and out of the reach of emergency call bells. It represents a serious deprivation of privacy and dignity.”
What is a TES?
Though “corridor care” is the term being used in this discussion, the technical term that is often used is temporary escalation spaces (TES).
In September 2024, NHS England published a report called “Principles for providing safe and good quality care in temporary escalation spaces”.
The report said that these TESs are being used more regularly and are no longer used “in extremis”.
How can improving the NHS' technology help?
Obviously eliminating the need for TES usage is the long term solution.
However, the healthcare industry must use every resource available to address the capacity issues that cause corridor care.
Reducing admissions: Increasing the hospital space and staff numbers is an obvious avenue to address this. But efforts to reduce the number of people that require higher level care is an equally as important.
Managing Director of AI software company C2-Ai, Dr Mark Ratnarajah, commented: “Responding to the downstream consequences and safety implications associated with treating patients in temporary areas like corridors is absolutely right. But it is also important that the conversation at system level focuses on mitigation of risk and managing demand in order to reduce the need for ‘corridor care’.”
Overall he thinks technology has a huge part to play in the solution, and “already is”.
“We have witnessed NHS organisations deliver measurable reductions in A&E presentations, by better understanding and unearthing individual risk at scale,” he explained.
Ratnarajah further explained that mapping which patients on elective waiting lists are at greatest risk of deterioration, as well as their modifiable risk factors and dependencies, can inform system level resourcing and response.
“This provides a significant opportunity to reduce unplanned admissions, the impact on emergency care, as well as the serious safety, privacy and dignity challenges associated with treating patients on corridors,” he said.
“The three core pillars, set out by the Secretary of State, can have a meaningful impact if put into practice: utilising data and digitisation, moving care and supporting patients into the community in targeted ways, and enabling prevention rather than reaction. Those capabilities exist and it’s now for government and ICBs to learn from best practice and scale pathways that can make a difference.”
Investing in flow and virtual care technology that integrates across ambulance trusts, EPRs and into community settings, could go some way to helping
Patient flow: In addition to reducing admission, creating efficiency in the patient flow through the patient journey can reduce unnecessary burdens on health providers.
Speaking to Dr Paul Deffley, Chief Medical Officer for Alcidion, he emphasised the importance of this factor.
At Alcidion, Deffley helps to build interoperable digital ecosystems for clinical services. He thinks that these real-time, integrated digital flow tools can be a significant factor in ensuring patients are cared for in the most appropriate environment.
Specifically, the executive thinks it can “preserve patient flow, and provide visibility of patient movements and available capacity.”
"Virtual care has been one response to alleviating pressure on busy acute environments,” Deffley said. “But there is now a requirement to move beyond standalone virtual care platforms, often hindered by integration challenges with clinical workflows, and that therefore limit the acute hospital team to manage a cohort of patients safely in virtual care settings.”
"Investing in flow and virtual care technology that integrates across ambulance trusts, EPRs and into community settings, could go some way to helping, and could help to unlock system-wide ability to manage demand across all settings, reducing the risk of the headlines we have been seeing for some weeks.”
Deffley also highlights the need for appropriate scaling adoption of this technology to enable Trusts and the NHS as a whole to optimise its use.