The health service has never before been under such strain, with dire warnings from doctors about patient safety.
Scotland, like every part of the UK, faces challenges if it is going to make the health and social care system work now - and into the future.2022 was the year when the health service shifted focus from combatting Covid to dealing with its consequences - and that is set to be the major theme of this year.
In the first week of 2016, just three patients waited longer than 12 hours in A&E. This year, it was 2,511 - one in every 10 patients. On any given day, about one in six of Scotland's acute hospital bed capacity is being taken up by people who do not need to be there. The Scottish government's proposed long-term solution is the National Care Service, billed by the health secretary as the "biggest public sector reform" since the NHS was established in 1948.
While all that plays out, the problems with shortages in social care are acute right now and continue to cause major capacity issues in hospitals. Akbar Mir, who runs Elsie Inglis nursing home in Edinburgh - which is looking after interim care patients - said integration between hospitals and the community should have been a priority well before now.
Some have spent their savings on private treatment because their condition is so debilitating and GPs say increasing numbers of patients need stronger medication or mental health support as their condition deteriorates.In July last year, Health Secretary Humza Yousaf set what he described as "ambitious" targets to eradicate the longest waits for treatment.
GP numbers have gone down this year despite a commitment from government to recruit 800 new family doctors by 2028. And there continues to be struggles attracting people to work in social care. Survival rates have improved over the past decade, despite more people being diagnosed with the disease. The latest quarterly data shows 25% of those who were referred waited longer than 62 days - the worst figures since the standard was set in 2012.The main concern is that people who do have cancer will receive a diagnosis too late and a treatable disease will become terminal.
The NHS is facing extreme pressure this winter, as hospitals struggle with a difficult flu season and staff shortages, as well as backlogs due to Covid.
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