Malpractice aims to bust NHS myths in hard-hitting second series

Yahoo

04-05-2025

Anyone who watched the first series of ITV's Malpractice will know it's both a compelling thriller and an insightful look at the workings and associated problems with the UK's National Health Service.
It's a combination that's as entertaining as it is thought-provoking. Grace Ofori-Attah, the mastermind behind the show, hopes Malpractice could make a real difference to the NHS as she prepares to discharge a second series.
"One of the things that was surprising in a really positive way with series one [was] it aired just as another set of doctors' strikes was happening, and we had feedback from some journalists who'd said that they were dead against the doctor strikes.
"And then they watched the show, they talked to me, and had a completely different insight into what it is literally that doctors do day-to-day, and why they might feel under-appreciated and undervalued given the stresses of the job,' Ofori-Attah tells Yahoo UK.
The screenwriter, whose credits also include Stephen Graham kitchen-set drama series Boiling Point on which she was a consulting writer, and the recent Playing Nice starring James Norton, says it's easy to roll your eyes when you hear doctors want a pay rise. But it's an oversimplification.
"It's more that we just don't want to be paid less to do more work, which I think most people would agree with,' Ofori-Attah explains. "People assume that doctors are these really wealthy individuals who have quite a glamorous career. Even with [the executives at] ITV, when we were making this series, one of the questions that I kept getting back was, 'Why does he live in a house share? He's a successful doctor', and I'm like, 'Because he can't afford to be living in his own property'.
"Most doctors who are junior doctors don't own their own homes. So just even tackling minor perceptions like that [leads me to] hope this show gives people pause for thought about what it is to be a doctor in this country."
The drama is drawn from Ofori-Attah's real-life experiences working within the NHS as an Oxbridge-educated addiction psychiatrist. It's dramatised, so the story unfolds accordingly and through the first series, a conspiracy is gradually revealed across the five episodes.
It's pacy and punchy, riveting and hard-hitting. Series two follows a different story in a different location — the Queen Mother's University Hospital in North Yorkshire — with mostly different characters. The plot revolves around Tom Hughes's psychiatric registrar and looks set to follow a similar arc. But precisely how true to life is what we see on screen?
Series two, says Ofori-Attah, is inspired by a number of actual cases she encountered during her work as a psychiatrist, and as a consultant perinatal psychiatrist.
"There are different aspects of the story that are inspired by situations that I've been in," she says. "The case that we see [in the second series], it's the startling, dramatic representation of mental illness, but it has so many common facets. Like, on a night shift — on any on-call shift — as a junior doctor who's on call, you'd see psychosis as the emergency presentation. And I saw it so many times."
The series spirals when Dr Ford is caught between a new mother's postnatal check-up and a psychotic patient, with devastating consequences. Ford is subsequently the subject of an internal investigation.
"It's not common knowledge how an emergency psychiatric admission comes through the hospital system," says Ofori-Attah. "Even for myself, having spent years doing the job, coming to set and seeing this representation of it… actually, I found it quite distressing, even though I'd written it and I knew what it was going to be like, and I witnessed it happening.
"Something about the separation in time, and then being confronted by it, but not being in control of it as a doctor having just to give production notes felt particularly stressful. I think it's just something that I feel is a real privilege to be able to depict truthfully on TV for people. And I'm tentatively excited and nervous about what people will feel about seeing that."
Actor Zoe Telford plays Dr Kate McAllister, a consultant psychiatrist who feels the pressure of carrying out ward work under the bureaucracy of NHS management. Telford reveals that there are two significant things that her character does that really happened. "I think everything that is within the script has happened, and even the most tragic parts of our story, even though they are obviously rare within the NHS, are taken from real-life experiences," she explains.
Selin Hizli plays obstetrics registrar Dr Sophia Hernandez, a single mother juggling a demanding career with raising her children. Hizli maintains that much of what unfolds in series two is rooted in truth.
"[Regarding] one of the things that happens in the story, there was a test case that [Grace] was able to give me lots of information about," says Hizli. "It was really useful to just know that Grace has worked with people if not exactly like the person that you're playing [then at least] that they are always rooted in truth… It was a real insight into the different specialisms, and how different they are from each other, but how when they overlap, there's a lot of personalities meeting, and there's a lot of different methods of working."
It's easy to see watching the series how this can inevitably lead to problems, clashes, oversights, and misjudgements. Consequently, there's a real sense of legitimacy to Malpractice that lifts it above other medical dramas. It's this authenticity that you feel could make a real-world impact to the running of the NHS, highlighting at a granular level some of the issues and knock-on effects in a way that makes things less abstract for viewers and more concrete. It's acutely observed and intricately woven and deserves to make waves the way that series like Adolescence and Mr Bates vs The Post Office have.
Hizli, who makes her debut in series two, says that one of the things that struck her about the first series is the suggestion of how much everyone cares: "Everyone is pouring so much of their energy and their effort into the work, but it's just such an impossible environment a lot of the time. Every decision you make has some kind of knock-on effect."
It's like trying to plug a hole somewhere, the actor says, and every time one hole is plugged, another forms. "I think that's what Grace captures so well in both series — these people are having to make decisions, and really difficult decisions, and a lot of the time they're having to make them really quickly. And with all of those other pressures of life and work and families. So anyone who really enjoyed that authentic aspect of series one, I think they'll find that in series two as well."
It's not only problems within the NHS and the theme of malpractice that link the series. While series two tells a different story to the first, a pair of characters thread through both. They are Norma and George aka Dr Callahan and Dr Adjei played respectively by Helen Behan and Jordan Kouamé. Norma and George work for the fictional Medical Investigations Unit (MIU) and get called in when there's potential malpractice to investigate. There's a real-life equivalent called the General Medical Council (GMC).
Behan, who like Ofori-Attah also worked within the NHS (as a nurse) tells Yahoo UK, "Norma's approach is always in the unpicking and the investigation, and it's a lot about looking at a doctor's work and their decision making."
She adds, "George is the one that will ease you in gently, and Norma's the one that'll cut your jugular. But they're a good team, and they're very necessary."
Necessary they might be but Ofori-Attah says that the process by which they operate is far from perfect and another problem the series highlights.
"We're not machines; we're not replaced by AI just yet," says the screenwriter. "We do make mistakes, and I think the people who regulate that need to be understanding of how that comes about – and also of the way they're processed in investigating [because it] can worsen the whole situation. It's bad enough to be under investigation, but having to go and do your day job and then having to be interviewed in what is [shown to be] quite an 'interrogation' style by Norma is very intimidating."
She continues, "I think there are, and they're looking into it at the moment, a number of doctors who have committed suicide whilst under investigation by the GMC, purely because of the process, and in a few of those cases, the doctors were about to be found innocent of all charges. But because the process doesn't really take into account the human person, it can sometimes get blinkers… there was a person who was being investigated, and yes, they might have done something wrong, but they didn't go to work to cause harm."
Series one was set primarily in accident & emergency and revolved around intentional wrongdoing as well as the overstretching of staff and its ensuing issues such as addiction. For season two, Ofori-Attah shifts focus, transferring the action to obstetrics and the psychiatric unit.
"I wanted to share with this series, slightly different to series one, how the whole system sometimes can work against you," reveals the writer. "With Dr Ford's character, he's trying his best. He's trying to advocate for his patients, but the mental health hospital [and] the structures that exist to facilitate that don't really help him. There are lots of problems with the NHS, but one in particular is mental health services and funding.
"Post-pandemic, we have quite a big mental health issue within the country that's presenting in so many different ways, and it just seems also to, at the same time, be the bit of medicine that keeps not getting the funding that the government says it's going to get. And so, without it being a public service announcement, I wanted to just take a look at that and just see if there was a dramatic way of sharing the struggles that doctors have in that area."
Post-pandemic, we have quite a big mental health issue within the country that's presenting in so many different waysGrace Ofori-Attah
Behan adds, "I think, globally, these issues speak to everybody. It's a worldwide thing. We are all struggling. Certainly, our men are better at talking now than they were 20 years ago; than my father was when he was growing up. But we're still only [just] unpicking that, and the services are so saturated. Everybody wants to see a psychiatrist, a psychologist, a counsellor, and it's impossible to get them.
"If you can afford them, it's still impossible to get. The services are not out there. And I think the importance of this show will be to highlight to people that everybody is doing their best, [and that, yes, these subjects are now on the table."
Telford believes that one of the key aspects of the series in helping it resonate is in its understanding of representation. "It's really important that we all see ourselves represented in the stories that we tell. And so I think the more we can do that, the better for us as a society," she says. That includes reflecting what so many of us as individuals are going through.
"I think it's fascinating, and baffling, that the mental health services within the NHS seem to be so woefully neglected. It was a real eye opener to me… learning that, I think, mental health services take up something like 20% of the disease burden but actually, the funding they receive I think historically is something like 11%. [NHS data shows it was 14.5% in 2023/24.]
"Why? Why is that happening? Why is it that we're willing to neglect that part of our society in such a way?" she asks. "What does it say about us? It sounds to me like there is still an element of shame around [it]. It's almost like we want to bury that somehow. I hope that [the show] does cause people to have conversations, because it's such an important story."
The power of the show, says Hizli, is in the human element. "I think we all have an opinion on what's going on in the NHS, and we all have a certain level of experience with it, and maybe some sort of preconceived ideas about what the service is and what it means to us and the people that work in it," she begins.
"But I think quite often those thoughts and ideas can be quite abstract. And hearing politicians talk and hearing figures and numbers bandied around, there's a level of detachment that we can view those things from, whereas I think this story gets into the real human element of it."
She continues, "I think it's really easy to forget that every person that works in the NHS … [is a] human being, with lives and pressures. I felt like the story and the show just puts you right in it, and you can't look away from it.
"These people are showing stories that really do reflect what people go through … The show gives people a real window into what's going on and the type of people that not only these things are happening to, but the type of people that are working in that environment. It brings it really close to home.'
Malpractice returns at 9pm on Sunday 4 May on ITV1 and ITVX.