Patients treated on corridors and waiting hours for treatment, says RCN

Published: 13 May 2012

Patients are being placed on hospital trolleys for hours on end and treated in corridors unsuitable for care, the Royal College of Nursing warned today, as it published results from a new ICM Research survey revealing the current state of the NHS frontline.

A survey of more than 1,200 nurses and health care assistants working in acute settings – including almost 100 in the West Midlands – raises questions about capacity in some hospitals.

One fifth of respondents in the West Midlands (20 percent) say patients receive care in corridors or areas not designated for patient care at least once a day, with a further 15 percent saying it happens weekly.

And nearly three quarters (74 percent) feel patients’ safety is compromised when they are kept in these areas.

The RCN is today calling for NHS organisations to halt the closure of hospital beds until they can clearly demonstrate that alternative, tried and tested, patient services in the community are up and running. In the last decade (2001-2011) in England, the average daily availability of general and acute hospital beds fell by 22 percent, with Trusts often cutting beds for financial reasons, despite soaring demand and an ageing population.  In the same period A&E attendances have increased by 60 percent and the number of emergency admissions has risen by 56 percent.

RCN Director in the West Midlands, Paul Vaughan, said: "This survey paints a worrying picture of what is happening in our hospitals. Two years ago we warned that the need to make £20 billion in efficiency savings in England alone would risk sending the NHS back to the days of treating patients in corridors or areas not designed for care. Sadly, it looks like those days have now returned.

"We know that there is huge demand in A&Es and that it is growing at a substantial rate. However, this sort of situation is not only unacceptable from a patient experience and safety point of view, but causes great distress to families, carers and nursing staff."

Other key findings from the survey reveal serious concerns about the length of time patients are being forced to wait, the use of temporary wards, and how patients are treated. The findings show:

• 17 percent of nurses in the West Midlands report that patients are kept in ambulances or held in a queue outside their intended department on a daily basis because of a lack of trolleys and beds;
• Almost half of nurses (45 percent) in the West Midlands have encountered patients being cared for or being asked to wait on trolleys for long periods in the last six months. Of these, 30 percent said patients were on trolleys for between four and eight hours;
• 45 percent in the region also said they witness patients being moved to wards not suited to their condition on a daily basis;
• More than a third of nurses (37 percent) in the West Midlands witness patients being moved every day for non-clinical reasons, ie to meet targets.

In addition to addressing bed closures, NHS organisations should develop a much greater understanding of pressure points in the system and better manage the changes in demand across the system. They must also provide safe staffing levels across all sectors. In November, the RCN identified that 56,000 NHS posts across the UK have been lost, or are earmarked to disappear, with many posts remaining unfilled across all parts of the health service.

Mr Vaughan added: "Treating patients on corridors or areas not designed for care is a high risk strategy, which can have a serious impact on patient care. Patients need to be able to interact with staff, to be able to reach call bells and to know they are visible. They also need regular monitoring and easy access to equipment if their condition deteriorates.

"Patients need to have their privacy and dignity protected. It is extremely disappointing that in this day and age they cannot rely on receiving this care."

Today’s survey also highlights the huge stress frontline workers are currently under. Almost a quarter of respondents in the West Midlands (22 percent) felt intolerable pressure was being placed on staff, with a total of 82 percent saying the current level of pressure was either not very manageable or not manageable at all.