Intended for healthcare professionals


Return of the “corridors of shame”?

BMJ 2013; 347 doi: (Published 08 July 2013) Cite this as: BMJ 2013;347:f4343
  1. J Nicholl, professor of health services research1,
  2. S Mason, professor of emergency medicine1
  1. 1School of Health and Related Research, University of Sheffield, Sheffield, S1 4DA, UK
  1. j.nicholl{at}

Emergency department attendances are rising, and a long term solution is needed

The proportion of patients spending longer than four hours in England’s emergency departments rose steeply in the first quarter of 2013.1 This produced a storm of headlines and commentary and led to the announcement of a major review of urgent and emergency services in England.2 The situation was blamed on an increase in the number of attendances, and this in turn was laid at the door of scapegoats such as general practitioners, out of hours services, NHS 111 services, and even immigrants.

Several questions arise. Firstly, was the rise in the numbers breaching the four hour target due to rising attendances? Attendances have been rising on average by 1.5-2% a year at least since 1966, when there were less than seven million attendees,3 compared with more than 20 million today. These increases have not occurred equally each year—for example, almost no change was recorded between 1997/8 and 2001/2. So could an unexpectedly large increase in 2012 have caused the disruption? The answer is no—there was actually a small …

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