Visible Women

Women of the NHS explain why it’s one of the best organisations in the world

To celebrate the 70th anniversary of the National Health Service, shares stories from five women who worked across five different decades of the NHS

Today marks the 70th anniversary of the NHS. That’s an incredible 70 years of free healthcare, 70 years of lives being saved, and 70 years of innovative, cutting-edge research being developed right here on our shores.

It’s hard for most of us to imagine a life without the NHS; a life where healthcare isn’t a guarantee. So, to celebrate the service on its 70th birthday, has spoken to five women who served across five different decades of the NHS, to find out what it’s really like working in the world’s largest single-payer healthcare system. 

From the Seventies right through to the present day, these incredible women have been on the frontline of the NHS at some of the most exciting times in its history – and they’ve got equally brilliant stories to share…

The NHS in 2018

Tasha is a 21-year-old paramedic working in the West Midlands Ambulance Service. She has been in the NHS for less than four years but can already imagine spending the rest of her career working in the organisation. Here, she explains why.

“I’ve been a paramedic for nearly four years now, and I never want to leave the NHS. The profession is still relatively new compared to midwifery and nursing, and I know that if I want to be the best I can be, the NHS is the employer for me – I wouldn’t get the same opportunities anywhere else. There are so many different things I can do, and so many different people I can learn from; I do emergency, frontline care, so I’m always testing my knowledge, and I can go into hospitals and learn from doctors, too.

There definitely isn’t a typical shift in my line of work – it is very random. One night I could be called out to a very poorly child, and the next I could be helping someone who is experiencing chest pain on the top of a hill in the middle of nowhere. Or I could be called out to something as simple as a stubbed toe… I wish I was joking.

I work predominantly with my crewmate, Marick, and we’re very close – we look after each other. Sometimes we might also have a student to mentor in the ambulance. There’s usually around 14 ambulances that go out on every shift, so altogether it’s quite a lot of people, but we’re still so stretched. It’s busier now than when I started out – I know that I’ll be going straight out on a job as soon as I start my shift. 

It’s tough because sometimes there’ll be a shout out for someone to take a high priority callout, but there won’t be any vehicles available. Hospital delays can mean we’re still in the corridor with a patient when we get another callout. We’re always having to drive out of our typical areas, and journeys can take anything from a couple of minutes to three quarters of an hour. It is very pressured and can be very stressful sometimes.

“It is very pressured and can be very stressful sometimes” (pictured: paramedics assisting a runner at the 2018 London marathon)

Due to budget cuts we’re also dealing with a lot more things than we used to. When you think of what a paramedic should, on paper, be doing, it’s major jobs such as cardiac arrest or helping someone who is having difficulty breathing. But now we’re finding that we get called out to things that are out of our skillset and we just have to learn how to deal with them on the job. For example, some people will call us because they can’t get an appointment with their GP, or they don’t want to wait a couple of hours for an appointment, or they can’t make their own way into the hospital. GPs train for seven years; we train for three. But we can’t leave them, so we’ll call a doctor and describe the symptoms, or get them to issue a prescription if needed.

Sometimes we just have calls from regular patients, who need help with something like turning their TV on and off. They need social care, not a paramedic, but there isn’t anyone else available.

I hope that things will settle down and become more stable over the next decade. We need more hospitals and more bed space, and for the paramedic profession to keep advancing – for example, it would great if we were able to prescribe medications ourselves, rather than having to rely on doctors. Our NHS is very precious, and we need to look after it.”

The NHS in the Noughties

Dr Karen Joash has been working in London as an obstetrician and gynaecologist since 2002. In her current NHS role she is the lead for postnatal care, and is also the lead for maternity guidelines at Imperial College Healthcare NHS Trust. Here, she remembers an NHS without emails, and explains the importance of baby boxes – an innovative new scheme she implemented in her unit, which has since been picked up by hospitals across the country.

“Both my parents worked in a hospital, so I was pretty much brought up in the NHS. My dad used to run a mental health secure unit and my mum was a nurse. I can remember being a little girl in the Seventies, skipping along these really long Victorian corridors to go and see my dad, who looked so important in his white coat taking care of all these people. The hospital beds lined the corridors and they were all so neat and pristine. That was my first impression of the NHS – that it was a place where people were taken care of, and taken care of really well. I wanted to be a part of it.

In the Noughties I was working as a house officer in the Chelsea Westminster trust. It was so different then – there used to be a phone in the restaurant across the road from us that the doctors would get called on when they were on call. Now hospitals are so busy that we can’t even walk out of the door.

There was a lot more time for interaction between teams, and you could learn from the people you really admired, which was so much better for morale. Now, we talk about human factors - possible safety issues in the NHS because some members of the same team don’t even know each other.

An example of a baby box, like the ones Dr Joash introduced to her unit

The technology has changed so much, too. When I started my first job, there wasn’t even email; now we have email bombardment! Our trust is trying to go paperless, so all our notes are logged on computers, meaning we can review everything there.

There has also been a real improvement on the emphasis on safety and on giving patients a voice. Now, patients are at the centre of what we do, rather than us having that very hierarchical doctor-patient relationship. I had an operation on the NHS and when I woke up I was told I’d had a blood transfusion. I asked why, and the response was, “well, you just did”. That would virtually never happen now; we’re much more open on explaining things, and letting patients voice any concerns they might have.

One of my most memorable moments was introducing the baby box scheme to my unit. No one really understands why, but the boxes help reduce mortality rates by encouraging safer sleep, and it improves education for the parents. It was amazing seeing the faces of the women who were able to take up the scheme. We deliver around 6,000 babies a year, and we had a 20-30% uptake, so loads of women were involved. Now the scheme has been taken up by other hospitals around the country. If that’s the one thing I can leave this world with, then I’m very happy with that.”

The NHS in the Nineties

Dr Nicola Jones MBE started her career as a GP back in 1995, when computers were only just being introduced in the NHS. She now works as Chair of Wandsworth Clinical Commissioning Group and has been the Wandsworth Clinical Lead for Cardiovascular Disease since 2005. She explains the changes to general practise in the NHS over the last 23 years, and looks ahead to the technological advances that have the power to change the face of our healthcare.

“Being a GP now is very different compared to the Nineties. When I first came to my practise, computers were only just arriving. My mentor used to drape her scarf over hers because she thought it had no contribution to make to her consultations. Now, I won’t pick up a pen for hours in the day. Computers enable us to keep more detailed records, making care safer and more effective. Patients want to access their healthcare online and be more in control of it – people are used to having everything at their fingertips now, so why would their healthcare be any different? Having people understand their health and take more responsibility for it is really important, but it’s the next stage of technology that is the most exciting. New digital capabilities will have a massive impact on health, and the personalisation of healthcare is now becoming more of a reality thanks to technological advances – we’re going to be able to tailor medications and treatments for people and have a better idea of what will work. GPs in the NHS can learn to be a part of that, and that’s really exciting.

“People are used to having everything at their fingertips now, so why would their healthcare be any different?”

However, the demands on the service are definitely greater now than they were in the Nineties. People have a much lower threshold for contacting their GPs now. Back then, the first port of call used to be a neighbour, or someone in your family, and it was practically unheard of for people to ring their GP. That’s not the case anymore, and the increase in accessibility has created more demand. Now, people are more likely to have done a lot of research about their problem before they come and see you, which means they’re more informed but also more anxious – and sometimes these anxieties are unfounded. Technology [such as Google] means there has been a shift in the kind of advice people come to us for.

There has been a real change in staffing, too. Men used to make up the majority of GP staff and they all worked full time, five days a week. Now our workforce is predominantly female and most of us don’t work full time for big chunks of our career, meaning we’re able to have time with our family. The increase in flexibility was a necessity because as women started getting more education and opportunities, and started to believe they could do anything they wanted, the workplace had to adapt. Ultimately, if you want really good women GPs, you have to make it possible for them to have families. In general practise, a career can span decades; I look after patients whose mothers I knew when they were pregnant with them. That’s one of the most amazing things about general practise in the NHS – it produces really dedicated people.

During my career I’ve also worked part time in the private sector, and the experience absolutely cemented me to the NHS. I saw the possibilities it offered and knew it was where I could really make a difference, and that is something I want to do every day. I hope general practise remains the absolute bed rock of the NHS because that is absolutely were patients should feel their care is centred. It is so important.

My favourite moment so far was being awarded an MBE by the Queen. She said to me, ‘oh, you work in Wandsworth! That must be so busy.’ That, for me, just summed it up. It is very busy and I am never short of anything to do.”

The NHS in the Eighties

Claire Murdoch began her career as a mental health nurse in London in 1983, where she quickly worked her way up the ranks. She now serves as the national director of mental health for the NHS in England. Here, she takes us back to life in the Eighties, painting a vivid picture of mental healthcare in the decade and beyond.

“My parents always taught me to have great respect for the NHS; I guess because they, and their parents, could remember a time when it didn’t exist. I started training as a mental health nurse when I was 23 after reading a magazine article about the profession – I didn’t even know such a thing existed.

It was 1983 and it felt like we were on the brink of a revolution. It was the pale end of the Victorian asylums – most mental health care took place in institutions or hospitals. It was quite literally out of sight, out of mind. But in the early Eighties there was a sense that this Victorian approach to mental health was crumbling; we were throwing away the keys to locked doors and getting rid of our uniforms, which was symbolic of our desire to really listen to what our patients wanted.

A sketch of a Victorian asylum in 1867

There was a new Mental Health Act introduced in 1983 and this gave many, many more rights to patients – they had the right to appeal and to be more informed about their care. The single biggest change at the time was in the approach to treatment. We introduced more group therapy and meaningful occupational therapy, looked at recovery approaches and worked on treatment models with shorter term interventions. We knew we needed to look at people more holistically. But the biggest change was in planning the treatment together with the patient. It sounds so obvious now, but in 1983 we were just starting to challenge the notion that doctors and nurses know best. Sitting down with someone and discussing their needs with them felt like being part of the new vanguard of change. Today, that is just mainstream – you would hope so!

It was a great time to train as a nurse and at every stage of my career, both then and now, I have felt like there was something to be fighting for and aiming at. I had the best advice I’ve ever received on my very first placement. My mentor said to me, ‘if you’re going to be any good as a nurse, you will seek to make a difference in every placement that you do’. So in every placement I’ve had, I’ve tried to understand, what can I do to help here?

One of the best moments was when I was working as a ward sister on a unit with people who had very serious, acute mental health issues. Our unit was called Ward Six but I wanted to give it a name rather than a number, to humanise it. I wanted to call it Oak Ward, but we had resistance from all corners of the hospital – the pharmacy, reception, management. We would put signs saying Oak Ward on the door and they would be ripped down. We would call reception and say, ‘it’s Oak Ward here’, and they would reply, ‘there’s no ward by that name’ and hang up. In the end, we compromised, and became Ward Six Oaks, but nonetheless, we finally had a name. It sounds ridiculous, but at the time it was very symbolic of those little triumphs – we will personalise things, we will humanise mental health. For myself and my team, and our patients, it really galvanised us in the common cause.

It was the best privilege to train as a staff nurse and ward sister back then – we’ve come such a long way in 35 years, and I’d like us to go the same distance again in the next five to 10 years. The whole country is talking about mental health now. I feel like I’ve got the Olympic torch in my hand and I’m passing it on.” 

The NHS in the Seventies

Cecilia came to England from Grenada in 1966 to train as a nurse. She worked at St George’s Hospital in London for her entire career, looking after both infants and geriatric patients while also working on surgical wards. Here, she shares what it was like working as a nurse in the NHS in the Seventies – from strict bed making, to the miraculous recovery of a patient who meant a great deal to her.

“When I was a little girl growing up in the West Indies I used to do small acts of kindness for everyone and they would say, ‘oh Cecilia, you are such a nice girl’. That really stuck in my mind, and when the NHS asked if I wanted to come and help in the profession, I jumped at the chance. I never once regretted it.

As a staff nurse in the Seventies I was in charge of the ward and had to deputise to other nurses, as well as mentor the junior nurses, especially those from foreign countries like myself. There have been so many changes to nursing since then. We were much stricter in the Seventies, but I really enjoyed it – you have to take pride in what you do. Back then, the doctors respected the nurses and the nurses respected the doctors. If you were a senior nurse, the junior nurses opened doors for you. 

The sisters on the wards were really strict as well; they were adamant that we knew how to make the beds properly. If the centre of the sheet wasn’t on the centre of the mattress, or the pillow case openings were not facing away from the door, then god help you. The sister would call you over and make you redo the entire thing properly, and she’d be standing over you the whole time. Believe me, you would be shaking like a leaf.

Student nurses at a class in 1968

We had to have good etiquette too, and be very nice to everyone. We had a proper uniform – people respect you more when you stand out. We wore aprons and caps, and black lace-up shoes with black stockings. We wore our hair back and didn’t wear rings on our fingers unless we were married. Things were much more relaxed by the time I retired. Now, I go into hospital and some of the nurses are wearing trainers; I think to myself, what is going on!

Computers have also meant a big change in nursing since the Seventies. In my day, everything was written in a book and all the patients’ notes were stored. Computers are good, but you have to have the basics. A computer cannot go and bathe a patient, after all. Nurses provide really hands-on care; you have to know what you’re doing.

One of the best changes to nursing has been all the research that’s happened over the last 50 years. Back in the Seventies there weren’t many things like heart surgeries, and it was difficult to diagnose cancer. The NHS has changed so much and it will continue changing as we go along.

“Nurses provide really hands on care” (pictured: a nurse at work in 1979)

The most memorable time of my life happened when I was a nurse. We had a 29-year-old patient who came in very ill; the doctors had really given up on her. She had to have a kidney transplant and I was responsible for looking after her, so I nursed her as well as I could. I tried my absolute best and then, after a few weeks in my care, she walked out of the door on her own two feet, perfectly healthy. It was amazing. You shouldn’t get emotional over your patients, but she was so young, and I felt it was my duty to help.

I loved nursing and I only gave it up because I had reached retirement age. I want to thank the NHS for giving me the opportunity to come over here and train as a nurse. It is one of the best organisations in the world, and I hope it will go on forever.”

From these incredible stories, it’s clear to see the impact that the NHS has had over the last 70 years - on both its patients, and its staff.

If you’re keen for the NHS to keep going for another 70 years and beyond, head here to read our advice on the six simple ways you can help the NHS to survive.

Throughout 2018, Stylist is raising the profiles of inspiring women past and present – and empowering future generations to follow their lead – with our Visible Women campaign. See more from Visible Women here.  

Images: Courtesy of NHS, Getty, Unsplash