Your browser is no longer supported

For the best possible experience using our website we recommend you upgrade to a newer version or another browser.

Your browser appears to have cookies disabled. For the best experience of this website, please enable cookies in your browser

We'll assume we have your consent to use cookies, for example so you won't need to log in each time you visit our site.
Learn more

Patients safer on trolleys in wards than in A&E

  • 38 Comments

Patients should be moved to trolleys in ward corridors to wait for a bed to become free rather than wait in overcrowded accident and emergency departments, according to the College of Emergency Medicine.

The advice from the college states that although the practice of “boarding” patients in this way is controversial, it is the safest way of dealing with current capacity problems in some hospitals.

Department of Health figures show the number of patients waiting more than four hours for a bed is increasing year on year.

Between July and September 2011, 21,000 patients waited more than four hours for a bed once the decision to admit had been taken. This compared to 16,260 during the same period the previous year. This is an increase from 1.9% of emergency admissions to type 1 A&E departments to 2.4%.

In the four weeks to 8 April, 7,878 patients waited between four and 12 hours for a bed.

The College of Emergency Medicine guidance says while there is substantial evidence patients are harmed waiting in overcrowded emergency departments or ambulances there is no evidence of harm to patients through waiting on wards.

It states: “The harm of having un-assessed patients in ambulances is greater than the harm of boarding patients who have been assessed by a doctor on their destination ward.”

The guidance stipulates no more than one patient should be boarding on each ward and patients should be “stable, orientated and not receiving active treatment or require monitoring”.

However, college vice president Dr Taj Hassan said it was not a permanent solution.

“The College of Emergency Medicine supports the ‘boarding’ of patients in the corridors of wards until they can be admitted.  However, this measure should be regarded as temporary until system design can ensure that all patients who leave the ED are found an appropriate hospital bed to meet their needs rather than applying a boarding strategy.

“We continue to work closely with the Department of Health on optimising system design for trusts delivering emergency care and are dedicated to ensuring patients receive the excellent care they expect and deserve.”

  • 38 Comments

Readers' comments (38)

  • No, many reasons why. The ward corridors are narrow, already congested by doctors notes trolleys, cleaners equipment, linen trolley, even dare I say patients on their frames going to the bathroom, not to mention our confused patients wandering around already a falls risk.
    The ward staff are already overstretched once the patients are on the corridors they would be ward responsibilty we wouldn't see an emergency nurse as they will be too busy in their own department, and an emergency doctor would want the ward doctor to take over care.
    The more I think about it the more I think a disaster waiting to happen.

    Unsuitable or offensive? Report this comment

  • "The guidance stipulates no more than one patient should be boarding on each ward and patients should be “stable, orientated and not receiving active treatment or require monitoring”."

    And we all know how well GUIDANCE works, don't we?! Give them an inch......! If the patient is 'stable, orientated and not receiving active treatment or require monitoring', they would most likely be safer at home than in a hospital corridor with no one looking after them. But of course, it wouldn't just be one stable, orientated patient, would it?

    It is a totally ridiculous and unworkable idea. Shift the responsibilty from A&E onto the already overstretched ward staff. We all know how this will end up. (I write this as an A&E nurse of many years).

    Anonymous | 20-Apr-2012 7:04 am

    You are right. This would be disasterous.

    Unsuitable or offensive? Report this comment

  • Anonymous | 20-Apr-2012 7:04 am

    Anonymous | 20-Apr-2012 8:00 am

    I agree with both of you completely it would be a disater. Wards as you say are already overstreched and crowded but hey what is one or or three more patients?

    I could see more complaints

    My relative was on a trolly for so many hours on such and such ward, they didn't receive good care, the weren't give enough drinks, staff did.nt ensure meals were given ect ect do need t go on???


    Unsuitable or offensive? Report this comment

  • hospitals should be capable of more accurate estimation of matching number of beds and staffing to meet demands. It is a scandal trying to save money by compromising the safety, comforts and standards of care and health and safety of staff.

    In case management still fail to understand, trolleys are only designed for brief periods of transport and not for patients to spend hours on. Maybe there should be an exercise during management training courses of leaving students lying on a trolley all day long to let them see how uncomfortable they are, how it feels to be left in a cubicle for long hours or even worse in a corridor, and to imagine how much worse for a sick or injured patient.

    What will happen during the Olympics when far more visitors enter the UK and many may need emergency medical/nursing care - not to mention if there is a major disaster ?

    Unsuitable or offensive? Report this comment

  • Anonymous | 20-Apr-2012 8:42 am

    why get students to lie on trollies for hours why not get management to do that

    Unsuitable or offensive? Report this comment

  • Anonymous | 20-Apr-2012 8:42 am

    good idea but why in a cubicle in the corridor would be better and more acurate

    Unsuitable or offensive? Report this comment

  • Anonymous | 20-Apr-2012 8:58 am

    From Anonymous | 20-Apr-2012 8:42 am

    I said in my post

    "Maybe there should be an exercise during management training courses..."

    presumably management also go on further training courses from time to time so should obviously be included in this exercise!


    Anonymous | 20-Apr-2012 9:02 am

    in a busy narrow corridor!






    Unsuitable or offensive? Report this comment

  • if patients are stable and not requiring any active treatment or monitoring why do they need to be in hospital.

    Can you imagine the scene - a patient trying to get to sleep or using a urine bottle in the corridor, laughable.

    Unsuitable or offensive? Report this comment

  • In a ward corridor - yes, very safe, what a fab idea.

    They could choose to be 'boarded' opposite the toilet, the sluice, the store-room or even next to the crash trolley if they like. Perhaps it might be even more appropriate if they could be parked right down the middle of the corridor so they could entirely block the fire escape route.

    The NHS - envy of the world.

    God help us.

    Unsuitable or offensive? Report this comment

  • Anonymous | 20-Apr-2012 11:35 am

    WRITING ON THE WALL

    good comment. should be pinned on the wall of the offices of everybody concerned!

    Unsuitable or offensive? Report this comment

Show 102050results per page

Have your say

You must sign in to make a comment

Please remember that the submission of any material is governed by our Terms and Conditions and by submitting material you confirm your agreement to these Terms and Conditions. Links may be included in your comments but HTML is not permitted.