After World War 2, thoughts turned to post-war reconstruction under a new Labour Government, with Minister of Health, Aneurin ‘Nye’ Bevan, introducing the revolutionary NHS. On July 5 1948 the Government took over responsibility for all medical services, with free diagnoses and treatment. The principle (which still holds) of healthcare free at the point of delivery and based on need not wealth was established. It was the first universal healthcare system available on this basis and is still revered by the vast majority of Britons.
There has been pressure on the NHS as long as most of us can remember, particularly over winter, but the recent COVID-19 pandemic took these pressures to a new and critical level. The NHS now faces a massive backlog of millions of cases, augmented by a growing and ageing population. The NHS will do its best - it always does - treating 1.3 million people a day in England alone, but it is incumbent on us citizens to also do our best, to live healthier lifestyles, easing some of the pressure that way.
The organisation adapts constantly as the needs of our people and the nature of illness evolve. The NHS was responsible for the world’s first liver, heart and lung transplants, as well as developing pioneering new treatments such as bionic eyes, and using robotic systems to help cure prostate cancer sufferers, and drones to deliver chemo drugs. Large-scale vaccination programmes were introduced, the most recent being only too recent: the COVID pandemic seeing the NHS researching on an unprecedented scale, enabling the world’s first effective treatment, then putting jabs into arms in a rollout that was both miraculous and urgent. In the single month of January 2021, there were 100,000 hospital admissions with the virus. Every single member of the NHS family matters, but in a year of 75th anniversaries we should perhaps pay a special tribute to ethnic minorities who make up 42% of medical staff working within the NHS. It was in June 1948, the month before the NHS’s launch, that the 'Empire Windrush’ docked at Tilbury.
To learn more about the NHS’s work locally I spoke to Janis Sulston, Child and School Health Fail Safe Officer, Hertfordshire Community NHS Trust, who clocks up an amazing 49 years in the regional child/school health system in September and is being recommended for an NHS Parliamentary Award for lifetime achievement. She’s a local gal and a twin to boot, born at Hertford County Hospital and living in Hertford. 'I was 16, left school and had a phone call from the careers office to discuss an NHS job. I was initially employed in a junior admin role and was told I’d got the job because of my neat handwriting! That was in September ’74. I was working in School Health, doing odd jobs, filing etc. A few months later I was helping out in the dental department, ordering stationery, dental supplies and so on. I was just generally helping out. It was 1979 when I was asked if I’d like to work in Child Health”.
Janis’s length of service tells us something about working in the NHS and it's repeated throughout the service. “I’ve enjoyed myself. There’s always something different every day, ' she says. 'I found the award nomination a bit daunting, though. I’m really happy doing the job but don’t desire too much attention! Child and School Health or the Child Health Information Service (CHIS) is where we register births and, sadly, deaths, plus we record new-borns’ blood spot screening tests on five days, and run reports highlighting missing results. We run all the immunisation programmes for children aged under three and a half, sending appointments out on behalf of GPs, sending clinic lists to the surgeries, and updating records afterwards for immunisation targets. Registering deaths is tough. I try to avoid the details, just recording what I must. I feel it’s best to remain ignorant sometimes as it could just get too much. We also record movements when a child moves in or out of the area, and deal with adoptions, too, ensuring all the records are up to date. I’m involved on the admin side, but my work supports health visitors and school nurses, too”.
Child Health is a massive operation. 'We used to cover just Hertfordshire but we now have Milton Keynes, Bedfordshire and Luton within our remit. Everything changed again on March 23 2020, when the Government announced working from home. It was my birthday and I had to bring everything home to work from there and have been doing so ever since. I’m part of a nice team, though. I was lucky I wasn’t in the front line. My sister-in-law and niece were intensive care nurses throughout Covid and their experience was very different. It was such a new experience so we didn’t really know any better at the time. Now we talk about 'before' and 'after Covid', which shows what a major event it was'.
Reflecting on her 49 years with the NHS, Janis says: 'I like to think I’ve always been helpful and brought much more to the job than neat handwriting - something that isn’t such an asset now anyway! I’ve worked in quite a few buildings, including County Hall with the Register Office underneath. I actually witnessed a marriage once, as the happy couple came without witnesses of their own. We once had office space in a junior school and used to attend the children’s assemblies'.
Janis works in one of Caroline Shepherd’s teams. Caroline qualified as a nurse in 2007 and is now Assistant Director of Operations Child Health and Immunisation Programmes, Hertfordshire Community NHS Trust. It’s a busy but impressive name badge. She’s based in an office in Welwyn.
Says Caroline, 'There are four immunisation teams for school-age children and there are four different teams for Covid vaccines, as well as one child health department, where Janis works. I’m responsible for about 200 members of staff but at least once a week I’ll be vaccinating - how can I look after my teams if I don’t understand what it’s like for people doing the work? I also enjoy the work, plus I get to know people better working alongside them. Putting jabs into very young arms can be distressing with babies but rewarding with older children where we’re protecting them from serious diseases. The more senior people are so used to having jabs they tend to take them in their stride.
'Immunisation is an unsung hero in a sense. Everyone could be catching measles, for example, if we didn’t have the programme. People don’t always realise how lucky they are to have free vaccinations. There isn’t normally any clue as to the impact it would have if we didn’t have these jabs, but Covid was a wakeup call: very scary and visible. The Covid pandemic has led to some vaccination fatigue. We have lost our immunisation rhythm as a country; the distrust of Covid vaccinations has impacted some of the other vaccinations that the UK has to offer. We’re responsible for some 660,000 children across Herts, Bedfordshire and Milton Keynes, plus around another 900,000 for other areas of Norfolk, Suffolk, Cambridge and Peterborough.
'We're seeing more vaccine-preventable outbreaks now; a downside of the Covid pandemic was that socialising stopped, which meant children were not exposed to chicken pox, measles and so on and vaccination programs were interrupted; a double whammy. Parents were fearful of taking children out; the NHS was responding to the pandemic. Some of the impacts of the Covid pandemic are yet to be realised. Children get exposed to viruses and diseases when mixing with people from outside of their households, but that didn’t happen during Covid, so there are large numbers now who have not been exposed to chicken pox, for example.'
'I believe in making work enjoyable for everyone in the team, ensuring people are happy to come to work. It has to be like that if you want to get the best out of people. I want to be approachable; I wouldn’t want anyone to feel uncomfortable or unhappy coming into work, so they can do the best job possible. The NHS is a hard enough environment without making it harder. My ways of thinking came from my Dad. He taught me no-one is better than anyone else and that anything is achievable.'
More NHS Herts Voices
Andrea Hone
We all can imagine how incredibly hard it can be to care for someone we love when they're unwell and Andrea Hone, who works for West Hertfordshire Teaching Hospitals NHS Trust, is someone who has made life for carers that little bit better. Last year, she won the NHS England-sponsored Commitment to Carers category of the RCN Nursing Awards. Working with the hospital’s integrated discharge team and Hertfordshire County Council, she started the Connecting with Carers Discharge Project and recruited a carer coordinator to help manage it. Carers are now supported during their loved one’s hospital admission, and the team works with voluntary organisations to ensure there are prompt referrals for any support they need. Carers receive follow-up calls at two and four weeks after discharge to review referrals, to check on their well-being and to discuss any concerns.
Says Andrea: ‘I am passionate about making a difference for our carers, so to win an award is absolutely amazing. To get the recognition for the hard work that has been carried out to develop the service is an honour. But as well as being proud, I’m really excited for the future as this will showcase the importance of supporting carers not only in my organisation, but nationally too. And it will give me opportunities to improve the service further.’
The Versius team
Last year, West Herts Teaching Hospitals NHS Trust became the first NHS trust in the country to install two Versius robots to assist with surgical operations. The state-of-the-art robots made their debut last summer and are being used to perform colorectal and urology surgery. By February of this year, over 100 operations had been performed.
Vanash Patel, consultant colorectal surgeon, is the driving force and vision behind the robotic programme at West Herts. He explains, 'The robot works by creating a virtual pivot point around the small incisions through which the robotic instruments are inserted. This minimises trauma and puts less strain on the patient. The patient needs fewer opioid painkillers, which leads to a faster recovery.'
Speaking earlier this year, Mr Patel said: 'We’ve now been able to competitively recruit to hard-to-fill posts based on a desire from surgeons to operate robotically. All surgeons and their teams go through a comprehensive training course before carrying out robotic-assisted surgery with patients. This includes practising using a Versius trainer simulator, e-learning modules, as well as face-to-face mentoring in the operating room.
'As a teaching hospital, having two surgical robots means we can accelerate our staff training programme, giving surgeons who join the robotics programme access to state-of-the-art technology to train when needed, while ensuring a robot is always available in the operating room.'
Karen Bowler
Karen Bowler, who joined the NHS as a student and rose up the ranks to become a deputy head of nursing, celebrates 45 years with West Herts Teaching Hospitals NHS Trust this year. Karen began her career with the trust as a student nurse in 1976, before joining the surgery division at Hemel Hempstead Hospital after qualifying. Having worked mainly in Hemel Hempstead, she moved over to Watford General Hospital to become the trust’s first ‘modern matron’ in 2001. After spending many years in the surgery division, she later worked in patient experience and education before becoming deputy head of nursing for medicine in 2018. Says Karen: 'I’m so proud to reach 45 years’ service in the NHS. It’s been an amazing career, made all the more special as it’s all been based at West Hertfordshire. I’ve worked with fantastic people and even after all these years, I wouldn’t change a thing!'
