Andy is a junior doctor in an NHS trust hospital sharing his observations in five NHS trusts. 

He joins Stephen Willson to explore the middle management challenges in hospitals in the national health system. The episode focuses on numerous tensions implicit within the NHS constitution of improving public health and wellbeing.

Should doctors be encourated to share staff across deparments given fluctuating demands that may push one over capacity while an adjoining area has surplus capacity?

How can the demands of different departments be reconciled when it comes to prioritising the limited capacity of shared services such as operating theatres and  laboratories?

Are general hospitals the appropriate channel for patients with mental health issues since they appear to disproportionately absorb resources and disrupt throughput?