Editorial

Issue 2 begins with a paper by Rachel Gibbons which, since its publication online on 16 May 2025, has already become the most read article ever published in this journal. Entitled ‘The “Impossibility” of working in the current NHS: sacrifice to a primitive god’, the paper explores the challenges facing the NHS, with a focus on employee experience.

Maddocks (2024) describes how, on any comparison with other nations, the NHS is neither the highest spender nor the lowest performer. For example, the UK spends less per capita than the G7 average or the OECD average yet is ranked third overall in a comparison of 10 of the world’s richest countries (Blumenthal et al., 2024). Despite this, the calls for greater NHS efficiency due to funding constraints seem to have been an ever-present feature of every government since the global financial crisis, 2008. My impression as a clinician working within the NHS since 2006 is that this over-performance relative to funding can be explained by the contributions made by its staff. With teams rarely at their full complement of staff due to huge challenges in recruitment and retention, staff members consistently go above and beyond in order to meet the ever increasing demand for services. Like many, I witnessed this at its most extreme during the COVID-19 pandemic. Whilst providing psychological support to nursing and care staff in a general hospital, they told me that it was expected that they would stay on and work a double shift with no notice, and commonplace for them to be separated from their families for weeks at a time so that they could live within close proximity to their work. This was an all too familiar story across the country.

In her paper, Gibbons explores the underlying psychodynamic factors that perpetuate these ‘impossible’ demands faced by NHS staff. She describes how the NHS has been idealised since its inception, and how this can lead to unconscious phantasies of dependency on omnipotent care amongst staff who are ex