Reflections on an overnight shift at Chelsea and Westminster Hospital

Health and Social Care Secretary Matt Hancock reflects on a night spent on a shift at Chelsea and Westminster Hospital and with the London Ambulance Service

Last night I did the overnight shift at the Chelsea and Westminster Hospital and on board with the London Ambulance Service. I’m a bit bleary-eyed but I thought it worth writing about what I saw.

My grandmother spent her career doing regular overnight shifts, so I was proud to don my blue scrubs, though mostly as an observer. I spent the first part of the evening shadowing a consultant in the busy A&E department, seeing GPs collaborating with hospital doctors and nurses to treat some minor problems and a whole series of very serious incidents in Resuscitation and Majors.

I then spent a few hours with the site manager – the most senior nurse on site – visiting each ward, as she allocated bed moves real time, checked on sick patients and managed staffing for the morning. After that, I jumped in the ambulance with the London Ambulance Service guys for 2 hours – watching their work and the A&E departments of St Georges and Charing Cross from the paramedics’ point of view – before returning to Chelsea and Westminster for morning handover and a much-needed coffee.

Reflecting on the night, 3 things have struck me.

First, the dedication and camaraderie. We all know the NHS staff work incredibly hard and do amazing things every night of every year, but to see how they work together under pressure with such professionalism and maintaining levels of human empathy was breath-taking. Watching the whole team in action, especially when a blue light arrives, or the emergency bleep sounds, is like watching an orchestra in full flow.

Next the technology. Or lack of it. I was already motivated to improve the IT of the NHS – but boy! Chelsea and Westminster Hospital is one of the better trusts for IT, but even there it was clear we have so far to go. And it was through no fault of their own – but rather the lack of national interoperability standards, which means systems just can’t talk to each other, so people are forced to revert to pen and paper. Staff were hindered by IT in a way that we simply wouldn’t accept in any other organisation in the 21st century. Tonight has motivated me more than ever to sort this out: interoperable data standards are on their way.

Third, the sheer communication skills of the teams. Being a medic, a paramedic or a nurse is of course about the medicine, but the professional ability of the staff to impart information efficiently and clearly under pressure was mind-blowing. We may think about medicine as a science but the staff’s capability to communicate clearly and concisely in these circumstances demonstrated an astonishing level of professionalism and skill. Operating on a 24-hour basis like hospitals do, you can’t depend on an individual knowing all – handover is everything. This, if anything, makes the importance of improving tech even stronger.

It was a huge privilege joining the amazing people of the Chelsea and Westminster Hospital and the London Ambulance Service on the frontline last night. Meeting the staff whose unstinting dedication, compassion and professionalism was an inspiration to behold, this was an experience that will last with me for some time.


Department of Health and Social Care
The Rt Hon Matt Hancock MP