The reality of working on the NHS frontlines

From managing heart attacks to tackling health inequalities and working in multidisciplinary teams, this article has it all. Dr Edroos, an award-winning consultant cardiologist at Luton and Dunstable Hospital, shares his reflections on the reality of working within the NHS frontlines.

1. Why cardiology?

When you become a doctor, you want to be doing something that helps people. You also want to do something that fits with what you like doing. I enjoyed doing procedures, but if I just did that, I would get bored. I also want to talk to people, have patients on the ward, and in my clinic. I enjoyed the research side of things. Cardiology gives you all three – procedures, being in touch with people and the research.

2. Rewarding aspects of your job

You have to remember you’re there to provide a service. You’re using your training and applying it to your patients. In cardiology, you can act in the condition that is causing harm – you’re there to make things better. In a heart attack, you have to receive treatment immediately, otherwise, the patient can pass away. You go from a patient who’s at risk of dying to being fine within 20 minutes. When you serve patients, all these rewards come – you see amazing things.

3. Challenging aspects of your job

When you’re doing procedures on 25-year-olds and 30-year-olds, you wonder why this is happening, why do people from certain postcodes have these problems, while others don’t? That’s where the research comes in. I’m based at Luton Hospital, a deprived area; other parts of Bedfordshire are quite affluent. You see variation in outcomes depending on where people are born – how do you work to minimise those problems? Across the country, people suffer from diseases not because it’s their fault, but because of a lack of opportunities and environment. That’s more than you can treat as a doctor and seeing that is quite challenging.

4. Approaching patients when talking about reducing risks

You need to understand where they’re coming from – is this important to them? Some say, “I don’t care.” Others have responsibilities and haven’t focused on their health due to pressures. Without that shared understanding, you’re not going to get anywhere. There may be language or comprehension barriers. I only see them for 20 minutes every 6 months. It’s about enabling them to access information and make decisions.

5. Skills that healthcare professionals need to excel

It’s making sure you don’t focus solely on excelling. You need to work with people around you – faculty development. If you focus on your own success or failure, it doesn’t get you far. You want a team where everyone is developing, taking on harder procedures and understanding difficult diseases. If I’m taking it all on, I’m not excelling – I’m drowning. You need to share in the difficulties and gains. You can’t succeed in isolation.

6. Working as part of the multidisciplinary team

You can’t do what I do on your own. In a heart attack procedure, I’m one of six: a physiologist, radiographer, nurses, maybe a registrar. The procedure can’t happen without them. Afterwards, the patient goes to the coronary care unit. To get to me, they go through A&E, ambulance, or GP. They meet 20–30 people through the course of their treatment.

7. Communicating under pressure in the multidisciplinary team

It depends on the pressure. For me, it’s when a patient is having a heart attack, and the procedure isn’t working. You need the nurses, consultant colleagues, and intensive care. We often call the ICU to breathe for and sedate the patient. It’s about being clear in your thinking. But you don’t get anywhere without knowing your team. When I call the ICU, I know their names. Working under stress depends on the relationship you’ve already built.

8. Discrimination and inequality in the NHS

No trust will say they’re discriminating. They all work against this. My trust emphasises respect and recruits from all over – India, the Philippines. Yet, our CQC inspection last year showed evidence of racial bullying. Nationally, it’s the same. The NHS is founded and dependent on people from abroad. If you don’t have immigration, you can’t support the NHS. Go back to post-war, Windrush, then Caribbean, Indian, Filipino, Irish, and European nurses.

9. Most undervalued NHS jobs

During COVID, nurses and doctors were seen as heroes. But did they recognise cleaning staff, equipment deliverers, and truck drivers? Also, do NHS staff get paid or trained like in other countries? It depends on what you call value. You want everyone to have development opportunities, from the lowest-paid jobs to the head of the hospital. Many don’t, and that is undervaluing them.

10. A lesson that you learnt over the years

Everything seems unstable now. You’re applying to medical school, jobs, and training, unsure if you’ll get in. There's a lot of uncertainty for junior doctors – lower salaries, people moving abroad. You’re allocated jobs randomly. Rewards have gone down; the pathway isn’t as strong. But ultimately, you will always need doctors and healthcare. Back yourself. Develop resilience. Don’t worry about rejections. Something else will come. I didn’t get into medical school several times. It didn’t mean I couldn’t be a doctor.

Amidst the uncertainty, Dr Edroos’ reflection underscores the resilience, empathy and collaboration at the heart of our health service. Our frontline workers’ unwavering commitment to patient care and professional integrity is not only admirable but essential to the survival of the NHS. Perhaps it’s time to fight the greedy and devilish depictions of our trusted workers portrayed by certain individuals and institutions in the media. After all, our lives are *literally* in their hands.

Written by Fatima

Moderated by Shelaa

References

Edroos, D., 2025. The reality of working within the NHS frontlines [Interview] 2025.