The NHS’s initiative to eliminate corridor care in emergency departments has raised concerns among ambulance leaders about potential unintended consequences, including patients being held in ambulance car parks for extended periods. Jason Killens, chairman of the Association of Ambulance Chief Executives (AACE) and chief executive of the London Ambulance Service, cautioned that efforts to clear corridors without addressing broader hospital flow issues risk shifting delays from one area to another, potentially putting patients and paramedics in greater jeopardy.
The government has committed to ending corridor care by the end of this parliamentary term, aiming to reduce the risks faced by patients left on trolleys in crowded Emergency Departments (EDs). However, Killens stressed that while corridor care is neither dignified nor ideal, leaving patients waiting for long periods inside ambulances parked outside hospitals may present a more serious threat, particularly for vulnerable individuals in the community awaiting emergency response.
“Corridors are not a dignified place to care for a patient. Equally, nor is the back of an ambulance in a car park,” Killens said. He emphasized the need for improved patient flow across the entire hospital system to prevent bottlenecks not only in ED corridors but also within hospital wards and ambulance handover areas.
Research from AACE indicates that over 23,000 patients each month are at risk of harm due to handover delays exceeding one hour. According to Killens, these delays mean that some 999 patients, often frail elderly or otherwise vulnerable individuals, may be left without timely emergency care for extended periods before an ambulance arrives.
Concerns about “car park care” have also been raised by West Midlands Ambulance Service (WMAS), which has seen some of the longest handover delays in the country. Internal communications and board meeting records reveal that ambulances have been used as de facto hospital cubicles during periods of severe congestion, as trusts seek to reduce corridor waiting times, sometimes at the expense of ambulance availability for new emergency calls.
In January, WMAS reported over 3,500 instances of ambulances being delayed outside hospitals, making it the most affected region nationally. Officials warned in board meetings that this practice increases the risk of patient harm, with some patients effectively stranded in ambulances rather than receiving prompt hospital treatment.
The issue has been a focus of WMAS’s ongoing efforts to address handover delays in collaboration with hospital partners. A WMAS spokesperson acknowledged handover delays remain a significant challenge but affirmed their support for ending corridor care. “We fully support efforts to eliminate corridor care, but improvements in patient flow must reduce delays throughout the system rather than result in more patients waiting to be handed over in ambulances outside hospital,” the spokesperson said.
As hospitals face increasing pressure to meet corridor care targets, ambulance services warn that without system-wide improvements, patients may simply be displaced from one form of inadequate care environment to another, with ambulance crews caught in the middle.