“It’s a really, really good hospital, to be honest. It doesn’t get the recognition it deserves. Staff are very proud of it. But the patient was right to say what he said.”
The speaker is a nurse at Whipps Cross hospital in London, where Boris Johnson had an awkward encounter last Wednesday with the father of a seven-day-old girl about conditions there.
The ward on which she was treated was “not safe for children” and her care was “not acceptable”, Omar Salem told a visibly uncomfortable prime minister as the television cameras rolled. “The NHS has been destroyed … and you come here for a press opportunity,” Salem said.
Because Salem is a Labour activist, some social media users expressed scepticism about the authenticity of his claim.
But in interviews with the Guardian, doctors and nurses at Whipps Cross have told a similar story. They paint a picture of a hospital that is routinely understaffed and where equipment often does not work, important treatment targets for A&E care and planned operations cannot be met, and where “if it wasn’t for the goodwill and generosity of staff doing unpaid overtime, it would fall on its arse”.
The same nurse said: “We’re so short-staffed that patient care is compromised. For example, patients are left suffering in pain for four, six, even eight hours at a time because there is no nurse available to give them the pain relief they need, or the latest dose of their antibiotics, because they are engaged in more pressing clinical tasks. That happens every day.”
There is a serious lack of staff and reliance on agency personnel to plug gaps. One doctor said: “We are so overloaded, so overstretched. I’ve forgotten parents’ birthdays because I was too busy worrying about someone not getting all their tests for possible cancer, and I often stay late into the evening so that I can get home without having all these things on my mind.” Operations get cancelled because there are too few porters, the medic added.
Like the building itself, much of the kit is old. “Sometimes there is only one CT [computed tomography] scanner working for the whole hospital and the computer system that holds all the patient data is down for the third time in a week. We could only do emergency scans last Friday,” said the same junior doctor.
But staff also describe a place of immense dedication to caring for an often needy local population, of major improvements made in recent years and of optimism that plans for a £350m new hospital to replace one which treated soldiers during the second world war will soon be approved.
There is praise for Alan Gurney, the hospital’s chief executive, who was caught in the middle – literally – of Salem and Johnson during their tense conversation.
Dr Ross Cunningham has worked as a locum at Whipps Cross since January 2017, in its A&E and elderly care units among others.
He said: “The culture at Whipps is a positive one. There is an atmosphere of openness and support across and between departments that does not exist in every hospital.
“There have been serious [patient safety] incidents here during my time, and I have found the culture to be one related to learning and improvement, not cover-up or silencing.”
While this combination of relentless frontline pressures and staff going the extra mile to hold things together may seem contradictory, it is also a microcosm of the reality in many – possibly most – NHS hospitals.
Cunningham said: “The reality is that Whipps is not exceptional in its failings. The challenges of too many patients and too few beds are widespread across the NHS.”
The Care Quality Commission (CQC) found the same mixed picture when it last reported on the hospital in the spring.
It found “substantial waiting lists for clinic appointments … challenges with staffing in some of the services we inspected … pockets of bullying in the emergency department. The A&E had high nursing and consultant vacancy rates.”
But inspectors also noted “improved referral to treatment waiting times [for planned operations] … [and] significantly improved standards of care, dignity and privacy in medical care, improved medicines management [and] improved record-keeping in surgery”.
Dr Heather Noble, the hospital’s medical director, is candid about the challenges. “Like any NHS hospital, we have our share of operational ups and downs.” But, she added, “overall the quality of care for patients has been transformed in recent years. The CQC has noticed a steady improvement in services throughout the hospital and has rated over half the areas it inspected – including paediatrics – as ‘good’.”
She is pinning her hopes on Barts health NHS trust, which runs Whipps Cross, getting the £350m needed to replace it with a facility fit for the 21st century. The health secretary, Matt Hancock, and the Chingford and Woodford Green MP, Iain Duncan Smith, are both behind the plan. Trust chiefs used Johnson’s visit to draw his attention to it, too.
Until a decision is made, Whipps Cross and its staff will carry on, as pressure on it and the wider NHS continues to rise. One consultant said: “I fell in love with Whipps Cross when I trained there. It’s got the most incredibly caring people. But I’ve watched it suffer for a lack of ongoing resources since austerity kicked in.
“It’s the sheer bloody-mindedness and pure blood, sweat and tears of the staff that mean a building that is over a century old can yield good modern-day outcomes. But with each passing financial year, people’s goodwill tanks run drier.”
