I want to begin this series of NHS reflections with someone who represents the heart of calm clinical leadership: Fiona Robinson, a senior cardiac nurse practitioner at Broomfield Hospital.
Fiona has worked in the NHS for many years and currently runs clinics for patients with suspected stable angina. Her role is part clinical, part investigative, and entirely people-focused. She sees five patients a day across two clinic days, carefully reviewing each case before they even walk through the door.
“A typical day? I come in early, pick up the paperwork for the clinic, and start triaging referrals, seeing what’s suitable and what they’ll need. That way, when they walk in, I can focus entirely on them.”
"It Should Be Two Weeks... But It's Taking Six"
Fiona’s clinic is designed for specific cases, namely, chest pain brought on by exertion and relieved by rest (typical of stable angina). But often, she receives referrals that don’t fit the criteria.
“I had a patient today with a heart murmur referred to this clinic, but that’s something for general cardiology. These mismatches are now causing delays.”
The referral process, usually from GPs or A&E, often lacks the filtering time needed to match patients with the right clinic. GPs working in 10-minute appointment windows are under their own pressures, and that strain reflects through the system.
“We’re meant to see people within two weeks, but now it’s six.We just don’t have the capacity.”
“It’s All About Communication”
When I asked Fiona what helps care work, she didn’t hesitate: communication and teamwork.
“Good communication. A good team. Working as a team, that’s what makes a difference.”
This came up again and again in our conversation. Not just between professionals, but also with patients. She emphasized that keeping patients informed and involved is at the core of what she believes to be good healthcare. And that’s something she tries to protect , even when capacity is stretched.
“If the patient knows what’s happening and you do your best to explain it, that’s what matters.”
“We Do Have Appraisals… It’s Like a School Report.”
Fiona also spoke about the feedback systems in place, annual appraisals and informal feedback loops that help teams reflect and adapt. There’s nothing overly dramatic about it, she says. But having a space to evaluate how things are going, both individually and as a team, makes a difference.
It was interesting to hear her compare it to a school report: structured, reflective, but mutual. A reminder that even experienced professionals benefit from stopping to ask: How are we doing? What’s working? What needs to change?
“There’s Just Too Many Patients and Too Few Staff”
Fiona linked most of the system’s issues back to staffing and capacity.
“It’s the burden. Too many patients. Too few staff. That’s what holds back care”
It’s a point that needs repeating, not because it’s new, but because it’s consistent. It’s a quiet, ongoing tension beneath almost every challenge described.
What Makes It Work?
Despite all this, Fiona remains motivated by two things: the patients and the team.
“If you didn’t have a good team, it would be miserable.But we support each other. I think we do a good job.”
There’s no forced optimism in her words, just a grounded, professional pride in what her team is able to deliver, even under pressure.
Next up: I sit down with Michelle Colton, the Principal Physiologist leading our cardiac department, to explore how care is delivered when you're balancing patients, people management, and everything in between. You won't want to miss it. 🙂
Exploring Healthcare with Beatriz Batista 
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