If you haven't started ITV's medical thriller Malpractice yet - head to ITVX and catch up on the first episode. Starring 30-year-old Irish actor, Niamh Algar (who recently starred in The Wonder with Florence Pugh and HBO's sci-fi series Raised by Wolves), the five-part series follows Dr Edwards, a competent and compassionate registrar in a struggling A&E ward, as she’s investigated for overseeing the preventable death of an opioid overdose victim. We witness her life quickly unravel as the investigation unfolds and pressure mounts both at work and at home – and it makes for devastating viewing.
When Niamh first opened the script for Malpractice on a bus journey home, she only planned to read the first ten pages, but she couldn’t put it down. ‘It was one of those things where I just read it straight though without breaks,’ she says. ‘I always wanted to play a doctor - I think they’re the closest thing we have to superheroes.’
Malpractice couldn't be more timely, with ongoing industrial action in the NHS over pay disputes dominating the headlines. And the challenges we see in Malpractice are informed by the first-hand experience of Grace Ofori-Attah, the former NHS doctor who wrote Malpractice.
‘There’s so much being thrown at this character,’ Niamh explains, ‘that when I saw it was written by Grace who’s a former doctor, I was like “I knew it!”.’ In the first episode there’s a scene where a wounded gunman storms into the A&E reception and staff are told to evacuate – this was all in a day’s work for Grace. ‘The level of detail she’s created can only come from someone who’s lived through that immense pressure.’
And if the plot sounds stressful, the direction from Boiling Point’s Philip Barantini does little to ease that feeling. ‘Reading it I drew instant comparisons with Boiling Point and Uncut Gems, it’s got a cinematic pacing that feels relentless,’ Niamh says, ‘and when I saw Philip was attached to direct, I thought that is incredible. I 100% want to be part of this.’
The way Malpractice is filmed - which is not dissimilar to Philip’s one-take restaurant thriller Boiling Point - is as unforgiving as the subject matter. The camera remains uncomfortably close to Dr Edwards as she’s forced to make a split decision to free up a bed for the gunshot victim – lingering over her as every passing second delays the patient’s chances of survival. We share the panic in Matron Beth Relph (Hannah Walters) and Dr Ramya Morgan’s (Priyanka Patel) eyes as they await instruction.
While life and death scenarios are commonplace in a hospital, the urgency with which these decisions are made is difficult to comprehend by reading a statistic or listening to an anecdote – Malpractice does something to bridge this gap. The whole series was shot in a ten-week ‘marathon of a shoot’ and, true to the world they hope to emulate, there were no rehearsals as there wasn’t time. ‘I had just finished a shoot on Disney, and Phil’s schedule was really busy, so it was difficult,' says Niamh. 'But it just meant we had a razor-sharp focus.’
How do you get into the headspace of someone facing that kind of pressure? ‘We’ve all had experiences in an A&E and pondered the idea of what it must be like to work in that environment. My mum was a nurse, my sister-in-law is an A&E nurse, my boyfriend’s sister is an A&E nurse and one of my good friends was a junior doctor in A&E,’ she says. ‘I feel like I’ve been surrounded by conversations about the undervalued attitude towards the healthcare system for a very long time.
‘I had a responsibility to showcase the effects that might have on a person,’ the actor continues, ‘in the most honest and truthful way you can as an actor.’ And that’s not something she undertook lightly. As soon as she accepted the role, she arranged to shadow an A&E doctor in a central London hospital so that she could visualise every procedure in the script. ‘I didn’t want to base my performance off a constructed TV series or anything I’ve seen before.’ Instead, she found herself immersed in the world of the show and asking questions like ‘when you’re doing a lumbar procedure, is everyone that relaxed even though you’re putting a huge needle into someone’s spine?’
Talk about immersing yourself in the world of your character, Niamh's on-screen husband Tom is played by her real-life partner Lorne Macfayden. ‘Neither of us knew that we were both cast in it until his agent got the email through. They had no idea we were together, so it’s funny when you’re able to run lines with your boyfriend the night before you’re both filming,’ she explains. ‘As Lucinda is put under more pressure at work, you begin to see how that affects her home life. It’s interesting to see two sides of the doctor – her at work and her at home.' Working and living in such an intense environment with little to no respite can’t have been easy. ‘It was difficult! We’d sit and watch Bake Off or any low stakes telly in the evenings so we could switch off.’
But as an actor, Niamh doesn’t seem particularly interested in anything low stakes. In Shane Meadows’ The Virtues, she plays a recovering addict hoping to reconnect with the son she gave up for adoption when she was 15, only to find that her own mother had deliberately severed ties between them. Has she ever been tempted to say yes to something lighter?
‘I like playing characters who aren’t trying to be liked and you could bump into them any day of the week and it’s almost like you’ve met them before. I think everyone is incredibly complex and flawed, and also extraordinary in their own way. There’s never a simple story.’ It’s this approach that makes Niamh such an expert of her craft – she puts such effort into empathising with her characters that she forces the audience to do the same. Her relationship with Dr Edwards in Malpractice is no different. ‘She’s good at her job,’ she assures me, ‘and she cares so much about the patients and her team. It’s just that she’s a cog in a machine that is falling apart.’
Malpractice continues on Sunday nights at 9pm on ITV1