‘The people make it work, even when the pressures are huge’: RCP president visits Queen’s Hospital in Romford

The visit formed part of the RCP’s ongoing programme of engagement with physicians across the UK, providing an opportunity to listen to member perspectives, understand local challenges and share learning that can inform national policy and advocacy.

Across discussions with consultant physicians, specialist, associate specialist and specialty (SAS) doctors, resident doctors and locally employed doctors, there was strong and consistent praise for the culture within the trust. Doctors described a supportive, collegiate environment, with good working relationships across specialties and a shared commitment to patient care:

‘We treat each other as a family rather than separate specialties’

Many highlighted the quality of undergraduate and postgraduate education, including strong consultant engagement in teaching, protected learning time and innovative approaches to training delivery. Several noted that resident doctors frequently return to the trust as consultants, which they saw as a reflection of a positive learning environment and strong professional support.

Participants also pointed to effective integration with primary care and community services, as well as good access to research, quality improvement and leadership opportunities – particularly for SAS and locally employed doctors:

‘Supporting SAS and locally employed doctors has gone a long way to helping retention’

The trust’s work to support international medical graduates and create clear development pathways was highlighted as a particular strength.

Doctors were clear that the trust operates under sustained pressure, serving a population with high levels of need and facing consistently high demand at the hospital front door. While this brings intense workload, many clinicians described the volume and complexity of cases as providing valuable learning opportunities, particularly when supported by senior decision-making:

‘It is immensely busy, but that workload creates huge learning opportunities for both resident doctors and consultants’

However, these pressures also present significant challenges. Workforce gaps, rota instability and difficulties releasing doctors for clinics, teaching and study leave were recurring themes, particularly among resident doctors. Several raised concerns about the administrative burden involved in accessing mandatory training and the impact this can have on morale and development.

Delayed discharges and corridor care were also discussed, with clinicians emphasising the link between bed flow, staffing levels and patient safety. While many recognised recent improvements and local initiatives to reduce pressure, there was a shared view that these issues reflect wider system constraints rather than isolated trust-level problems.

Doctors were keen for the RCP to use the insights from the visit to strengthen national advocacy on workforce planning, training reform and service design. In particular, participants called for:

• clearer recognition of NHS experience and progression for doctors outside traditional training pathways
• more flexible and realistic approaches to postgraduate training and specialty recruitment
• stronger national guidance on safe staffing and consultant-to-patient ratios, especially in acute medicine
• investment in systems and infrastructure that reduce administrative burden and support safe, efficient care.

Resident doctors also emphasised the importance of protected time for training, supervision and wellbeing, alongside simpler and more consistent processes for raising concerns and filling rota gaps.

Professor Mumtaz Patel, RCP president, said:

‘It was a privilege to hear directly from doctors at Romford. We were struck by the strength of teamwork, professionalism and pride in patient care, alongside the very real pressures clinicians are facing every day. These conversations matter – they ensure that real life experience shapes the RCP’s national work on workforce sustainability, medical training and how we support doctors to deliver safe, high‑quality care for patients.’

The RCP will feed back to the trust executive team in writing. The outputs from these discussions will inform our policy, advocacy and influencing work and give a voice to our members in central and north east London.

Your RCP membership, local to you

Our visit to Romford was part of the RCP’s programme of local engagement. We visit several hospitals every year to meet with fellows and members, supporting them to deliver high-quality patient care.

Our 18 local networks across England, Wales and Northern Ireland provide members and fellows with access to events, CPD, training and conferences close to home, supported by dedicated regional teams. They offer opportunities to connect with peers, stakeholders and RCP representatives, and ensure local issues are heard at a national level: