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As figures for knife crime nationally hit a record high, Merseyside has seen a doubling in the last five years. In Aintree Hospital’s major trauma centre, a 15-strong team are trying to save the life of a young man who has just arrived by emergency helicopter. He has been stabbed in the chest – one of three stabbings to arrive during the day. After the patient is sedated, the medical team scan him to find the full extent of the internal damage that has necessitated a transfusion of eight units of blood. This reveals that the weapon has reached the patient’s heart and caused bleeding into its protective sac, preventing his heart from beating properly. With his life hanging in the balance, the patient is blue-lit 15 minutes across the city to the Liverpool Heart & Chest Hospital for emergency open heart surgery. A cardiac surgeon needs to release the pressure around the patient’s heart and repair the damage that the weapon has caused.

Three and a half miles away in the heart of the city centre, the Royal Liverpool University Hospital provides emergency care for ten of the most deprived areas in the UK. The Royal deals with an increasing number of regular attenders or ‘frequent fliers’ – patients who return multiple times and who put extra strain on the system. Alongside unprecedented demand in A&E, there has been a nationwide increase in violence against staff. The Royal alone has a team of 39 security personnel, providing round the clock protection at a cost of nearly £1.5 million annually.

Clinicians and security staff find themselves once more dealing with a regular attender who has an unenviable track record of aggression towards hospital employees. The homeless man has been coming to the Royal’s A&E for as long as many staff can remember – at least 18 years. Clinicians deal with him with patience and dignity, giving him somewhere safe and warm in the department to sleep off his alcohol or substance misuse. But with over 130 incidences of aggression towards staff over a seven-year period, he is finally given an ultimatum – stop abusing staff and the system or face a year-long exclusion. Since 2012, NHS Trusts have had the legal right to withhold treatment from violent or abusive patients.

As pressure continues in the department, Les, an elderly man with a serious cardiac problem, is brought in. Due to lack of space, he is cared for on a trolley in the corridor for nine hours. A&E managers try to find patients who can be discharged to create space on wards before a place is found for Les – 27 hours after he arrived in the hospital.

As the Royal’s A&E struggles to cope with pressure at its front door, across the city in Aintree Hospital’s specialist ventilation unit, 47-year-old Stephen, a patient with motor neurone disease, is trying to leave. Despite the debilitating and progressive nature of his disease – he can no longer breathe, talk or eat - Stephen is hopeful that he can return home. Stephen has been a patient in Aintree for 16 weeks but he has been ready to leave the hospital for over a month. Putting the complex NHS-funded, 24-hour care package in place to facilitate this is proving hard. After determining the medical equipment needed to allow Stephen to survive away from the ward, he goes for a challenging trial in the hospital grounds. The eye-gaze computer that allows him to communicate does not function effectively outside, and Stephen struggles to cope with the emotions of leaving the ward for the first time in four months. He begins to lose hope that he will ever get home, let alone for Christmas.

Hospital is a co-production with the Open University.