shutterstock Andrey_Popov/ShutterstockWhat happens when the NHS is hit by an emergency it cannot predict? A heatwave can send thousands more people to hospital. A power cut can put patients who depend on electricity at risk. A cyber-attack can suddenly knock out systems that hospitals rely on to function. Government officials told reporters at the FT that Andy Burnham’s government is preparing a publicity campaign, telling households to prepare for a disaster. It will set out how people can prepare for extreme weather, power cuts and attacks by hostile states. The idea is that if households have basic supplies ready, public services can focus on those who need help most. The government will advise people to keep a small stock of tinned food and bottled water.But heatwaves, power failures and cyber-attacks ultimately test the health system; and that system is already under pressure. HeatMore than 2,700 people are estimated to have died from heat-related causes in England and Wales during the record-breaking heatwaves in May and June this year. That followed 1,504 heat-associated deaths in England in the summer of 2025. This year has also brought a red heat warning and temperatures of 37.3°C in June, and in August, amber extreme-heat warnings and a record month for wildfires. Heat could cause up to 10,000 deaths a year by the 2050s if the country does not adapt, according to government projections.The effects are felt directly by the health service. July 2026 saw a record 2.5 million A&E attendances in England across two heatwaves, with around 3,000 patients a day cared for in corridors or other unsuitable spaces. Hospital buildings themselves are under strain. NHS England reported a 53% rise in overheating incidents in its hospitals since 2016, and the cost of outstanding maintenance now stands at £15.9 billion. July 2026 saw a record 2.5 million A&E attendances in England. ajpenniallphotography/Shutterstock.com PowerFor most households, a power cut is an inconvenience. For people who rely on home oxygen, ventilators, home dialysis or refrigerated insulin, it can be life-threatening, which is why energy companies run a priority services register for customers who depend on electricity for medical reasons. However, no national plan for this group exists. The Department of Health said in 2024 that individuals and their care teams are best placed to prepare for losing power.Recent events show how long outages can last. Storm Éowyn in January 2025 disconnected 30% of premises in Northern Ireland, with thousands still without power a week later. When a substation fire closed Heathrow two months later, it also cut power to Hillingdon Hospital. An official review found that network operators are generally unaware of which customers are critical national infrastructure.Cyber-attackThe NHS has more experience of hostile cyber activity than most public services. The WannaCry attack in 2017 affected at least 81 of England’s 236 hospital trusts and cancelled around 19,000 appointments at an estimated cost of £92 million. In June 2024, a ransomware attack on the pathology provider Synnovis led two London trusts to postpone more than 10,000 appointments and 1,700 operations, prompted a national blood shortage alert because hospitals could not cross-match blood, and was later found to have contributed to a patient’s death.The government has responded with a cybersecurity strategy for health and social care running to 2030. But the threat is evolving quickly. The National Cyber Security Centre, part of GCHQ, dealt with 204 nationally significant attacks between January and August 2025, more than double the previous year. And an Iran-linked attack in July was blamed for shutting down a small UK power generator for four days.A plan is not the same as capacityThe NHS has a framework for emergency preparedness, resilience and response. But having a plan is not the same as having the capacity to carry it out. Such plans assume there is some slack in the system: beds that can be freed, staff who can be redeployed, work that can be paused. But that slack has been shrinking for years.Bed occupancy in England has been above 90% continuously since September 2021, compared with the 85% widely regarded as the safe limit, and reached nearly 95% in January 2026. The UK has 2.4 hospital beds per 1,000 citizens compared with an average of 4.6 across 38 high-income countries. At those levels, any emergency plan is asking the system to find room it does not routinely have.The COVID inquiry reached the same conclusion: preparedness depends on spare capacity. Its first report found the UK lacked resilience going into the pandemic. And its March 2026 report on healthcare concluded that the NHS coped, but only just, recommending that hospitals be given the ability to implement surge capacity.The government’s 10-Year Plan promises to end corridor care, which would help. There is less focus, however, on the wider question of how a health system already under such strain withstands a national emergency.Asking households to prepare is a sensible first step, and a relatively inexpensive one. The harder part is ensuring that hospitals have room to absorb a surge in demand, that health facilities are protected as critical infrastructure alongside the power grid, and that people whose treatment depends on reliable electricity are not left to shoulder the responsibility alone. The new campaign is a welcome sign that the government is taking resilience seriously. Extending the same urgency to the health system would be the natural next step.Philip Broadbent receives funding from The Wellcome Trust 223499/Z/21/Z