*Warning: This article contains minor spoilers for Malpractice season 2.*
Making the jump from being a junior doctor to being a screenwriter is one that a passionate storyteller like Grace Ofori-Attah hadn't actually initially envisioned.
Although she had dreams of writing a novel in her very limited spare time at medical school, it was actually her experience in the field of medicine that has gone on to inform the kinds of powerful, gripping tales she's dedicated to bringing to life on the screen.
"It all feels surreal," Ofori-Attah admits, saying that the fact we're sat talking about her show over Zoom just adds to it.
Having gone from working as a consultant psychiatrist to the world of TV, her first original series Malpractice is now returning for its anticipated second outing. The first season was a hit, centring on Niamh Algar's Dr Lucinda Edwards, who was embroiled in a medical scandal after a career-defining night working in A&E.
This time around, the show centres on Tom Hughes's Dr James Ford, a psychiatric registrar who appears committed to his work but is torn between two patients, leading to consequences nobody could have foreshadowed.
This second instalment, I tell Ofori-Attah, is arguably stronger and more emotional than the first; no easy feat for any writer. But it also firmly proves that Malpractice works as an anthology series, shining a light on different issues and sectors within the NHS.
It was an exciting opportunity, Ofori-Attah tells me, to move from A&E to the world of psychiatry, one in which she obviously has incredible first-hand experience of.
"I think it is a much more nuanced speciality. Mental health is an area that isn't often depicted on TV, and I felt like we had a real opportunity to depict severe enduring mental illness accurately and really show what it's like to be in a psychiatric medical setting," she says.
Having been in the exact same role as Dr Ford herself, did it add a level of ease to devising the story? It made it "quite straightforward", Ofori-Attah says, explaining that the bounty of medical cases she's personally worked on over the years have common themes and issues that she wanted to explore and combine, resulting in the two main stories of Rosie (Hannah McClean) and Tony (Seraphina Beh).
Rosie's a mother juggling the demands of a newborn and toddler who attends a routine post-natal check-up. But it's there that Dr Sophia Hernandez (Selin Hizli) recommends her for a psychiatric evaluation by Dr Ford, the start of a story that has a tragic outcome and shows the degrees of mental illness.
"What I think is really important about Rosie's story is showing how a seemingly 'normal' person can become this unwell and can have been trying to contain it.
"I really wanted to show that this can happen to anybody. I think sometimes there's a sort of othering of people who have severe chronic mental illness, but it really can happen to anybody and it just needs to be managed with compassion and care," Ofori-Attah explains.
When writing this second season of Malpractice, it also coincided with the announcement of the Metropolitan Police changing the way they deal with mental health callouts in London. As part of the Right Care Right Person (RCRP) strategy in London, fewer police officers now attend mental health calls, but it's a move that many charities and those working in the mental health sectors have voiced their concerns over.
As Ofori-Attah tells me, it was something her own psychiatrist friends had worries about, wondering how they would be able to manage these patients by themselves.
"It sort of makes sense when you hear the police saying, 'We're not the right people to call when someone's acutely mentally unwell,' but we know that acutely mentally unwell people can present as aggressive.
"Not because they are 'violent', but because what's going on in their heads is frightening for them and then you have people who are trying to contain it and it can escalate, as you see in the situation," Ofori-Attah explains.
In regards to Rosie's story, we do see the police use a "terrifying" head mask and restraints on her in the first episode, but that escalation in her story is one that Ofori-Attah was adamant on keeping in.
"You have a tiny woman who seems very calm and a bit placid earlier on, who later on is so aggressive, she could take them all out. I really was clear with World [Productions] that it's not an exaggeration to show her escalating like this.
"I think that we kind of owe it to patients who have passed away in these circumstances to show exactly what it is that staff are dealing with, and exactly why A&E staff, the police – it's not just that they're busy, they're also scared and they don't want to have to be responsible for what's going on."
On the other hand, we also have the story of Tony, a psychotic woman who is heavily pregnant and who Ford's team are planning to section. Her story, like Rosie's, is one that is incredibly heartbreaking, but in a different way.
It's no coincidence that Tony is a pregnant Black woman who has an emergency hysterectomy performed on her without her consent, something which will undoubtedly stop many viewers in their tracks. Her story is one that also shines an important light on the very real systemic issue of racial injustice in maternity care.
"Tony is a really key part of the story," Ofori-Attah tells me. "In setting up the beginning with these two patients, Tony's always the one who just seems to get the raw deal.
"She's in this horrible situation which you see at the beginning, she's being taken advantage of. The way the obstetric team talk about her, it's so disrespectful, and what I hope the audiences will take away from it is that, even though Dr Ford might come across as a bit self-assured, he has Tony's best interests at heart. He's one of the only people who's really advocating for her."
Although Dr Ford may be a divisive figure in the series, his depiction as a psychiatrist and his advocation for Tony especially is one that often gets lost in depictions of medical professionals, Ofori-Attah states.
"You've got these patients who often don't have capacity and you need a really compassionate doctor to want to treat them and advocate for them, not just treat them and get them out the door because they often do stay in hospital for a long time.
"So I think you see how he's trying very hard to get the best treatment for her, whereas obstetrics are very concerned about bed-blocking patients. They don't want the complications to affect their lists and things. They don't want someone who's like her on their ward and they come up with this ludicrous plan.
"I don't know what people who are watching it think when they hear that, but that is something that happens a lot in UK hospitals. I'm interested to know whether people say, 'As if that would ever happen.' But it happens.
"In one of my first jobs as a psychiatry registrar, one of my patients, I turned up on the ward to a heavily pregnant patient who was completely psychotic and the plan was to walk them across a car park to the main hospital, and you can guess what happened. It seems shocking and people may think it's there for dramatic effect, but it's not. It's something that happens quite frequently."
Over the course of five episodes, we not only uncover more about each of these patient's cases but also more about Dr Ford who, actually, was initially written by Ofori-Attah as a woman.
While Ofori-Attah had original plans to make the season 2 lead Dr Martha Ford, it was a discussion with executive producer Simon Heath that changed her mind after wanting to shake up the format from season 1's female main character.
"Actually, at first I thought 'no' because in psychiatry, there's quite an interesting gender split. You tend to have quite a lot of female doctors working in it, so it's quite unusual to have a character like Dr Ford within psychiatry.
"But the more I thought about that, the more I felt it really added to the complexity of the story, and you'll see how that plays out. I've really enjoyed creating that character because he is so heavily informed by my experience as working as a psychiatry doctor at the registrar level," she explains.
Jessica Layde's Bernadette is the junior doctor working on Dr Ford's ward, and is a character that isn't far from Ofori-Attah's own image. While the series writer does admit that Bernadette is not dissimilar to season 1's Ramya (Priyanka Patel), she says that Bernadette has elements of her own junior doctor experience when she was "less aware of what stuff was going on".
Essentially, Ofori-Attah wants to use her own experience to show the other side of being a doctor in the UK. So often medical dramas are glossy, involve steamy affairs and unbelievable twists, but working in the medical field in the UK is "not glamorous", Ofori-Attah tells me.
It's very high-pressured and involves juggling a lot of things, with the hectic night in episode 1 even being a very simplified version of what Ofori-Attah had initially plotted out.
Basing it on her own encounters of working as a psychiatric registrar, she'd included the realistic volume of work in the episode that she'd have had to undertake.
Having to streamline it was something that initially worried Ofori-Attah, in case viewers didn't quite grasp just how busy Dr Ford's shift is, but it's something that has still been expertly achieved in the final version, something she's very happy about.
That first episode in particular manages to retain a steady level of palpable stress for viewers, showing just how busy an on-call night shift can be, and it is something that many people won't have seen on TV before. In choosing what to include, Ofori-Attah says that it was key to keep in the chaos and the fact that doctors can often be all over the place.
"They try and teach you from medical school that one of the key roles of a doctor is to be able to prioritise. You have to be able to make a risk assessment yourself of who is the most at-risk person and who needs your attention and care. But in the moment, it's very difficult. I really wanted to show that you have these doctors who are trying to navigate all of that on their own at night," she says.
It's not lost on Ofori-Attah that the jump from being a doctor to writing TV shows is an intriguing one, but having always wanted to tell stories, she says, it's an apt way of using her medical knowledge in a dramatic way to engage people about these topics and themes.
Although these shows are crafted for entertainment, there's always something serious to sink your teeth into; Ofori-Attah just never wants to be "too preachy with it".
With the likes of Malpractice, Playing Nice and Boiling Point all under her belt so far, Ofori-Attah says that her love of "dark, psychological and thriller-y stories" will naturally continue informing her work.
"I love a story where you can imagine that happening to you. Like in Playing Nice, the idea that could happen to you or that you could be the child that that's happened to, I think it just adds another layer of entertainment and engagement.
"I hope with Malpractice, I know it's specifically about doctors, but we're all going to be patients at some point or we know people who've gone through that and the setting is familiar. So I hope when people watch it, they feel that could be me, or that could happen to me," she explains.
Joking about doing something lighthearted and fun, Ofori-Attah says a romcom or period piece would be nice to do later down the line. "Some Dickens to adapt, where it's like a jolly Dickens, not like a deep, dark city in Victorian England," she says.
But looking to the future of the TV industry as a whole, Ofori-Attah admits she wants to see "more and more diverse storytelling". "I'd love to see more minority communities represented, even within the UK.
"I am a Black female writer, but I was born in Glasgow and I grew up in Yorkshire. Since starting to write TV, I've talked about setting some of those shows in places where you have a Black family and they are kind of in isolation in a bit of the UK – people aren't so keen," she reveals.
Why is there that initial reticence from the industry to tell these kinds of diverse regional stories, I ask Ofori-Attah? "I think it's a very risk-averse business," she shares.
"Because there's been success with Black stories set in London, certain tropes about London Black families or Black youths, they are familiar and they feel safe and understood. People are happy to invest in that. So I think it'll just take another stretch of the imagination to make the leap to families in other parts of the country.
"I think there's an understanding of a certain type of depiction for TV, and I think it would be really nice to expand that because there are people all over the country. I feel like those would be really interesting diverse stories because you do get a lot of pushback sometimes from audiences where they'll say, 'Why is this entire show for ethnic minorities? Because nothing in my community looks like that.'
"So why not go to the regions and have that one Black family, just focus on them and all the people around them (who don't look like them), because that is a very British story."
Ofori-Attah says that it's precisely those kinds of 'fish-out-of-water' tales that she likes, citing the many ethnic minority families and communities that live all over the UK but that we don't get to see represented onscreen.
"Those stories and the issues that they face are no less entertaining, fascinating or with their own challenges. I'd love to see a story about maybe a Ghanian family that are living in a small village in Yorkshire and having to deal with that. Not autobiographical," she laughs.
"I love the regional stuff. Even with Playing Nice, we talked about diversity when we were setting that up. We picked Cornwall because it's the poorest county in the country. It's very beautiful, but there are lots of problems there.
"That's another way of tackling diversity by setting a production there, bringing some good attention to it, using a local crew and all that kind of stuff. Just more diverse storytelling from all over the country."
In her work so far, Ofori-Attah has crafted engaging series that do all shine a light on important and often serious subjects, but it's clear that representation and diversity continue to be an important facet of her own writing and craft.
"It's really important because the stories that we tell, the content we create, it's like a historical record of our time and people. It's also so powerful. You make a TV show and you have direct access to people within their homes.
"If you're watching TV or growing up watching TV and you don't see people who look like you, you don't understand those lives – it can be quite alienating. But also, if you start to see just even a few people who do look like you, it's a way of making people understand other cultures, other ways of life, expanding and broadening people's horizons, without forcing it on them.
"I think the arts just has a real place, responsibility and opportunity to really do a lot of social good without hopefully hammering people over the head with it."
Malpractice season 2 will debut on ITV1 and ITVX on Sunday 4th May, airing at 9pm, while season 1 is available in full on ITVX now.
Check out more of our Drama coverage or visit our TV Guide and Streaming Guide to find out what's on. For more from the biggest stars in TV, listen to The Radio Times Podcast.
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