Nothing can save you now! The death of Holby City is a huge loss to the BBC

The BBC’s announcement that Holby City will die next March will not have greatly concerned its most devoted viewers.

They will assume the show will be placed on a table, someone will shout “Stand clear!” and, after two shocks from the defibrillator, it will carry on as if nothing has happened. If that intervention failed, an eccentric surgeon – perhaps Mr Anton Meyer (George Irving) from the early days, or the current Henrik Hanssen (Guy Henry) – would improvise a pioneering bypass to BBC Two.

However, a show criticised by the NHS for falsely suggesting that emergency resuscitation is a more successful part of medical practice than in reality now has to face the fact that its broadcasting flatline is final. (At least until a desperate scheduler a few years hence needs to revive a famous franchise.)

An oddity of medical dramas is that while actors are often lucky to last more than one episode – those playing patients are written out by discharge or death – the shows themselves come to seem immortal. On BBC One alone live Casualty (born 1986), Holby City (1999) and Doctors (2000).

In retrospect, the first symptom that Holby City (created by Tony McHale and Mal Young) would only just make its 23rd birthday next January came on 18 March this year, when BBC director general Tim Davie announced a “UK-wide” policy, increasing spending and representation outside London. These plans included “two new soap-style network drama series – one from the north of England and another from one of the nations – produced over the next three years”.

The regional identity of the BBC’s medical shows is complex. Both Holby City and Casualty, sibling shows with some shared characters, are set around south-west England in the fictional county of Wyvern, although Holby City is filmed at the BBC studios in Elstree, and Casualty in Cardiff (having moved there from Birmingham).

In production terms, then, Holby counts as a London show, and became vulnerable to the spread of what the corporation calls “drama spend”. Doctors, filmed in Birmingham, and Casualty, made in Wales, were less at risk from the attempt to reduce London-centricity. The money saved from closing Holby City General Hospital will be invested in the new series. And the new soaps will have to wear their locations on screen – if made in Scotland or Northern Ireland, they must be set there; licence payers will see where the money is being spent.

Culture secretary Oliver Dowden has been a champion of the BBC heading out from the south, but may have mixed feelings about this example: the Elstree studios are a key business in his Hertsmere constituency, and will be less busy with the loss of Holby.

Vulnerable to the spread of the BBC’s ‘drama spend’ … Holby City. Photograph: Screengrab/BBC

It is unlikely, though, that the soap’s successor will be a medical one. The pandemic has been hard for all TV drama, but particularly so for doctor-and-nurse work. Set largely inside, they are less able to move scenes outdoors in the way that other shows (such as Line of Duty) did, and limitations on filming have resulted in episodes being cut from 50 to 40 minutes.

But the bigger dilemma was whether the staff in Holby City, Casualty and Doctors should deal with the pandemic. Too much Covid and viewers would be getting more in the evening of what they were dealing with all day; too little and the genre would shift from soap to sci-fi. Since Holby City returned in January, it has featured an uneasy mix of the storyline avoiding Covid-19, but the production suffered from it – actors spaced two metres apart, surgeons improbably carrying out complex heart surgery with a single, socially distanced assistant.

Regardless of pressure from the BBC’s new regional policy, then, hospital drama has become problematic at a time when medicine has dominated headlines. This may also have reduced audience appetite for medical fiction.

Even so, Holby City is a loss. Due to a combination of critical interest in soap and chronic hypochondria, I have been a regular viewer. In recent years, the show has tended too much towards towards thriller plots such as gunmen stalking the corridors, and there have been rather too many cases of the staff turning up as patients. (Insiders claim this resulted from a reduction in the “guest star” budget that previously paid for a well-known TV face being wheeled in each week.)

However, apart from Mr Meyer and Mr Hanssen (whose high-handed ways are said by some nurses to have encouraged real surgeons even further in that direction), I have fond memories of general surgeon Ric Griffin (Hugh Quarshie), cardiothoracic consultant Connie Beauchamp (Amanda Mealing) and anaesthetist Zubin Khan (Art Malik).

Not even these surgeons can keep this heart beating … Amanda Mealing as Connie Beauchamp. Photograph: Alistair Heap/BBC/PA

Medical shows also matter in the history of TV because they were often decades ahead of the drive for diverse casting. What became a virtue was rooted in realism – so great has been the contribution of immigrant and British-born people of colour to the NHS since the 1950s that a clinical setting provided casting chances little available elsewhere at the time.

The content of the final Holby City episodes next year is tantalisingly fascinating. Both Casualty and Holby City have depicted the broader context of NHS funding and urban unrest, some of the more political storylines causing tension within the BBC and, externally, with politicians and regulators.

Producers and scriptwriters will surely consider the hospital being closed down by a cruel government or area health trust, or the whole cast dying in an operating theatre shootout caused by cuts in the security budget. Whether BBC bosses have the heart for that is doubtful, however, and, with commissioners nervous of ruling out a hit’s return, the show seems more likely, as not even its extraordinary cardio team has achieved for patients, to die with its heart beating.