Baroness Pidgeon
To ask His Majesty’s Government what progress they have made on their commitment to end corridor care.
The Parliamentary Under-Secretary of State, Department of Health and Social Care (Baroness Merron) (Lab)
My Lords, corridor care is unacceptable, and we are tackling its causes by preventing avoidable admissions, improving patient flow and accelerating safe discharge. Just this weekend, we announced almost £140 million for 14 urgent care schemes, alongside 25 new or expanded sites, which are due to open for winter. Despite unprecedented summer demand, around 50 trusts reduced corridor care. We are working to end corridor care by the end of this Parliament.
Baroness Pidgeon (LD)
My Lords, the Royal College of Emergency Medicine has reported today that two-thirds of clinical leads say their trust does not count as corridor care patients on chairs in corridors, patients who have been put on chairs in waiting rooms or even patients in corridors on the way in. What action will the Government take, and by when, to make sure that every trust counts every patient, so that we have a true picture of corridor care in this country?
Baroness Merron (Lab)
We are a lot closer to having a true picture, because in March this year we introduced a consistent national definition of corridor care, which I know the noble Baroness has been very keen on. In addition, for the first time monthly national data has been published since June, which is giving us greater visibility of where corridor care is occurring and, in particular, allowing support to be targeted at the most challenged hospitals.
Lord Harris of Haringey (Lab)
My Lords, in the 1990s, when I was a little boy, I was director of the Association of Community Health Councils. Each year, we ran something called National Casualty Watch, which involved local community health council members going into every local casualty department and not only counting the number of people there but asking them how long they had been waiting. Successive Secretaries of State, some of whom are in your Lordships’ Chamber, were not very happy about this, but it had a profound effect on making people realise that this is not a way to run A&E departments. Can my noble friend the Minister assure us that, given that the Government are rethinking their plans to abolish Healthwatch and national Healthwatch, facilities will be available for that sort of thing to continue in whatever new arrangements come forward?
Baroness Merron (Lab)
The principle of assessing patient experience, as my noble friend described, is absolutely key to the Health Bill, and I know we will discuss this more. Since my noble friend was a young pup—as he described himself, in a different way—we now have the facilities to be much more transparent and to use data. It is important to say that the collection of data is new—it started only this year and did not exist before—and we are continuing to work with providers to improve the consistency and quality of reporting. That is absolutely key.
Baroness Finlay of Llandaff (CB)
My Lords, given that three-quarters of physicians report difficulties in accessing essential equipment, sometimes including resuscitation equipment, for patients in corridors, and even more report compromised care, what work are the Government now undertaking with the Royal College of Emergency Medicine to increase the provision of medical assessment units, particularly working with the clinical governance leads for those emergency departments?
Baroness Merron (Lab)
All of this is important, as the noble Baroness said. We are already undertaking a number of actions and one is about additional urgent care capacity; for example, in total some £2 billion is going into urgent care, particularly capital projects, which the noble Baroness did not specifically mention. The improvement of facilities, which is part of this, is absolutely key, as is getting care closer to home. With the kinds of improvements we are already seeing—for example, the emergency departments at Basildon and North Tees have had refurbishments—and by working with clinical leads, we will improve a long-standing situation that should never have been normalised and should only be exceptional.
Baroness Browning (Con)
I am sure that the Minister has seen some of the hospitals that have solved this problem. Is there a problem with hospitals that have overcome what is a very difficult problem sharing that information with other hospitals that are struggling? It always amazes me: when you see best practice, you just do not understand why it is not shared. If they do not voluntarily share it, is there anything the Minister can do to make them share it?
Baroness Merron (Lab)
The noble Baroness is right. While we are very mindful of the need to make more progress, sharing best practice is key to how we are improving things across the whole pathway. The majority of corridor care occurs in a small number of trusts, and that is why we are putting in targeted teams to work with those trusts to do exactly what the noble Baroness suggests.
The Lord Bishop of Southwell and Nottingham
My Lords, I pay tribute to the NHS staff who provide vital care under immense pressure. Recent reporting from the Queen’s Medical Centre in my diocese of Southwell and Nottingham has highlighted their compassion and professionalism. Does the Minister agree that the challenge of corridor care is one not only of clinical safety and privacy but of human dignity? Hospital chaplains provide invaluable pastoral and spiritual support to patients and families at moments of vulnerability and distress. What consideration have the Government given to ensuring that access to such support is not diminished when patients are cared for in temporary settings?
Baroness Merron (Lab)
I pay tribute to the service provided by hospital chaplains, because they extend support to those of all faiths and none, and that is crucial. Corridor care is not an acceptable normalisation. We want to end it by the end of the Parliament. I agree that dignity is very much part of it. The guidance given to hospitals is that, in exceptions where there has to be corridor care, they must take account of supporting the patient in the best way possible. For example, that can, of course, include support from hospital chaplains.
Lord Kamall (Con)
My Lords, the Minister said that the department, or maybe NHS England, has been able to identify the hospitals where corridor care is at its worst levels. What specific targeted support does the Minister’s department or NHS England intend to offer to those particular hospitals in order to reduce the high levels of corridor care?
Baroness Merron (Lab)
We are putting in specialist teams to work with those particular hospitals. The Secretary of State has made it quite clear that ending corridor care for children is an absolute priority. As I said to the noble Baroness earlier, we are ensuring that best practice is applied. Because of the additional funding, we have been able to and will be able to extend capacity. The noble Lord will have looked at the areas that are receiving targeted financial support. Where we have greater levels of corridor care, our teams are working with those hospitals to say, “Why is this the case? This is how to sort it out”, and make sure that they can. The small number of trusts means that there is greater reliance in some areas than others, and that is not all right.
Baroness Watkins of Tavistock (CB)
My Lords, what additional support are the Government going to give to the healthcare staff in accident and emergency departments, who are feeling very demoralised following a difficult summer and now face a difficult winter? Most importantly, in preventive terms, is it not time that we linked care in the community by subcontracting some beds in care homes, so that patients who could be discharged immediately if that was available can be, to enable things to be a bit better for staff and patients this winter?
Baroness Merron (Lab)
I share the views of the noble Baroness, as I do the comments of the right reverend Prelate about the role that our healthcare staff play. The noble Baroness is right about the connection with social care. Better patient flow and discharge actually rely on that, and that is why we have published the Model Emergency Department, the Model Acute Pathway and the Model Discharge Pathway, so that we can see earlier assessment, timely senior clinical review, improved discharge and better patient flow, because it is down to beds and also to pressure. If there is one thing we are promoting in terms of prevention, it is for everybody to get a flu jab who is eligible, because we want to prevent people unnecessarily presenting at hospital. That will assist us greatly.