Kingston Hospital is facing a pivotal moment in its history.

A multi-million-pound deficit, a looming junior doctors’ strike and hundreds of extra patients through its already stretched accident and emergency (A&E) department this winter puts the hospital in a more precarious position than it has ever been.

Interim chief executive Ann Radmore is upfront about the challenges the hospital is facing, but says “extremely dedicated staff and a lot of hard work” means she is positive about the future.

“In Kingston and Richmond we do have an ageing population.

“It is very common, especially in these winter months, to have bays of six beds and every one has a patient over 90 in it,” says Ms Radmore.

She has been in the NHS for three decades, starting as a trainee manager in Guildford, and has worked the majority of her career in London and the south east.

Having taken up the position in August to cover chief executive Kate Grimes’ period of sick leave, Ms Radmore inherited a hospital under investigation by health regulator Monitor due to its excessive A&E waiting times and predicted deficit.

Since August the predicted financial shortfall has gone down from £8.8m to £6.1m.

Ms Radmore is diplomatic when asked whether Government cuts and austerity measures are to blame for the hospital’s money troubles – but admits they are going through a period of “counting the paperclips”.

“I think the NHS as a whole needs to get better at harnessing its purchasing power,” she says.

“The NHS is huge.

“We have to be looking at how much we pay for plastic gloves, seeing if we can get better deals on everything from paperclips to replacement hips.

“Having said that, I could always do with more money.

“The NHS will never have enough and if the chancellor said tomorrow we would be getting more, then we would easily be able to spend it.

“In a world where there is never enough money the best you can do is make sure the taxpayer’s pound is being used the best way it can.

“It is hard for all public services. We are all being asked to save money.

“The pressure in health is even higher.”

Last Thursday, 98 per cent of unionised junior doctors voted for three days of strike action over proposed Government changes to their pay and hours.

The doctors will go out on strike for 24 hours from 8am on December 1 and then again between 9am and 5pm on December 8 and December 16.

This is sure to hit Kingston Hospital hard.

Ms Radmore says: “I have not gone over the exact details of the strike with the union yet and we are in the process of working out how we will deal with it.

“I do not expect our A&E departments to be hit too hard. Same with maternity and x-ray because we do not have too many junior doctors in those departments.

“Where it will really be noticed is on the medical and surgical wards I think.

“It is the junior doctors you see buzzing around, checking on patients.

“On the first day we will try not to cancel outpatients; on the second and third we might have to.

“We haven’t agreed anything, but I would think if there was a terrorist disaster or major threat, they would come back.

“I know some health professionals find it very hard to go on strike.”

Ms Radmore will not give her opinion on the decision for strike action and admits she has never been on strike herself, despite being part of a union.

But she says that almost everyone works too hard in the NHS.

“It is true that junior doctors can end up with long blocks of hours.

“The nurses here also work long hours.

“They go the extra mile, staying late and arriving early. What is good is that the junior doctors have done this completely legally and are working with us to make sure the hospital is safe.”

Ms Radmore says hospital staff are “focusing on the here and now” to get them through the winter, but is not sure what lies ahead in the long run.

“Everyone has done such a wonderful job so far.

“We have got our deficit down, but getting it to zero will be a very significant jump for us.

“I am only here until March.

“After then, hopefully Kate will be well enough to come back.

“If not, we have to see.”