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.”