Nottingham University Hospitals has fallen behind its plan to end corridor care, with staffing shortages, rising emergency admissions and delays discharging patients slowing improvements.
Papers prepared for the Trust’s board meeting on Thursday 10 September warn that measures introduced so far have not produced the sustained reductions in overcrowding and admission delays needed to meet its timetable.
NUH has committed to eliminating emergency department corridor care by 30 September and ward corridor care by 31 October.
However, its latest update says pressure during the final two weeks of August left both parts of the programme behind their planned progress targets.
“The report records corridor care levels of 28 in the emergency department against a planned level of 15, and 25 on wards against a planned level of 10. Combined, the figures were more than twice the level the Trust had aimed to reach.”
The report states: “The programme is currently behind plan against the ED and ward trajectories through specific constraints occurring in month.”
Corridor care involves patients receiving care outside normal treatment or bed spaces while waiting for suitable accommodation to become available.
The report identifies lower staffing numbers across key services as one reason for the shortfall, saying this restricted how much capacity could safely open and reduced the Trust’s flexibility in responding to demand.
Higher numbers of patients arriving by ambulance and requiring emergency admission increased pressure on inpatient beds. High occupancy and difficulties discharging patients then limited how quickly beds could become available.
Five periods of significant hot weather also added to demand, the complexity of patients’ needs and pressure on services.
The report says: “Programme activity has not yet translated into the sustained reduction in demand, occupancy, admission delays and corridor utilisation originally anticipated.”
NUH had aimed to recover to its planned progress targets by 4 September. The papers do not confirm whether that was achieved, leaving an important point for the board to address when it meets.
Although the programme is behind schedule, neither deadline for eliminating corridor care has yet passed.
The report describes discharge performance as the most important factor in reducing corridor care and says it is slightly behind plan. The number of patients ready to move from assessment areas to wards also remains above the level needed to keep the emergency department operating effectively.
NUH says its immediate priorities include improving discharge arrangements, reducing the length of hospital stays, increasing consultant reviews and ensuring specialties take clearer responsibility for patients.
The September recovery effort also depends on whether its general internal medicine service and changes to ambulance referral arrangements produce quicker movement through hospital beds and shorter waits in assessment areas.
Separate performance figures in the board papers show that emergency care remained under pressure in July.
Performance against the four-hour standard improved slightly from 66.7 per cent in June to 67.4 per cent in July, but remained behind the Trust’s plan.
The proportion of emergency department stays lasting more than 12 hours fell from 22.6 per cent to 19.5 per cent. That was still above the monthly planned level of 14.5 per cent.
NUH had continued to use additional beds opened during winter to help manage demand.
The corridor care report acknowledges that some milestones have been delivered, but says the next task is to turn those changes into measurable reductions in waiting and overcrowding.
