8:10 am - February 13, 2025
The Reality of NHS Struggles in 2025: A Glimpse into Royal Berkshire Hospital
Marina Strange, a 90-year-old living alone, recently suffered her third heart attack in two years. Despite her critical condition, it took two hours for an ambulance to reach her—a delay she surprisingly found impressive. Marina’s experience is not unique; it reflects the harsh reality of the National Health Service (NHS) in 2025, where long waits and overburdened services have become the norm. Royal Berkshire NHS Trust, where Marina is treated, is performing close to or even above the national average in most metrics, yet the challenges faced by its staff and patients are stark. Over the winter, Sky News visited the hospital, speaking to patients, consultants, and administrators to understand the systemic pressures overwhelming the NHS. What they found was a system stretched to the breaking point, struggling to meet growing demand andkönnen’t keep up with the influx of patients.
Winter Pressures and Overcrowded Wards
The winter of 2024-2025 has been particularly brutal for the NHS. On January 9, Sky News attempted to visit the respiratory ward at Royal Berkshire Hospital but was turned away because the ward was too busy. Chief Executive Steve McManus explained that bed occupancy was running at 99%, with almost half of the respiratory unit dedicated to flu patients. The hospital was overwhelmed, with 20-30 patients waiting for beds in the emergency department each morning. Flu and other winter viruses, such as norovirus and COVID-19, have surged this year, peaking in early January at levels nearly twice as high as the previous winter. While Royal Berkshire’s bed occupancy rate of 94.7% this winter is slightly worse than the national average of 93.6%, it is far from an outlier. The recommended maximum bed occupancy to ensure efficient care is 92%, with at least 8% of beds kept free. This target was only met on ten days across England this winter, all between December 21 and New Year’s Day. For the rest of the season, the NHS has been operating over capacity, with no room to breathe.
Emergency Care Under Strain
The situation in the emergency department is equally dire. Dr. Omar Mafousi, the clinical lead at Royal Berkshire, described how the lack of beds in the main hospital has crippled emergency care. “We say every year it gets a little worse,” he said. “This year has felt worse than any other year I remember.” With only 20 major cubicles but 25 patients waiting for a bed, some are forced to wait in chairs or the waiting room. Ambulances can’t offload their patients, creating a backlog that delays response times for new emergencies. On December 4, the emergency department had already seen 191 patients by 1 p.m., a number Dr. Mafousi described as the “new norm.” The NHS target is for no more than 5% of patients to wait more than four hours in A&E, but this standard has not been met in over a decade. In December 2024, 28.9% of patients waited longer than four hours, rising to 44.7% at major A&E units. At Royal Berkshire, 44.2% of patients in the major A&E waited longer than four hours, with 14 patients waiting over 15 hours—delays Dr. Mafousi called “too long.”
The Ripple Effect of Delays
The consequences of these delays extend far beyond the emergency department. Ambulance handover delays, where patients can’t be transferred from ambulances to A&E staff, have become a significant problem. The NHS standard is 15 minutes, but at Royal Berkshire, the average this winter has been 25 minutes—still better than the national average of 40 minutes. One in seven handovers now takes over an hour, three times more than just four years ago. These delays not only worsen care for patients in ambulances but also reduce the availability of ambulances to respond to new emergencies. For Category 2 emergencies, such as Marina’s heart attack, the target is an 18-minute response time. In December, the average wait across England was over 47 minutes—nearly three times the target. The cost of these delays is staggering, with over 600,000 hours lost to handover delays this winter, equivalent to more than £100 million.
Patients Caught in the Backlog
The ripple effects of overcrowded hospitals and delayed care are felt deeply by patients like Colin Waters, who has been in the hospital for ten days after being hit by a car. Despite being stable and no longer needing acute care, Colin remains in the hospital because there is no space for him in a community hospital for rehabilitation. He is one of thousands of “fit to be discharged” patients across England who are stuck in hospital beds, unable to move to appropriate care settings. On January 25, over 300 such patients were waiting in the Royal Berkshire region alone, with a national peak of 13,894 patients on February 1. These delays not only prolong hospital stays but also block the flow of new patients through the system, worsening ambulance delays and emergency care. The backlog extends to routine operations as well, with 7.5 million people on the waiting list—more than one in eight people in England. Over 221,000 have been waiting for treatment for more than a year, 120 times higher than before the pandemic. At Royal Berkshire alone, 60,000 patients are on the list, with nearly 3,000 waiting over a year.
A System Struggling to Keep Up
The NHS is facing unprecedented demand, driven by a combination of rising health needs, increased health anxiety, and a crumbling infrastructure. For patients like Simon Shurey, who has complex conditions including asthma, COPD, and a recent bout of sepsis, the system is failing to meet their needs. Simon has waited up to two days for a ward bed and has seen the pressure on healthcare workers grow with each visit. “Every time you come in, it’s getting worse for them,” he said. “There seems to be so much pressure.” This pressure is compounded by a surge in health anxiety post-pandemic, with young people seeking care for symptoms linked to mental health, such as chest pain or breathing difficulties. Dr. Amrit Sharma, a GP near Royal Berkshire, noted that appointments have skyrocketed, with over 40 million in December 2024, compared to less than 30 million in 2018. Yet, over a million people couldn’t even get through to their GPs that month. The NHS is doing its best, but it is fundamentally unprepared for the scale of the demand.
The Broader Picture: A System in Crisis
While Royal Berkshire Hospital is performing relatively well compared to other NHS trusts, its challenges are emblematic of a system in crisis. The hospital’s aging infrastructure, with parts of the building dating back to 1839, is in disrepair, and plans for a new hospital are mired in delays and funding disputes. Across England, the NHS is grappling with aPerfect storm of overcrowded wards, ambulance delays, and a backlog of routine care. The human cost of these systemic failures is profound, with thousands of patients like Marina, Colin, and Simon bearing the brunt of a system that is no longer able to cope. Targets are being missed in every department, and the ultimate consequence is worse health outcomes and increased risk of death for patients. The NHS remains a cornerstone of British society, but without urgent action to address its capacity, funding, and workforce challenges, the crisis will only deepen. The stories of patients and staff at Royal Berkshire Hospital serve as a stark reminder of the need for change.