This is an emergency- we cannot tolerate the normalisation of NHS ‘corridor care’.

Call To Action

An article was posted around midnight last night by The Sunday Times, and it’s a piece that has hit me very hard. The story has now been picked up by lots of other media outlets, and as The Independent has written:

“A hospital has posted adverts calling for nurses to take on 12-hour ‘corridor care’ shifts amid ‘very significant pressure’ in its A&E department … Whittington Hospital in Archway, north London, posted bank shifts available for A&E nurses which said “corridor care” in the notes, The Sunday Times reported … It comes as several NHS trusts declared critical incidents because of sustained pressure in A&E departments, with people being treated in corridors and a patient at one hospital forced to wait 50 hours to be admitted to a ward.”

This news has hit me hard because of my personal experiences of the Whittington, or the Whitt, as everyone I know calls it. I went to medical school in London, at UCL, and the Whitt was one of the core hospitals where we received training. The Whitt is where I learned how to do a respiratory examination, where I did my first night shift shadowing a team of doctors. It’s where I sat through infectious disease tutorials, and studied in the lovely quiet library which was always well-stocked and well-staffed. The canteen there was big and sold cheap food, and we used to sit as medical students with the senior doctors on our team at lunch time (because back then, lunch breaks existed), asking them questions about the work we would do in the future, and soaking in the rich atmosphere which medicine can provide when it functions properly.

The Whittington was never perfect, because no NHS hospital is. It’s awkwardly laid out, with old bits and new bits tacked together like a patchwork. I can still, if I close my eyes, remember the specific feel of the Whittington’s lino under my feet, the squeak and give of floors which were a bit uneven and a bit worn in places. But The Whitt felt special back then. It was well-run, it had excellent senior doctors, it was organised and efficient and the patient care was considered excellent. I hoped to return one day myself, and I did that after I’d been working as a doctor for about 5 years.

It was the first hospital where I worked in liaison psychiatry, caring for hospital patients who had mental health problems. A lot of my formative memories of psychiatry, the cases where you’re really tested as a resident doctor, happened at the Whitt. I remember the patient we cared for in intensive care, who had been very distressed and agitated, to the point that they’d had to be sedated. I remember an elderly patient with dementia who wanted to leave the ward, and watching as my consultant navigated the situation with grace, listening to her family and providing excellent care. I remember long night shifts in the A&E department as the junior doctor on call, assessing patients who felt unsafe, who had been brought in by police, who required emergency attention. When I think about the places that shaped me as a doctor, the Whitt is top of my mind. It was a really special place. To read that the care within that hospital has descended to a place where “corridor care” is deemed acceptable for patients is both horrifying and heartbreaking.

I doubt there are many relaxed lunchtime conversations now between senior doctors and medical students, to help them to learn. I doubt that many of the resident doctors have the time to take the students patiently through a respiratory examination multiple times, as mine did for me. I doubt that there’s much time for anything. I dread to think how things feel for the A and E doctors sitting in the very same chair in which I sat, with the same view, holding the same responsibility for their patients. It doesn’t bear thinking about. And yet it must be thought about; it must be thought about, and I can think about little else right now. I have been ruminating all morning about that article, and the context of that article, and the profound failure with which Wes Streeting and Keir Starmer are managing this truly awful situation. The NHS is in a state of absolute emergency, and they cannot claim that it has come from nowhere.

Politicians cannot claim that this was unexpected, unanticipated, or that favourite phrase of politicians in recent years: unprecedented. This situation is predictable and indeed has been predicted by many experts, experts who have been ignored again and again. The Royal College of Emergency Medicine (RCEM) have made valiant efforts to speak up and raise the alarm over the past couple of years. On the first day of 2023, we faced a similar situation to the utter emergency facing the NHS right now, and they told the press how severe the problems were (iNews covered it like this):

“Up to 500 patients die weekly due to emergency care delays in NHS, warns top A&E doctor”

RCEM followed this up with further warnings in the Summer of 2023 and data in the Spring of 2024, with an “explainer” (well-worth reading here), which contains this chilling quote:

“There is considerable scientific evidence to show that delays to care and long waits in admission to hospital increase a patient’s risk of harm and death, even after leaving an ED. A large observational study of more than five million NHS patients showed an increase in all-cause 30-day mortality, adjusted for age and co-morbidity. This quantified the harm, demonstrating that there was one additional (excess) death for every 72 patients that spend 8-12 hours in the ED.”

Sometimes in politics, bad decisions are made because there’s a lack of evidence about the correct course of action. Politicians often use confusion or grey areas as cover for very bad political decisions. But there’s no excuse when it comes to NHS emergency services. The facts are laid out, and yet have been wilfully ignored. Some have become complacent since Labour took office, assuming that problems would be tackled, but not the Royal College of Emergency Medicine. They spoke up after the autumn budget with their concerns about a lack of adequate provision within the budget to resource emergency services, they’ve kept going, and today they have published the results of a shocking new survey of doctors working in emergency departments on their website, which showed a terrifying lack of resilience in our A&E departments…