By 1941 the hospital and its staff were under extraordinary stresses. Hospital overcrowding was extreme; there had been a growing bed shortage for a number of years. Plans to embark on a major new building programme were commenced in 1935, but the project was delayed by controversy over rising costs, and with the onset of WW2, a critical shortage of building materials. Construction of a much scaled-down ward block - the 210 bed block - was begun in 1941, but not completed until 1944. A temporary ward - Ward 20 - was hastily erected, as were two military wards - Wards 21 and 22.
The outbreak of WW2 had a major impact on hospital staffing. Thirty members of the senior medical staff were absent on overseas service for varying periods of time, typically three - four years. This created a major increase in workload for those remaining at the hospital. A number of relieving staff were appointed, in many cases from the general practice area. A significant number of junior medical staff also served in the War, resulting not only in a shortage of medical manpower at the hospital but also interruption of career development. On the other hand, a number of careers were determined by war service, especially in the surgical area.
In all, 49 doctors who were already on the senior staff or subsequently became members of the senior staff served overseas during the War. Two senior medical staff members died whilst away - Dr John Plimmer was killed in action in Crete, and Dr F Montgomery Spencer died of typhus in North Africa.