Malpractice review: Authenticity is key in Niamh Algar's gripping medical thriller

Malpractice stars Niamh Algar as Dr Lucinda Edwards, a smart, battle-hardened doctor who has a nightmare shift, one which ends in the death of an opioid overdose victim, who was being overseen by a junior doctor, Dr Ramya Morgan played by Priyanka Patel.

This leads to an inquiry into Lucinda’s actions that night, which threatens to implode her career. But is Lucinda hiding something?

The first thing working in the series's favour is its star, Niamh Algar. For anyone who's seen Algar's work before, it's hardly a surprise that she is phenomenal in this role, in a script which demands Lucinda to be all things to all people. At one moment she's a hugely capable, empathetic doctor fighting to do the right thing, the next she is an untrustworthy bully.

It's crucial to the premise of the series that the audience remain uncertain about Lucinda throughout and Algar treads this line perfectly. It's an assured, compelling performance which permeates through every scene.

The rest of the cast are excellent too. Priyanka Patel has a similarly tough role to fill as a foil for Lucinda, meaning just as our perspective on the lead has to change, so too it does for Ramya, something Patel carries off well.

Elsewhere in the Malpractice cast, James Purefoy, Brian Bovell, Helen Behan and Jordan Kouamé all give compelling, grounded performances which play well off Lucinda's often manic energy, helping to ground scenes while also adding to the already bountiful emotional depth.

However, a cast can do so much and the series can still underwhelm if the writing isn't up to scratch. Thankfully, there are no such problems here.

That's why Malpractice's greatest asset isn't Algar, it isn't the high-octane medical setting, it isn't even the twisting, turning plot. It's authenticity.

The series has been written by former NHS doctor Grace Ofori-Attah, who brings her wealth of experience in the medical field to the expertly crafted scripts, which despite dealing with some heightened situations, at all times manage to feel utterly grounded in the reality of modern healthcare.

Like This Is Going to Hurt before this, the series immerses us in the world of an A&E department, no holds barred. It doesn't play up precarious scenarios for shock factor, it merely lays the realities of the current state of the NHS out on the table for the audience to see and experience.

The dialogue feels realistic and genuine, managing to be populated with legitimate medical terms while still being comprehensible to a general audience.

The best part is that all this work to ground the series doesn't get in the way of the thrills - it is a nerve-racking ride from the very start, as Lucinda's own fears about her career strike home more than life or death situations might do in another, more superficially high-stakes show.

The first episode is particularly pulse-pounding, as we get a sense of just how stressful a nightmare A&E shift can be. Beyond this, one thing which occasionally does let the series down is the pacing, particularly when episodes are put in contrast with that first instalment.

Of course the pace has to slow somewhat, but there are times in episodes 2 and 3 where the momentum feels ever so slightly lost. Still, it's a fairly minor quibble in what is overall an eminently successful series.

In fact, watching Malpractice made me think of another series which aired on Apple TV+ last year, Surface. Not in the ways the two are similar, but how they are different. That series described itself as an "elevated thriller", a term I found to be pompous given the show's content, and fairly patronising to the genre as a whole.

The idea that the thriller genre needs "elevating" is a nonsensical suggestion at any time - as in any genre, there are weaker additions (a number of which we've seen recently) and stronger ones. But if any series could be legitimately described as "elevated", Malpractice may just fit the bill.

Malpractice premieres on ITV1 and ITVX at 9pm on Sunday 23rd April 2023. Check out more of our Drama coverage or visit our TV Guide and Streaming Guide to find out what's on.

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