After years of outsourcing, many essential staff work for the NHS without receiving its benefits. In one London hospital, the fight is on for a better deal. By Sophie Elmhirst

On 9 February, a cold, damp Sunday, an Uber pulled up to University Hospital Lewisham in south-east London and dropped off a woman who had recently returned from China. The woman walked up to the reception desk and outlined her symptoms. She was given a mask, taken to a designated area outside the A&E building and tested for coronavirus. When, three days later, the test came back positive, it confirmed what medical authorities had already suspected: this was London’s first case.

That day, Ernesta Nat Cote, a cleaner at Lewisham hospital, heard the news from a nurse in her department. The nurses, Ernesta told me, are always the best source of information: “They tell me everything.” Ernesta has been cleaning the hospital for 11 years, ever since she first came to London. She arrives just before the start of her shift at 6.30am, clocks in and goes to clean the paediatric operating theatres, changing rooms and corridors. Over the years, she has come to know these rooms intimately: every corner, every surface, every tap.