Quietly brilliant and deserving of a lot more noise, Jo Brand, Joanna Scanlan and Vicki Pepperdine's hospital comedy has explored the intersection between what's funny and what's heartbreaking without any self-regard or fuss.

Joanna Scanlan: Getting On funny because it's accurate

The co-creator of BBC4's hit hospital comedy series on the art of simple humour and dog training.

Cast announced for American pilot of Getting On

Roseanne's Laurie Metcalf, Family Guy's Alex Borstein and Reno 911's Niecy Nash are checking into Getting On, HBO's medical comedy pilot.

Radio Times review

A obvious triumph for BBC4's understated cleverness, increasingly celebrated as the superb third series developed, was Getting On, which ended its run on Wednesday. Jo Brand, Joanna Scanlan and Vicki Pepperdine write and act this comedy, set in a women-only geriatric hospital ward. It's a masterclass in letting your creations breathe.

The main characters are all female, something that hardly ever happens on television but is never emphasised. This series acknowledged the accelerating privatisation of the health service, but wove it into Pepperdine's ace portrayal of the antagonist Dr Moore, a brittle snob who uses her sharp elbows to nurse her own reputation and sees patients as stock to be processed - or, in series three, potential subjects for her photographic study of vaginal atrophy in the elderly.

Dr Moore's desire for profitable efficiency is constantly undermined by grubby reality in the form of Den and Kim, the ward sister and nurse who have to dish out the drugs, shuffle the beds and "wipe the bums". Scanlan's Den is a jumble of kindness, daydreams, delusion and loneliness whose pregnancy this year made her even more distracted and vulnerable - but Kim is our eyes and heart, thanks to Brand's selfless performance.

Getting On gives Kim no comic traits apart from weary bluntness and a drab home life, hinted at in phone calls about running out of fish fingers and ketchup. While the funny, absurd stuff was happening to Pepperdine and Scanlan, Brand represented the show's frustrated compassion, buffeted by bureaucratic idiocy and often disobeying orders to do little favours for the patients or avoid another dirty, pointless task.

Kim's attempt to become a doctor was crushed in mundane fashion: she didn't have the time or ability to pass the relevant course. The last episode had emotional pay-offs for Dr Moore and Den, earnt through careful but unobtrusive series-long plotting, that gave the characters new depth. Kim just bumbled off home as usual but, BBC4 budgets willing, she'll be back to win more tiny victories against depressing odds.

Not just funny: it's a radical, profound masterpiece

BBC4's acclaimed but little-watched hospital sitcom is quietly groundbreaking in its portrayals of women, age and the NHS. And it's very, very funny

The end of visiting hours is upon us as this perfect, bittersweet hospital drama reaches the end of its run. The personal lives of Kim, Den and Pippa criss cross with life and death on the wards, where there's a surprise appearance - a silent cameo from Oscar-winning actress Tilda Swinton, followed up by Hugh Bonneville as Pippa's ex. It seems everyone wants in on Getting On.

Considering it's such a bleakly intimate comedy, Getting On attracts glittery attention. It's a favourite of Mad Men's Jon Hamm and, in the final episode, Oscar-winner Tilda Swinton has a wordless cameo as the assistant to a preposterously pretentious artist.

Swinton, barely recognisable with black hair, turns up on K2 ward with a bunch of kids doing an art project. Their teacher is a ludicrous bearded German who announces to his little group, "All human interraction is social sculpture." He then insists they pester the old ladies, adding, "Bodily fluids can also be part of the creative process", when one worries about her wee.

It's a lovely valedictory episode - hugely funny in parts, but brushed with sadness in others.

Honest, warm and human, Getting On's wry dramatisation of the inefficiences of the NHS is as clever as it is funny; the script is a credit to Jo Brand, Joanna Scanlan and Vicki Pepperdine. In the series finale, a group of schoolchildren arrives at the geriatric ward to sketch images of the patients and Sister Den (Scanlan) is sceptical: "Most are doolally, deaf or asleep. Good luck to them." Watch for cameo appearances by Hugh Bonneville and Tilda Swinton.

Tilda Swinton and her real-life partner Sandro Kopp cameo tonight; he plays art teacher Dylan Shwarz while she's his mute assistant Elke. "All human interaction is social sculpture," Shwarz tells his band of schoolkids, who must make artworks based on tales the patients tell them. "Well, they're all doolally, deaf or asleep, so good luck to you," retorts Den - who's in for a surprise later. Last in the sublime series, and therefore the last time Richard Hawley croons that lovely song over the credits - at least for now.

Getting On doesn't heave with belly laughs, it's more about smiling in pained recognition at the small things about life and death and the NHS. But there's a proper gut-buster of a gag on K2 ward tonight involving a Christmas card competition among hospital staff for the kids' oncology ward and an unfortunate guinea pig on the terrible Dr Moore's icky pet project.

Moore (Vicki Pepperdine) is at her tin-eared worst when she tries to save her skin and later when she has to break some bad news. The woman is barely on nodding acquaintance with compassion and, as usual, she has to leave the tenderness to others. Well, I say "tenderness", but in the case of wily Sister Den (Joanna Scanlan) it's more a case of revising history.