Documentaries have always been a powerful tool in raising awareness among the public of ‘wicked’ policy issues and, in some cases, leading to changes in government policy.

Cathy Come Home, Hillsborough and Who Bombed Birmingham? are just three examples of documentaries that have not just informed the public but also framed key public policy agendas. 

The NHS has had several ‘fly on the wall’ documentaries in recent years but Hospital, BBC Two’s new six-part series on life at Imperial College Healthcare NHS Trust, is likely to transcend these and take its place alongside some of the UK’s most significant documentaries.

Timing is often everything and Hospital’s opening episodes are being broadcast in the middle of one of the NHS’s busiest ever periods – a period in which stories about delays in treating patients in A&E departments have been splashed all over the front pages of the national newspapers. The NHS has dominated media and political debate at the start of 2017, even managing to momentarily eclipse coverage of Brexit and the incoming US president.

Both opening episodes have shown how a lack of beds and other resources can mean one patient’s care coming at the expense of another’s. The human cost of this was captured most vividly when Simon, a patient with a tumour in his oesophagus, had his operation cancelled as Janice, an incoming patient requiring life-saving surgery following a ruptured aneurism, needed the intensive care bed that was intended for Simon.

This was hugely distressing for Simon, Janice and their families, as well as the surgical team who were understandably becoming increasingly frustrated at the inefficiency caused by the lack of available beds.

Hospital may be based on one hospital but its experiences are not unique. The majority of NHS trusts are struggling with record numbers of people requiring treatment, constrained funding and a lack of staff.

Like other NHS trusts, Imperial has been grappling with bed occupancy rates above the 85% level that is considered safest and most efficient. The causes are multiple and predominantly outside of the trust’s control – for example, a lack of support in care homes and other services in the community.

The second episode told this story through the eyes of Dolly – said to be one of Imperial’s oldest patients. She was medically fit to be discharged but a lack of available support in the community meant she was stuck in a bed that could have been used by another patient. This highlighted the breakdown we often see between local health and social care services and the inefficiency caused by delayed transfers of care – an issue NHS Providers addressed in the Right place, right time commission, chaired by the Rt Hon Paul Burstow.

Through these patients and their experiences, as well as the staff that treat them, Hospital is giving the public a glimpse of the trade-offs and difficult decisions that NHS staff and patients face every day. The way they need to prioritise care within finite resources at a time when the number of people needing treatment is rising.

Hospital may be based on one hospital but its experiences are not unique. The majority of NHS trusts are struggling with record numbers of people requiring treatment, constrained funding and a lack of staff.

Despite these pressures, Hospital also captures how nurses, doctors, physios and other staff at Imperial are continuing to provide safe, high-quality care for the public. It is easy to forget this amid the headlines.

It was also refreshing to see the cameras focus so much on Lesley, a manager who was working against the odds to find beds for patients. NHS managers are not always portrayed favourably but this was a good illustration of how important how they are and how tough their job is.

Hospital is giving the public a glimpse of the trade-offs and difficult decisions that NHS staff and patients face every day.

The patients, staff and leadership team at Imperial deserve credit for enabling this moving portrayal of life at the NHS front line to be shown to the public. They gave the documentary makers, Label1, unfettered access to the hospital for several months and hours’ of filming has been condensed into six, hour-long episodes. At such a febrile time in the debate on the performance and funding of the NHS, this would not have been an easy decision.

But by letting in the cameras and showing the reality of the challenges NHS trusts are facing, the series is set to make a serious contribution to much needed discussions about how we need to change the way health and care services are delivered to the public. And the debate that we as a country need to have on the quality of care we want and how we much we are willing to pay for it.

This blog was first published in PR Week on 25 January 2017