My simple tips to help you stay out of the A&E war zone: As record numbers wait more than 12 hours on a hospital trolley, this is how to avoid the mayhem…

Winter is always tough in A&E – but nothing has ever been as bad as it is now.

On my last shift I handed over a department that looked more like a disaster response to a humanit­arian crisis than a modern hospital.

Thirty-five patients were lined up in a corridor, some having waited more than two days for a bed, laying cheek by jowl, sharing space and infections.

Older patients were stuck on trolleys, some forced to endure the humiliation of soiling themselves in public.

In the middle of that chaos were mental health patients in acute crisis, their suffering made worse by the noise, lack of privacy and constant disruption.

Staff were in tears, knowing that despite working flat out they could not provide the care their patients deserved.

The problem isn’t to do with delivering emergency treatment – by the end of the shift, there were relatively few patients waiting to be seen by an A&E doctor. Those lining the corridors needed other kinds of care, in other parts of the hospital.

When I got home, my wife asked me how the shift had been. ‘Not too bad,’ I said without thinking. Later, it hit me that my sense of what is acceptable care has shifted.

I’ve had to adapt to it, adjusting in order to cope psychologically and keep coming back to work.

Figures published last week by the NHS showed that last year more than half a million patients in England were left waiting 12 hours or more on a hospital trolley after a decision had been made to admit them – the highest number ever recorded. Before Covid, in 2019, that figure was about 8,000.

It’s a shocking increase in just five years, and rightly makes headlines. But it also drastically underestimates the problem.

The truth is, the clock on these trolley waits starts only once a patient has been seen by a doctor and a decision to admit has been made (often by a speciality team, such as surgeons – not just A&E staff). They say nothing about the hours waiting to get to that point.

When you include that hidden time, the picture is far bleaker.

The Care Quality Commission estimates that, from April 2024 to March 2025, more than 1.8 million people waited more than 12 hours in A&E from the moment they arrived to the point they were admitted or discharged.

What once felt shocking and unthinkable after an isolated bad day has become so familiar that it barely registers – and that, in itself, is the most worrying part.

We’ve all read the newspaper reports of A&Es being like ‘war zones’ after a string of bad days, but colleagues nationwide say it’s like this every day – and worse than in real war zones such as Ukraine, say those who know.

But unless you’ve been in A&E yourself, outside the hospital, hardly anyone notices.

Last week, multiple hospitals across the country declared critical incidents – many more should have – to signal they are under exceptional pressure. This is meant to be a distress signal, and should trigger actions such as cancelling non-urgent operations, speeding up discharges and trying to free-up beds.

The problem is that this level of pressure is no longer exceptional, so the declaration changes little.

The consequences are stark. An analysis last year by the Royal College of Emergency Medicine shows that hundreds of patients are dying every week because of long delays in being transferred from A&E to appropriate wards.

I’ve seen experienced, resilient clinicians break down at the end of a shift. Not quietly upset, not a bit stressed, but crying because they feel helpless and ashamed to be at a point where they feel they are participating in something unsafe and degrading.

This is not just about winter viruses (although, yes, norovirus, flu and other infections are a major factor). And it is not a story about underfunding. In fact, the NHS is receiving more money than it ever has, but it is using it badly, led by politicians and civil servants who are running it the wrong way.

And people are sent to hospital when they don’t need to be.

We’re losing experienced GPs who know their patients well, replaced by less experienced doctors working under intense pressure. In such circumstances, too many patients get referred to hospital as a precaution, when they would be better off being cared for in the community.

Once someone crosses the hospital threshold, everything becomes harder as patients can’t be discharged easily and those blockages ripple backwards until it hits the emergency department, leading to corridor care.

So what can be done?

Firstly, politicians and managers need to stop fighting over money – the NHS is probably as well funded as it is realistically going to be for the foreseeable future.

Instead of spending more money in hospitals on more expensive tests and cutting-edge treatments, we should spend it on retaining experienced generalists, particularly GPs.

We need to fix community care to free-up hospital beds for patients who need them. This means care packages should be available in hours, not weeks.

If patients need to be in corridors, they should be moved to corridors attached to the relevant specialism. For example, those with cardiac chest pain should be on cardiology wards. This would speed up decision-­making by the specialist ward doctors as to who needs to be admitted and who can be cared for in other settings.

And doctors need to rethink admitting people to hospital in the first place.

Much of our guidance was written for a system where an empty bed existed at the end of the decision tree.

But as that is no longer the case, with every patient we need to ask ourselves: are they safer tonight in a hospital corridor or at home with a clear plan?

And what can you do to avoid going to hospital and ending up in a corridor?

Clearly there are harms you cannot actively prevent, but there are steps you can take:

Get the flu vaccine. It’s not too late, as the flu season usually lasts until March/April. It works, reduces severe illness and keeps people out of hospital.

Take basic hygiene seriously. Handwashing, alcohol gel and simple infection-control measures genuinely reduce the spread of illness, particularly in winter. Wash your hands whenever you’ve been to the loo and before cooking food. Take extra care when preparing raw meat.

Clean kitchen surfaces frequently, regularly wash tea towels and cleaning cloths. And clean your bathroom sink more than once a week. A 2024 study showed they had more bacteria on them than hospital sinks.

Stay on top of long-term conditions. Take your medication as prescribed, make sure you do not run out and have a clear plan from your GP of what to do if your asthma or heart failure flares up. Many winter A&E visits are due to long-term illnesses that have suddenly worsened and there’s no plan in place.

Prevent falls at home. Simple things such as good lighting on the stairs, non-slip mats in the bathroom, sensible footwear indoors and keeping walkways free of clutter can stop the kind of falls that so often end with a broken hip and a trip to A&E.

Go easy on alcohol. A size­able chunk of weekend A&E visits relate to middle-class drinkers having too much and falling down stairs after a dinner party.

Have a simple medicine kit at home – paracetamol, oral rehydration powders and dressings can help you manage minor illnesses and injuries safely, without a panicked trip to A&E in the middle of the night.

Think carefully before coming to A&E – it should be a last resort, not a default. If you can’t see your GP, go to the pharmacist. But if you need to come into hospital, do so, as we are still effective at delivering immediate, emergency, life-saving care.

Crucially, if a doctor says your relative needs to stay in hospital, it is reasonable to ask why. If the answer is simply that they are waiting for blood tests, scans or a review the next day, it’s worth asking whether this could be done as an outpatient.

Corridor care is a sign of a crisis. The danger now (on top of the obvious patient harm) is that staff are beginning to accept it as normal.

Once that happens, it becomes very hard to remember it doesn’t have to be this way.

SECRETS OF AN A-LIST BODY 

How to get the enviable physiques of the stars 

This week: Jennifer Garner’s legs

Wearing tailored shorts recently, the actress, 53, showed off toned legs. She trains hard to stay in shape for her roles, including Marvel superhero Elektra, and is said to enjoy a variety of workout styles, from dance-cardio classes and yoga to trampolining and strength training.

WHAT TO TRY: Walking lunges tone the leg muscles. From a standing position, take a stride forward with one leg, then bend your knees and lower down until your front leg forms a right angle and your back knee brushes the floor.

Stand up and step your back leg forward so you’re standing up straight again with your feet together.

Repeat, taking a stride forward with the other leg. Walk like this, alternating lunges from leg to leg, across your living room, turn around and repeat four times. Do four sets, three times a week.

@drrobgalloway