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NHS at 75 How Britain's health service wound up in intensive care

The Guardian Weekly

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July 07, 2023

Squeezed budgets, staff shortages and an ageing population have pushed hospitals to the brink. But is there cause for hope?

- Denis Campbell

NHS at 75 How Britain's health service wound up in intensive care

Dr Nick Scriven can pinpoint the exact day he realised the NHS could no longer cope. "I first noticed it when I D was on call on New Year's Day 2012. We ran out of beds in our hospital. As a result, medical patients had to occupy the beds in a surgical ward meant for people with broken bones waiting to have planned orthopaedic surgery.

"We'd always had 'outliers'; the occasional medical patient who'd ended up in a surgical bed. But this was the first time cases like that had ended up taking over almost all the 30 beds on the orthopaedic ward. This went on for a month and was a massive stress for everyone as we'd never had to cope with this amount of patients being looked after elsewhere before. I hoped it was an anomaly but sadly the same thing happened every year after that," recalled Scriven, who works at a hospital in Yorkshire.

However, in his experience it was not until 2015 that the NHS went from struggling with a temporary overload in the cold months to "eternal winter": the same difficulties almost all year round.

Scriven was talking about England. But the trajectory of the health service in Scotland, Wales and Northern Ireland has followed the same pattern of dramatic, relentless decline.

Scriven a doctor for 32 years believes the NHS is in the worst state he has ever seen. It was in a "downward spiral", he said. "Care is in some respects dire. The target used to be to treat 95% of A&E patients within four hours. Now it's just 74%. Patients face delays all year round that would have been unacceptable five to 10 years ago and until recently would have been reported to NHS England as an 'adverse incident'. Unfortunately, we are in the position where dire circumstances, such as 'corridor care'... have in fact been normalised."

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