‘We are absolutely full’: This hospital is outperforming most – but it is still on its knees

The State of the NHS: A Case Study Through Royal Berkshire

Marina Strange, a 90-year-old living alone, experienced her third heart attack in two years and waited two hours for an ambulance—a wait she surprisingly found impressive. This incident, while alarming, reflects the current state of the NHS, where such delays are becoming commonplace. Royal Berkshire NHS Trust, where Marina was treated, operates near national averages, indicating her experience is typical for 2025.

Overcrowded Hospitals and Winter Pressures

In January, Royal Berkshire’s respiratory ward was overwhelmed, with bed occupancy at 99% due to a surge in flu cases and other viruses. This situation highlights the broader winter pressures on the NHS, where bed occupancy averages 94.7%, exceeding the recommended 92%. Such high occupancy rates, seen across England, severely hinder efficient patient flow and emergency care.

Emergency Department Crisis

The emergency department at Royal Berkshire faces a daily influx of over 500 patients, often exceeding capacity. With 44.2% of patients waiting over four hours, some enduring waits of more than 15 hours, it’s clear that A&E services are in crisis. These delays have contributed to 23,000 excess deaths, underscoring the severe impact of overwhelmed emergency care.

Ambulance Delays: A Ripple Effect

Ambulance handover delays, averaging 25 minutes at Royal Berkshire and 40 minutes nationally, exacerbate the crisis. These delays not only prolong response times but also reduce ambulance availability for new emergencies, affecting patient care and outcomes significantly.

Infrastructure Challenges and Bed Shortages

Infrastructure issues at Royal Berkshire, including unusable buildings, highlight the NHS’s structural problems. Plans for a new hospital, delayed until 2037, are costly and uncertain. Bed blockages, like Colin Waters’ case, where patients ready for discharge await transfers, contribute to logistical nightmares, exacerbating waiting lists for operations and emergency care.

Health Anxiety and Long-term Implications

Post-COVID health anxiety has surged, overwhelming GPs with appointments. Dr. Sharma notes increased anxiety-related visits, while Dr. Mafousi observes unnecessary emergency visits driven by fear. This anxiety, coupled with prolonged waits, strains the NHS further, leading to a cycle of delayed care and potential health deterioration.

In conclusion, the NHS faces unprecedented challenges, from overcrowding and delays to infrastructure woes and anxiety-driven demand. Royal Berkshire’s story is a microcosm of a system in crisis, emphasizing the urgent need for systemic reform to meet growing healthcare demands effectively.