Corridor care in emergency departments (EDs) remains a contentious issue, with the Royal College of Nursing (RCN) calling for its elimination. While acknowledging its challenges, we argue that corridor care, when managed appropriately, plays a vital role in patient flow and safety. Removing it without viable alternatives risks worsening ambulance delays and increasing ED pressures. Rather than outright abolition, policymakers must focus on improving best practices to ensure patient dignity while addressing systemic issues such as workforce shortages and overcrowding. Sustainable long-term investment is essential, but interim solutions must also support both patient care and staff wellbeing.
On 10 January 2025, the RCN joined a coalition of trade unions, professional bodies, charities, and patient groups in writing to the Secretary of State for Health and Social Care, calling for an end to corridor care (RCN, 2025). This follows the challenges highlighted in the RCN's report, Corridor Care: Unsafe, Undignified, Unacceptable (RCN, 2024). We, the authors, fully agree that the practice of corridor care is far from ideal and must be addressed. However, the RCN's call for its eradication overlooks the complex reality of ED operations and, paradoxically, may introduce even greater risks.
The role of corridor care
The current state of corridor care, although suboptimal, plays a critical role in managing patient flow within overstretched EDs. Patients in corridors are often seen by multiple health professionals and can be more closely monitored by nursing staff who can quickly respond to any signs of deterioration. Patients who are placed in corridors are being taken from the back of ambulances or the waiting room and once in the corridor they will often have better access to food and drink. For patients who are at risk of falls, the visibility provided by corridor placement can enhance their safety compared with being isolated in a side room.
Terminating corridor care would have a detrimental impact on ambulance offloading times. Eliminating corridor care without a feasible alternative could result in significant delays, forcing patients to be treated in ambulances for extended periods. Delayed offloading has already been identified as a major stressor for ED staff and detrimental to patient outcomes (Dawson et al, 2022).
The RCN's report rightly points out the demoralising effects on staff who are compelled to deliver care in such conditions, where the standard of care does not meet their professional expectations. However, the suggestion that abolishing corridor care would alleviate these pressures is overly simplistic. The reality is that doing so would likely exacerbate already extensive ED waiting times.
A pragmatic approach
We strongly oppose conducting clinical interventions, such as examinations or discussing results, in corridors, as these practices compromise patient dignity and confidentiality and should never be normalised. However, even if every ED were redesigned to provide private rooms for all patients, it would not address the core issues of overcrowding and limited resources. A more practical approach would be to rotate patients into private rooms as needed for examinations or discussions, then return them to corridor areas. This ties in with the NHS Improvement (2019)Fit2Sit resource, and can help maintain both privacy and safety while optimising the use of available space. The Royal College of Emergency Medicine (2024) suggests that identifying a ‘fit to sit’ cohort is a key priority during periods of overcrowding.
If any other public space experiences overcrowding (eg, a tube station), then, on safety grounds, it is closed. However, when EDs become overcrowded, there isn't the option to stop urgent and emergency care. Instead, staff must develop workarounds.
Although the RCN's recommendations for addressing the workforce crisis and enshrining nurse-to-patient ratios into law are crucial long-term solutions, they are not quick fixes. In the interim, we must acknowledge that corridor care, when managed appropriately, has a place in our current system. To dismiss it entirely, without considering the full spectrum of its impact, risks further demoralising an already overburdened workforce and diminishing the quality of patient care.
The RCN must recognise the significant mental health toll on nurses, who are increasingly demoralised by their inability to provide the level of care they aspire to. We do not wish to normalise corridor care, but there is a need for systemic change across complex organisations. This will require long-term, sustainable funding alongside dedicated policymaking, which we acknowledge will not be a quick fix. In the meantime, to help protect staff morale and maintain patient safety, there is perhaps a more pressing need for policymakers, trade unions, professional bodies, and patient groups to develop best practice guidance on how to deliver corridor care with as much privacy and dignity as possible. It is also crucial to remind frontline staff that the work they do, in incredibly difficult circumstances, is recognised, respected, and valued.