NHS e-Referral Service

 

Click here to View and download all of our OPD clinics available on eRS. To open, first save to your computer.  Then just filter by Specialty, Clinic Type, or Location, just like eRS. Display Published and Non-Published Services with service notes.

Can’t find the service you’re looking for?  Contact the eRS Manager at St George’s for service enquiries on 0208 725 4957.

Referrers can email our friendly scheduling team between 9.00 and 17.00 at RMC@stgeorges.nhs.uk

For enquiries related to patient specific eRS appointment requests contact our Central Booking Service on 0208 725 0007

Any correspondence regarding patients already within the St George’s system, i.e. letters to consultants, can be sent to this email and will be distributed to the appropriate team:internal.referrals@stgeorges.nhs.uk

Exemptions to e-Referral

The following services are exempt from e-referral and should continue to be referred to in the usual way:

e-Referral Service exclusions

e-Referral Service exclusions
Service/department How to send referralsHow to contact us
Allied Healthcare Professional/Nurse/Psychologist (excludes Physiotherapy)RMC@stgeorges.nhs.uk
Antenatal/ObstetricsAntenatal.Referrals@stgeorges.nhs.uk
Brysson Whyte Rehabilitation Unit at Queen Mary's Hospitalstgh-tr.bryssonwhyte@nhs.net
Cardiac investigations cardiac.investigationreferrals@stgeorges.nhs.uk
Diagnostics at The Nelson Health Centre stgh-tr.ref1@nhs.net
Douglas Bader Gymnasium at Queen Mary's HospitalBaderGymReferrals@stgeorges.nhs.uk
Endoscopy - flexible sigmoidoscopy and Gastroscopy- at Queen Mary's HospitalStgh-tr.Qmhendoscopydirectaccess@nhs.net
Frenulotomy (tongue tie division) stgh-tr.plasmops.plasticsurgery@nhs.net
Gynaecology Pelvic Ultrasound Radiology.Department@stgeorges.nhs.uk
Neuro Rapid Access clinic (For referrals to the acute neurology clinic (Please note NOT for rapid access spinal/neurosurgery referrals.)stgh-tr.stgeorgesrapidaccess@nhs.net
Neurology- Stroke stgeorges.TIA@nhs.net
Neurophysiology stgh-tr.neuro@nhs.net
Neurovascular services NeurovascularMDT@stgeorges.nhs.uk
Nutrition and Dietetics Community Service for adult and paediatric patientsCSW.dietitians@stgeorges.nhs.uk
Paediatric “Hot Clinic” (previously known as Paediatric Rapid Access/Referral Clinic) paediatric.rrc@stgeorges.nhs.uk
Physiotherapy- non MSK and non Wandsworth GP- Adults RMC@stgeorges.nhs.uk
Physiotherapy – community and non-community Paediatrics cdcreferrals@stgeorges.nhs.uk
Podiatry WACCG.healthshare@nhs.net
RadiologyRadiology.Department@stgeorges.nhs.uk
Rheumatology Bone Densitometry stgh-tr.SGHdexascans@nhs.net
South West London MSCC Service- (Metastatic spinal cord compression) SGH.MSCC@stgeorges.nhs.uk 
Spasticity service, Queen Mary's Hospitalstgh-tr.stgeorgesspasticityclinic@nhs.net
St John's Day Hospitalstgh-tr.stjohnsdayhospital@nhs.net
Wandsworth Community Neuro team and St John's therapy centre ( including Falls and Bone Health Team ) stgh-tr.TherapyReferrals@nhs.net
Wheelchair services - Roehampton wheelchairservicereferrals@stgeorges.nhs.uk


Booking your NHS e-Referral Service appointment

Book your NHS e-RS appointment online now

You can contact the NHS e-Referral Service at the following times, using the numbers below:

Monday to Friday:
08:00 – 20:00hrs
Weekends and bank holidays:
08:00 – 16:00hrs
Christmas day:
Closed
NHS e-Referral Service telephone appointment line:
0345 6088 888
Textphone service:
0845 850 2250

Please use the reference number and password from the patient’s appointment request letter. You will need to have these in front of you when booking an appointment.

Help and guidance

Please search our services to find the service you are looking for. Clinicians in all specialties have been involved to ensure that our information accurately reflects the services that we offer.

Two-week rule referrals are also supported by the NHS e-Referral Service. If there are no slots available, please defer to provider.

 

Why we are using the NHS e-Referral Service

Reduction in DNAs

Data from previous electronic booking pilots show that when patients are given a choice of date and time for their appointments they are more likely to attend. This leads to fewer wasted appointments and helps to improve the overall efficiency of outpatient clinics.

Reduction in non-clinical primary care consultations

The amount of time spent by administrative support staff in responding to patients’ enquiries about the progress of referrals is huge. In some cases a patient will book an appointment with their GP specifically to enquire about their referral. This reduces the amount of clinical time available in a practice. Eliminating this administrative burden brings an immediate benefit in primary care for patients, GPs and practice staff.

Reliable and comprehensive clinical information

Referral information from primary care systems will be made available to hospital clinicians in a legible and consistent format. Development of the National Care Record service will allow relevant patient information supplied by GP and hospital systems to be accessed by authorised users wherever and whenever it is needed.

Benefits for patients

Increased provision of services which are convenient to patients.

The journey through the NHS is increasingly patient focused. Appointments and admissions are made in discussion with the patient to get a mutually suitable date and time.

Reduced anxiety

Waiting to hear about appointments is a key concern for all patients. The electronic booking of appointments provides patients with more certainty. This helps them make arrangements and plan for the appointment. They will know straight away when their appointment will be, so they don’t have to wait for a confirmation letter to arrive.

Increased referral security

The system gives patients confidence that the referral information reaches the hospital. The information is protected by a series of stringent access controls and information governance. The system can also update referrals with up-to-date clinical developments.

Filter services

Site

Service

A

Anaesthesia

St George’s Hospital is one of London’s leading teaching hospitals and one of four Major Trauma Centres in the capital.

The anaesthetic department has over 100 consultants  providing expertise in a wide variety of anaesthetic subspecialties. We also have over 60 trainees from the St George’s School of Anaesthesia and fellows who rotate through these subspecialities.

Assisted Birth

Sometimes your baby may need to be assisted to be born  with the help of a doctor. This can be because there are signs that you are getting tired or the baby is getting tired and speeding up the birth is advised.

It can usually take place in your birthing room but occasionally there may be reasons to move you and your birthing partner to the theatre for the birth.

Atkinson Morley Regional Neurosciences Centre

The Atkinson Morley Regional Neurosciences Centre at St George’s Hospital is an internationally renowned unit for neurology, neurosurgery, neurorehabilitation and stroke services.  The hospital offers comprehensive services for the diagnosis, treatment and care of all conditions that affect the brain, spinal cord and the peripheral nervous system and muscles.

St George’s is the regional specialist centre for both inpatient and outpatient services for south west London, Surrey and Sussex, serving a population of more than 3.5 million people.

The majority of services are provided in the Atkinson Morley Wing at St George’s Hospital.   Neurorehabilitation services are also provided at Queen Mary’s Hospital, a specialist rehabilitation community hospital.  The Atkinson Morley Wing and Queen Mary’s Hospital are both new state-of-the-art buildings that were built specifically to cater for neurology patients, with staff and patients having access to modern facilities and equipment.

As the only hospital in the UK with a medical school on site, St George’s is a major centre for research and education.  This means that St George’s patients benefit from the latest and most innovative treatments and procedures, improving the outcomes for thousands of patients each year.

The department provides a number of specialist services:

Autonomic disorders
Botulinum toxin therapy
Cognitive neurology and dementia
Epilepsy
Headache service
Infectious diseases and HIV neurology
Mechanical Thrombectomy for Stroke
Movement disorders
Multiple sclerosis
Neuro and vestibular outpatient physiotherapy
Neurological pathology
Neuromuscular disorders
Neuro-opthalmology
Neurophysiology
Neuroradiology
Neurorehabilitation
Neurosurgery
Obstetric neurology
Pain clinic
Paroxysmal motor disorders
Stroke unit
Tourette Syndrome
Traumatic brain injury
Huntington Disease Clinic

Children’s services

Paediatric neurology
Paediatric neurodevelopment, neurodisability and epilepsy
. . .

Audiology and Audiovestibular Medicine

The Audiology and Audiovestibular Medicine team deals with the diagnosis and management of hearing (auditory) and balance (vestibular) disorders.

Since it was established in 1986, the department has become a reputable, highly specialist third tier service, responsible for all aspects of audiovestibular medicine for persons of all ages.

The department provides a full range of state of the art diagnostic auditory and electrophysiological services supporting its various clinical activities.

It also offers extensive rehabilitation options including a range of amplification solutions, hearing therapy and vestibular physiotherapy. These activities are peer reviewed and audited and comply to national and international guidance.

The team consists of doctors, audiologists, audiovestibular scientist, hearing therapists and physiotherapists working within a multidisciplinary environment. Services are provided at St George’s Hospital as well as at a nursing home, a school and health centres, consisting of consultant led as well as non-consultant led services.

The following services are offered:

 Adult Hearing and Hearing Aid Service
 Paediatric Hearing and Hearing Aid Service – St George’s Hospital
 Vestibular (Balance and Dizziness) Service
 Tinnitus and Hyperacusis Service
 Hearing Therapy Service
 Auditory Implant Service
. . .

Auditory Implant Service

The Service was planned in 2005 in response to a shortage of capacity for new patients in the other London programmes. Patients, especially children, from Southwest London, Kent, Sussex and Surrey were often required to travel great distances to access Auditory Implant services. The ENT and Audiology departments at St Georges felt the new Auditory Implant Service at St George’s could fill this void and the service took its place in 2006.

The senior medical staff in the department has considerable experience of cochlear implantation assessment, surgery and rehabilitation through previous work in Sydney, London and Nottingham. Expert advice on new service design was sought from our colleagues at other established Implant services to design the patient pathways and systems. We want to provide excellent habilitation services for children from day one, so we work in close collaboration with the specialist speech and language therapist, teacher of the deaf from Wandsworth Sensory Support Service and Children’s Psychology service at St George’s.

The Service started as a Paediatric Cochlear Implant programme and first surgery was on a child in 2006. Since then over 500 adults and children have been implanted, including many bilateral cases. The Service started accepting adults in 2008 and has now implanted patients from 8 months of age through to over 90 years of age. Over this time the service has further expanded to offer Bone conduction hearing implants and Middle ear implants to suitable patients, allowing us to provide a complete range of implantable hearing solutions and managing over 700 patients with implants currently.

The Service also takes active part in National and International Research Studies. The team members have authored and presented various research papers at National and International conferences.

  . . .

B

Bereavement Services

If your loved one has died at St George’s, the Bereavement Services team are here to help you. We can guide you through the necessary steps following your bereavement. We also work with clinical teams to ensure that all necessary steps are taken, and paperwork completed.

Please call us at your earliest convenience on 020 8725 3410 or 020 8725 3411. The office is open between 9:00 and 16:00, Monday to Friday. Outside of those times you can leave a message and we will get back to you as soon as we can. You can also contact us via email at Bereavement.Services@stgeorges.nhs.uk

Full information is available in the booklet ‘A practical guide for when someone dies’ which is available here. There is also information available which we hope will provide support during the pandemic.

Support from other organisations may be helpful at this time. Below is a list of just some of these groups, some of which can also provide help before bereavement.

GOV.UK
Online: www.gov.uk/when-someone-dies

Macmillan Cancer Support
In person: Located next to Bereavement Services in St George’s Hospital
Tel: 0808 808 00 00
Online: www.macmillan.org.uk

Hospice UK
Online: www.hospiceuk.org

Cruse Bereavement Support
Tel: 0808 808 1677
Online: www.cruse.org.uk

The Good Grief Trust
Tel: 0800 2600 400
Online: www.thegoodgrieftrust.org

Age UK
Tel: 0800 678 1602
Online: www.ageuk.org.uk

Samaritans
Tel: 116 123
Online: www.samaritans.org

Marie Curie
Tel: 0800 090 2309
Online: www.mariecurie.org.uk

Wandsworth Bereavement Service
Tel: 020 7223 3178
Online: www.wandsworthbereavement.org.uk

ThriveLDN
Online: www.thriveldn.co.uk

Switchboard LGBT+ helpline
Tel: 0300 330 0630
Online: www.switchboard.lgbt

Royal British Legion
Tel: 0808 802 8080
Online: www.britishlegion.org.uk

Anne Robson Trust
Tel: 0808 801 0688
Online: www.annerobsontrust.org.uk

  . . .

Bowel Cancer Screening - Health Promotion

The aim of the Health Promotion Team at St Georges Bowel Cancer Screening Centre is to spread awareness on Bowel Cancer and the Screening Test in order to improve screening uptake across South West London. We do this by engaging with communities and GP surgeries across South West London.

The Health Promotion Team is made up of Lisa-Lyna Ofosu-Asare (our Health Improvement Specialist) and Annice Norman (our Health Promotion Assistant).
Health Promotion Events so far in 2024
Bowel Cancer Stall at Wide Way Medical Centre

19th February 2024, Wide Way Medical Centre, Mitcham. We set up a Bowel Cancer stall at Wide Way Medical Centre as part of our Health Awareness Days. The stall was in the waiting room where we were available for patients to come and ask questions about bowel cancer and the screening process.

 

Talk for the Association for Polish Family

13th February 2024, New Horizon Centre, Mitcham. Lisa-Lyna gave a talk at the Ukrainian Hub run by the Association for Polish Family. An interpreter was present at the talk. The talk was well received with a range of questions asked from those who attended.

 

 

 

World Cancer Day 2024 Event

2nd February 2024, St Georges Hospital. This event was put together by the cancer team at St Georges Hospital in celebration of World Cancer Day. Various member of staff from across the trust attended this event and gave talks on cancer. Lisa-Lyna attended this event to give a presentation on Bowel Cancer, alongside the RM partners Cancer Alliance and The Breast Screening service at St Georges. Lisa-Lyna also held a stall at the event where she was able to continue sharing information.

This April: Bowel Cancer Awareness Month
A Snapshot of Health Promotion Over the Last Year (2023)

April is Bowel Cancer Awareness Month! Bowel Cancer Awareness Month occurs annually in April and is a fantastic opportunity to raise awareness of bowel cancer. Throughout the month we will be attending a range of events across South West London.

Talk with the Hong Kong Migrant Group

11th January 2023, Kingston Library. An interpreter was present for the presentation.

 

 

 

Merton Health and Wellbeing Fair:

Saturday 21st January 2023 at The Lantern Arts Centre in Raynes Park

 

 

 

 

 

Black Communities Healthy Living & Lifestyle Fair

Held at Chestnuts Community Centre in Tottenham to help support the NHSE Bowel Cancer Campaign

 

 

 

 

Talk with The Kingston Tamil Group

14th of June 2023 at Abbey Smile Hall, Kingston. An interpreter was present during the presentation

 

 

 

 

Talk With Kingston Migrant Advocacy Group

December 14th, 2023, at Kingsnympton Park Estate

 

 

 

 

 

Carshalton Health and Wellbeing Fair

8th November 2023 at David Weir Leisure Centre

 

 

 

 

Feedback from the community

Hear from a member of the Hong Kong Migrant group who attended the talk in January 2023.

 

NHSE Radio Campaigns

Health Improvement Specialist Lisa-Lyna discusses all things Bowel Cancer and Bowel Cancer Screening related.

Lisa-Lyna discusses Bowel Cancer facts, the process of bowel cancer screening and the NHS Bowel Cancer Screening Campaign.

  . . .

Breast Service at The Rose Centre

Please note: patients should continue to attend their breast screening appointments unless contacted by the Trust. Breast screening appointments are deemed as essential activity and therefore exempt from restrictions imposed in Tier 4 areas. 

Breast screening is important in the early detection of breast cancer. It offers a significant opportunity for early diagnoses which increases the chances of recovery.

Breast screening units across London have put measures in place to reduce the risk of Covid-19 to keep you safe. Access to screening services is also easier as you can have your appointment on days and times of your own choosing.

The Breast Service at St George’s University Hospitals NHS Foundation Trust is based predominantly at the Rose Centre building which provides a comprehensive service for patients which includes initial consultation and diagnostic services in the same location as well as providing a one-stop service.

St George’s Healthcare has three consultant surgeons in the breast team, providing surgery for breast cancer, as well as a wide-ranging diagnostic and nursing team. All patients are offered the option of immediate reconstruction at the time of mastectomy.

Since December 2006, St George’s Healthcare’s breast cancer surgeons have been using the latest techniques to avoid unnecessary removal of a patient’s underarm lymph nodes which can leave patients at risk of side effects including lymphoedema (swelling), shoulder stiffness and nerve damage.

For more information regarding the service and your appointment, please click on the links to the left of this page.

  . . .

C

Cancer Services

St George’s Hospital is uniquely placed in South West London as a Cancer Centre, providing high quality, patient centred diagnostics, care and treatments to our local community as well as to some regional and national patients.

We provides the majority of south west London’s complex cancer surgery. We have a number of regional and supra-regional cancer services with specific expertise in the management of complex surgical patients, and we are the south west London hub for a number of services including:

Brain and Central Nervous System (CNS) cancers
Breast cancer
Children’s cancer
Gynaecological cancers
Haematological cancers
Head and Neck cancer
Lung cancer
Urology cancer

St George’s Hospital is also a national centre for skin and penile cancers.

We maintain an active cancer research portfolio and also host the South London Cancer Research Network, which aims to improve the speed, quality and integration of research, ultimately resulting in improved patient care.
Screening services
St George’s hosts the regional breast, colorectal and cervical cancer screening services. Screening services help the hospital find out if patients have a higher risk of developing cancer or other health problems. They look for cancerous and pre-cancerous cells or abnormal changes to aid in early diagnosis or treating the affected cells before cancer develops.
Diagnosis & Treatment
We provide a full range of diagnostic services to support local patients. This includes tests and scans which are used to diagnose cancer and monitor patients during and after treatment. These tests can be imagery, such as an x-ray, or they may require some tissue, such as a biopsy.

Treatment for all types of cancers may include surgery, radiotherapy, hormone therapy, chemotherapy or a combination.

We have a large regional oncology service, providing both chemotherapy and biological treatments. We deliver in the region of 16,000 cycles of treatment each year. Chemotherapy uses anti-cancer (cytotoxic) drugs to destroy cancer cells.

Hormone therapy works by manipulating or reducing the production or activity of particular hormones in the body. It is most commonly used to treat breast cancer and prostate cancer. The type of cancer being treated will determine the type of hormone therapy given.

St George’s provides the majority of south west London’s complex cancer surgery. The Trust receives referrals from local services as well as from further afield. We are a tertiary centre which performs much of the cancer surgery for several local hospitals.

The Royal Marsden Hospital provides radiotherapy services for St George’s patients. Radiotherapy uses high-energy rays to destroy cancer cells. This treatment is used to cure cancer or to relieve symptoms.
The Multi-Disciplinary team
Many people are involved in diagnosing and caring for cancer patients. Each cancer type has a specific multidisciplinary team of staff diagnosing and providing treatment and care for patients. These may include:

Oncologists, also known as cancer consultants, and may be medical, clinical or surgical. Medical oncologists specialise in treating cancer with chemotherapy and clinical oncologists specialise in using radiotherapy to treat cancer.
Clinical Nurse Specialists or ‘keyworkers’ who coordinate aspects of patient care and offer ongoing support to patients and their families both in an inpatient and outpatient setting, they are supported by a Macmillan Support Worker.
Radiologists who specialise in reading scans and x-rays
Geneticists
Pathologists who specialise in looking at cells under a microscope to determine if cancer is present
Psychologists, psychiatrist & counsellors
Dietitians
Physiotherapists
Occupational therapists

Multidisciplinary teams specialise in specific types of cancer. They discuss with each other all patients with a confirmed or suspected cancer diagnosis, and  potential treatment options depending on a patient’s test results and situation. This is normally where cancer is diagnosed. This team approach ensures all treatment options are considered and patients receive the best care. St George’s also links with specialists from other hospitals to discuss patients via video link.

Palliative care aims to improve the quality of life of people facing serious illness. The palliative care service at St George’s provides specialist support and advice to patients with progressive life-limiting illness and their carers, regardless of diagnosis. We are very proud of our close working relationships with the voluntary sector and community providers including several local hospices.

What is Personalised Cancer Care?
 Personalised Cancer Care means your team will support you to take an active role in your cancer care by giving choices and control based on what matters most.

Together with your key workers’ team, like your Clinical Nurse Specialist and Macmillan Support worker, we will aim to help you access the care and support that meets your individual needs from the moment you receive your cancer diagnosis so that you can live as full, healthy and active a life as possible.

You will be invited to complete a Holistic Needs Assessment (HNA) to identify any concerns you may have when you have been diagnosed with cancer. These concerns may be physical, emotional, practical, financial and spiritual.

You will answer a simple set of questions or fill in a checklist about all areas of your life. It is to find out about the concerns you may have. You are often asked to rate how important these concerns are to you. It could help you decide what to discuss first during the assessment.

Once you have completed the assessment, your Clinical Nurse Specialist will discuss your needs, maybe face-to-face in a clinic or over the phone. During the discussion, you and your Clinical Nurse Specialist will agree on the best ways to manage your needs and concerns. They will write down what you have decided in a document called a care plan.  They may write it during the discussion. Or they may make notes and send them to you afterwards. Your care plan will record the following:

The main concerns you talked about
Suggestions and actions to help you manage your concerns
Services that may be able to support you, and any referrals that are made
What is already being done to help – for example, the services you are already using
Information about who to contact if you need more help
The details of other health or social care professionals with whom you have agreed to share the information.

You may not wish to complete the holistic needs assessment at this time. The care you receive will not be affected in any way, and we will be happy to discuss this again in the future

 Health and wellbeing information and support also include:

Access to the Macmillan Information & Support Centre to find out what support is available in the community, e.g., practical, financial, and how to access it
Help with understanding cancer and its treatment and how to manage its impact through videos and workshops run by healthcare professionals at St George’s and in the community.
Attend wellbeing activities which are great opportunities for you and your carers to get together with others affected by cancer.

Cancer Genetics 

The Cancer Genetics team at the Southwest Thames Centre for Genomics serves a population of approximately three and a half million people across South West London, Surrey and West Sussex. The aim of the service is to identify people at increased risk of developing cancer because of underlying genetic factors. If we find that a person has an increased chance of getting cancer due to genetic factors we can any screening options to pick up cancers early at a treatable stage and other treatments to reduce the risk of cancer.

For more information about this service, please click here. . . .

Cardiac Sarcoid Clinic

What is cardiac sarcoidosis?

Sarcoidosis is a disease that leads to inflammation and clustering of immune system cells in various organs of the body. It has no known cause. These immune cell clusters, or granulomas, most commonly form in the lungs, skin, and/or lymph nodes. It’s much rarer for them to occur in the heart; but when they do, the inflammation may damage or disrupt the function of the heart’s muscle, electrical system, arteries or valves,

Diagnosis

Cardiac sarcoidosis can be difficult to diagnose, especially if the patient does not have sarcoidosis in other organs

Accurate diagnosis depends on the use of advanced, non-invasive, imaging modalities such as cardiac MRI and FDG PET/CT scans. In some cases a lung or heart biopsy may be required.

St George’s Joint Cardiac Sarcoidosis

The clinic is run by Dr Raminder Aul (Consultant Respiratory Physician) and Dr Nesan Shanmugam (Consultant Cardiologist), both leading experts in the field of sarcoidosis.

A comprehensive respiratory and cardiac assessment is performed:

Clinical assessment
Initial selection of appropriate respiratory and cardiac investigations:

Blood tests – including serum electrolytes and B-type natriuretic peptide
Chest CT scan
Lung function tests
Electrocardiogram  (an instantaneous record of your heart’s electrical activity that tells us if there are any problems with your heart’s rhythm)
Echocardiogram (an ultrasound of the heart chambers and valves)
24-hour ECG (Holter) monitoring test
Cardiac MRIIf there are suggestive features of cardiac sarcoidosis, an FDG-PET/CT scan is performed. This state-of-the-art test is highly sensitive in detecting cardiac inflammation. 
Management
The tests, once completed, are reviewed by our multidisciplinary team and the results and management plan discussed with the patient.

Sarcoidosis can’t currently be cured, but it can be managed to prevent other problems, such as heart failure, from developing over time. Treatment is directed at reducing inflammation and managing any heart problems caused by inflammation and granulomas. This often involves a regimen of anti-inflammatory drugs and lifestyle changes, and, in some circumstances, may also mean other steps like the implantation of a pacemaker.
A Collaborative Approach to Care
The cardiac sarcoidosis team includes specialists in the following areas:

Heart Failure Specialists
Electrophysiologists
General Cardiologists
Interventional Cardiologists
Cardiovascular Imaging Specialists
Cardiothoracic Surgeons
Respiratory Physicians

Referrals

We accept referrals of patients with clinically suspected or proven cardiac sarcoidosis for further evaluation and management plans.

If you need to refer a patient to us, please send your referral letter to

Dr Nesan Shanmugam, Consultant Cardiologist. . . .

Cardiac Surgery

St George’s is home to one of the largest cardiac (heart) centres in the south east of England.

We carry out more than 700 cardiac surgery operations every year, and provide services for people living in south London, Surrey, as well as further afield.

We have a team of seven consultant cardiac surgeons, who work as party of a multi-disciplinary team that also involves cardiologists, specialist nurses, anaesthetists, therapists, plus many more.

Our cardiac surgery teams provide the full range of adult cardiac surgery operations, including heart bypass surgery, mitral valve repair and aortic surgery. We also provide pre-operative and post-operative care.
Key wards and departments
Ben Weir ward
Cardiothoracic Intensive Care Unit
Cardiac surgery outpatients
Consultants
Mr Steve Livesey (Clinical Director)
Mr V. Chandrasekaran
Professor Marjan Jahangiri
Mr Robin Kanagasabay
Mr Aziz Momin
Mr Justin Nowell
Mr Mazin Sarsam
Mr Paul Govewalla (locum)
Other key staff
Naomi Sheeter, General Manager
Kelly Davies, Head of Nursing . . .

Carotid atherosclerosis

In conjunction with the regional stroke unit, the St George’s Vascular Institute offers a comprehensive service for patients with carotid atherosclerosis. Indications for surgical intervention are defined for both asymptomatic and symptomatic patients with a stenosis greater than 70%. Outpatients with suspected carotid atherosclerosis are assessed in a one-stop clinic with access to immediate duplex scanning. All patients who have symptomatic carotid stenosis are subject to multidisciplinary discussion, which includes stroke physicians, neurologists, vascular surgeons and interventional radiologists. In current practice the timing of carotid surgery is crucial following a neurological event.

Contemporary studies have demonstrated that patients derive maximum benefit from carotid revascularisation if surgery is performed shortly after the onset of symptoms. In the St George’s Unit, surgery is planned within 48h of admission with a stroke or TIA, if clinical condition permits. . . .

Chest medicine

The Respiratory Department at St George’s University Hospitals NHS Foundation Trust is one of the largest of its kind in southwest London. Our mission is to deliver outstanding and accessible clinical services that are continually developed and refined in response to the needs of the people we serve.

Centralised to one site are a comprehensive service covering the breadth of Respiratory medicine, including airways disease, lung cancer, interstitial lung disease, lung function testing, bronchoscopic and pleural procedures, pulmonary hypertension evaluation and treatment, as well as a busy TB diagnosis and treatment programme.

An in-house sensitive blood test for detecting latent TB infection (based on the ELISpot platform) has been available since October 2007. A consultant-run joint connective tissue disease-interstitial lung disease clinic has been in place since August 2008.

Lung nodules patient information resources
Click here for some useful information which may help you to understand what a lung nodule is, how your medical team will look after you and access to some videos and leaflets available for your viewing and downloading. . . .

Children's services

St Georges University Hospital has a long and proud history in providing specialist children’s services from the days of the Fountain Hospital. We currently provide an integrated mix of secondary care and specialist services to children of Wandsworth, Merton and South West London, Surrey and further afield.

Our aim is to provide an excellent, safe and innovative service that is child and family orientated. We are developing new services to help reduce inpatient admission while we work towards more consultant led provision of care.

We have a comprehensive range of paediatric specialist services in both medical and surgical fields. These are supported by PICU and NICU. Our medical specialities include: Allergy, Asthma, Cardiology, Developmental, Diabetes & Endocrinology, Epilepsy, Gastroenterology, Haematology, Infectious Diseases, Neurology, Respiratory and Rheumatology with a joint treatment centre for Oncology with the Royal Marsden Hospital. These services offer a seamless transition from birth through to transition to adulthood.

Children are also seen in ENT, orthopaedics, dermatology and plastics clinics in the children’s outpatients centre, booked through those parent specialities.

The surgical services cover all aspects of paediatric surgery and urology (excluding cardiac) including minimally invasive techniques. The department is the designated lead centre for South West London and Surrey.

There are five children’s wards. In recent years there have already been improvements and expansion in PICU, NICU, outpatients and the Child Development Centre. . . .

Clinical Perfusion Service

The Clinical Perfusion department provides Clinical Perfusion services to the Adult Cardiothoracic Unit at St. George’s University Hospitals NHS Foundation Trust..

This speciality is only associated with hospitals performing open heart surgery and is conducted by highly specialised individuals – Clinical Perfusion Scientists.

Clinical Perfusion Scientists are responsible for setting up and running heart-lung machines, which are used to support patients during open heart surgery.

We also set up and provide support for the Ventricular Assist Device (VAD) and Intra-aortic ballon pump (IABP); both used to support the function of a patient’s heart. The use of these techniques allows the heart time to recuperate following injurious events.

Clinical Perfusion Scientists at St. George’s Hospital are also principally responsible for the use and management of other machines including cell savers, blood gas analysers, thromboelastograph (TEG), platelet mapping and activated clotting time (ACT) monitors.

St. George’s Hospital is also one of the only centers in the UK that has the high fidelity “Orpheus” cardiopulmonary bypass simulation system. The Clinical Perfusion department collaborates with the Society for Cardiothoracic Surgery (SCTS) to provide a simulation course. The simulation course is held at St. George’s Hospital and sees a number of cardiac surgical specialists across the UK attend annually.

Clinical Perfusion team

Annually, over 1000 adult patients receive Clinical Perfusion services at St. George’s Hospital. This makes us one of the busiest adult Clinical Perfusion teams in the country.

The team comprises of six qualified Clinical Perfusion Scientists, and we currently have an in-house Clinical Perfusion training programme with one Trainee Clinical Perfusion Scientist. The in-house training programme is supplemented with academic teaching via a 2-year MSc Perfusion Science course held at the University of Bristol.

A 24-hour on-call service is provided across the Trust to cover any Cardiac procedures that are carried out outside normal working hours or in the event of an emergency. . . .

Clinical Pharmacology and Therapeutics

What is clinical pharmacology and therapeutics?
‘Clinical pharmacology’ is the science of drugs and ‘therapeutics’ is the safe and effective use of medicines within healthcare.  Clinical pharmacologists are doctors who specialise in making sure that patients get the best medicines.  Areas of training and expertise include: medicines optimisation (polypharmacy, pharmacogenomics), medicines management, clinical trials, education and training. They are often employed jointly by the NHS and universities.

St George’s Hospital has one of the largest groups of clinical pharmacologists in the country.
What do we do?
Our main role is to treat patients by ensuring the safe and effective use of medicines, taking into account their medical conditions, symptoms, priorities and lifestyle.

We work with all specialties within the Trust as well as pharmacists and GPs across South West London to provide safer and better medicines for our patients.

We have varied roles in healthcare and academia. Our main roles are listed below:
Clinical work
Polypharmacy service – we run a service to support the care of people who take multiple long-term medicines (also known as polypharmacy).  We run a weekly outpatient  clinic, provide advice to other healthcare professionals and run a Skills Development Network to share expertise.  Click here for more information and here for instructions on how to refer.
Personalised medicine – we work with scientists and health professionals to develop the NHS genomics service to ensure that patients get the best medicines based on their genetic make up.
Medicines management – we support pharmacy colleagues in ensuring that patients get the safest, most effective medicines.   Our work includes the Drug and Therapeutics Committee, Medicines Optimisation Group, South London Immunoglobulin Assessment Panel and the COVID clinical reference group.
Specialist therapeutic interests – we have additional specialist interests in managing patients with high blood pressure, supporting women with health issues through their pregnancy and we work as doctors to care for patients directly on wards and in intensive care.
Research
Clinical trials – we conduct research to test the safety and effectiveness of drugs to treat conditions such as COVID-19
Healthcare evaluation – we are researching how we can best provide care for patients who have problems with their medicines
Teaching
Undergraduate – we teach the science of drugs, how they are developed and how they are used in healthcare to students on our Clinical Pharmacology BSc and Medicine MBBS courses at St George’s, University of London
Postgraduate – we provide training and support to healthcare professionals working at St George’s to ensure our staff continue to develop their prescribing skills after qualification
Contact Details
Email: stgh-tr.clinpharm.enquiries@nhs.net

Hospital Switchboard: 020 8672 1255 . . .

Clinical Services

Treatments

Antenatal screening:

Combined first trimester screening
Pre-eclampsia screening

Prenatal diagnosis:

NIPT (non-invasive prenatal testing)
Chorionic villous sampling

Amniocentesis
Routine assessment of fetal growth, anatomy, and blood flow by experienced twin sonographers
Specialist twin midwife appointments throughout the pregnancy
Specialist perinatal mental health support
Specialist breast feeding support
Detailed fetal medicine ultrasound by fetal medicine experts
Detailed fetal echocardiography by fetal Cardiologists
Fetal therapies:

Fetoscopic laser treatment for twin-twin-transfusion syndrome (TTTS) and twin anaemia polycythaemia sequence (TAPS)
Selective reduction for higher order pregnancies
Selective termination for babies with abnormalities
Placement of fetal shunts for excess fluid in the lungs or severely distended bladders

Intrauterine blood transfusion for fetal anaemia
Fetal MRI scans
Rescue cervical cerclage for twins with open cervix who are not in labour
Specialist consultations with neonatologists and paediatric surgeons before delivery
Tour of our delivery suite
Tour of our advanced neonatal units
Advanced neonatal care for extremely premature babies and facilities for surgeries for newborn babies with abnormalities

The video below shows specialist midwife Sarah talking about the multiple birth service at St George’s:

Dr Justin Richards, Consultant Neonatologist, shares excitement for the launch of the Twins Trust Centre of Research and Clinical Excellence and what it means for research at St George’s:

Basky video

Deborah brown video

. . .

Community services

We provide a full range of community services to patients for people who live and work in Wandsworth, making sure people can manage their health better by accessing the services they need closer to where they live and work, and in their homes.  The services we provide are listed in the menu bar to the left.

We provide community health services at:

Hospitals

St George’s Hospital
Queen Mary’s Hospital

Therapy centres

St John’s Therapy Centre

Health centres

Balham Health Centre
Bridge Lane Health Centre
Brocklebank Health Centre
Doddington Health Centre
Eileen Lecky Health Centre
Joan Bicknell Centre
Stormont Health Centre
Tooting Health Centre
Tudor Lodge Health Centre
Westmoor Community Clinic

Community

We also provide services in GP surgeries, schools, nurseries, community centres and in patient’s own homes. . . .

Complications from Excess Weight (CEW) clinic

Who we treat

The service is designed to support obese children and their families to lead a heathier lifestyle. We take a holistic approach, providing advice and interventions, to help young people make sustainable changes to improve their health and quality of life.

We treat children and young people, aged from 2 years old up until their 18th birthday, with obesity and significant health issues. They need to live in South-West London and have been referred by a paediatrician. Both the children and their families need to be motivated and engaged to work with the service to implement strategies to help manage their weight and medical issues.

Key staff

Paediatric Consultant
Physiotherapist
Dietitian
Mental Health Practitioner

Location

St George’s Hospital
Blackshaw Road
Tooting
SW17 0QT

Referral criteria

Obesity
Significant obesity-related medical comorbidity that would benefit from weight loss (eg type 2 diabetes, sleep apnoea, NAFLD with fibrosis) that has not responded to treatment with specialist team
Family wants help to change

Or

Severe Obesity – BMI is currently set at >3.33 Z Score (although this may increase in the future)
Family wants help to change

CEW services are based on home address and corresponding London borough. We will accept referrals for south-west London (SWL): Croydon, Kingston, Merton, Richmond, Sutton, Wandsworth.

Complications from Excess Weight Referral Form

Contact Details

Email: paedscew@stgeorges.nhs.uk

Telephone Paediatric medical secretaries: 0208 725 2990

What to expect  

You will be asked to come into hospital for an initial appointment with the consultant. We will take some baseline measurements and ask you to complete some baseline questionnaires.  We will link you up with other members of our multi-disciplinary team of professionals to help support your child’s journey.

We will review your child over a period of time, reflective of their needs. We will support you as a family and your child, to implement strategies and deliver treatment plans to support their needs. This can include:

Changing eating habits
Improving physical activity
Improving sleep hygiene
Medical advice on health issues
Signposting to local support

Once we have implemented strategies, you will be expected as a family to continue to apply these into daily life to support your child with their onward journey.

What to bring to the appointment

Bring your child ready for a physical assessment and baseline measures which might include blood testing. Loose clothing or shorts and t-shirt will be helpful.

Bring the completed questionnaires you received with your appointment letter – completed.

Please know your child’s school attendance percentage and medication list (if they take any).

Useful Resources

Advice for parents of overweight children – NHS (www.nhs.uk)

Healthier Families – Home – NHS (www.nhs.uk)

Physical activity for early years: birth to 5 years (publishing.service.gov.uk)

Physical activity for children and young people: 5 to 18 years (publishing.service.gov.uk)

YoungMinds | Mental Health Charity For Children And Young People | YoungMinds . . .

Covid-19 medicines delivery unit (CMDU)

The Covid-19 medicines delivery unit (CMDU) is based at the Bence Jones Unit, Blackshaw Road, St George’s Hospital. We provide new Covid-19 treatments to people at the highest risk in south west London that have tested positive for Covid-19.

How to get treatment

You can access an assessment in the following ways:

Phone on 0208 725 1559 between 9am and 5pm.
E-mail covid.mdu@stgeorges.nhs.uk and include the following information:

Full name
Date of birth
Home address, and address where you are currently staying if different
Current contact phone number (home phone and mobile if available
Date of your first positive test
Date when your symptoms started
List of your current medical conditions

Contact your GP practice or 111, who may refer you to the service.

Frequently asked questions

What happens after I have contacted CMDU?

You will be phoned for an assessment within 24 hours by a nurse or a doctor.  The assessment will take around 10-30 minutes. If after assessment you are eligible and suitable for either of these medicines, the team will make arrangements with you to get the right treatment.

It is really important that you answer our phone call so please make sure you stay close to your phone after you have contacted us.

You may be told that your immune system is working well, and you don’t need treatment for your Covid-19 infection.

If you need antiviral tablets, these will be prescribed at St George’s Hospital and someone can come and pick them up for you (preferred), or we can deliver to you. If you need an antiviral infusion (drip) we will make an appointment for you, this is usually a next-day appointment but does depend on capacity.

What happens for children?

If you are the parent or carer of a child over 12 who is at highest risk and who tests positive for covid-19, please contact the service using the ways described above.

Your child will be assessed by a member of our specialist paediatric team, who will tell you whether they need treatment.

How do I know if I am eligible for treatment?

You may be at highest risk of getting seriously ill from COVID-19 if you are an adult and have:

Down’s syndrome, or another chromosomal condition that affects your immune system
certain types of cancer, or had treatment for certain types of cancer
sickle cell disease
certain conditions affecting your blood
chronic kidney disease (CKD) stage 4 or 5
severe liver disease
had an organ transplant
certain autoimmune or inflammatory conditions, such as rheumatoid arthritis or inflammatory bowel disease
HIV or AIDS and have a weakened immune system
a condition affecting your immune system
a condition affecting the brain or nervous system, such as multiple sclerosis, muscular dystrophy, motor neurone disease, myasthenia gravis, Huntington’s disease, Parkinson’s disease or certain types of dementia
certain lung conditions or treatments for lung conditions

This list is a summary and does not cover everything. The criteria for children are different.

Find out more about people at the highest risk who are eligible for COVID-19 treatment on GOV.UK

  . . .

D

Day Surgery Unit

The Day Surgery Unit allows you to be admitted to St George’s Hospital for surgery for a procedure and to be discharged home on the same day. It’s for patients who do not need to stay overnight on a ward and makes the surgery more convenient for them.

The following services use the Day Surgery Unit:

General Surgery
Gynaecology
Paediatric Dental
Plastics
Maxfax
Orthopaedics
Urology

The unit offers AM & PM sessions to each service and is open Monday to Friday. The Unit has five operating theatres.
Covid-19
To minimise the risk of Covid-19 the following measure have been put in place before and while attending the Day Surgery Unit.

You will have swab test 48-72 hours before you come in for surgery. You must be tested negative and you will be asked to self-isolate after your test until your surgery. If you have complex medical issues your surgeon may ask you to self-isolate for 14 days prior to your surgery date.
You should have no symptoms for 7 days and be advised to adhere to social distancing and hand hygiene measures.

When you arrive at the entrance you will meet a member of staff who will check that you are in the right place. You will be given a facemask if you don’t already have one on and will be asked to gel your hands. You should keep your facemask on during your entire time in the day surgery unit unless you are asked to remove it by one of the staff. If you are uncomfortable wearing a facemask please speak to one of our staff who will try to help with an alternative.
Tell us what you think
We hope your experience with us at St George’s Day surgery Unit is as pleasant and smooth as possible. If you have a compliment or concern regarding the unit, please let us know by:

speaking to a member of staff caring for you
contacting our Patient Advice and Liaison Service on 0208725 2453 or email pals@stgeorges.nhs.uk

Coming to Surgery
The leaflet below offers information about coming in for your procedure. If you have any further questions or concerns please speak to the doctor or nurse in charge of you care.

DSU leaflet
Where are we?
We are located in the Maxillofacial & Day Surgery Building along Perimeter Road. Coming by public transport on the 493 or G1 you can get off at stop HA/HB outside the Rose Centre.

STG site map . . .

Dentistry

Dentistry comprises three departments: Restorative Dentistry, Orthodontics and Paediatric (Children’s) Dentistry, and works closely with the Oral and Maxillofacial department providing joint clinics for patients.

  . . .

Diabetes and endocrinology

Diabetes and Endocrinology departments are at St George’s Hospital, Queen Mary’s Hospital and also at St John’s Therapy Centre.

At St George’s Hospital the diabetes and endocrinology department is part of the internal medicine, located in the Thomas Addison unit.

Patients benefit from a uniquely integrated approach to the treatment of diabetes, endocrine, metabolism and obesity, working in close collaboration with ophthalmologists, vascular surgeons, endocrine surgeons, obstetricians and paediatricians.

In addition to a large outpatient service, the department also provides a daily consultation service for inpatients. The team provides an inpatient service for both Diabetes and Endocrinology and there is a dedicated endocrine investigation unit within the department. Close liaison between paediatric and adult physicians in endocrinology ensures a seamless service of high quality for young patients.

St George’s University Hospitals NHS Foundation Trust treats children and adolescents for growth, endocrine and diabetes problems. The endocrine services sees both local and regional patients either at St George’s or at peripheral outreach clinics.

We have close links with the adult diabetes and endocrine service to ensure a smooth transfer to the adult services

Specialist clinics aimed at people with general endocrine disorders, covering all aspects of endocrinology including thyroid disease, calcium disorders, neuro-endocrinology and reproductive endocrinology.
Services we offer
Across St George’s University Hospitals NHS Foundation Trust we offer a range of services across our site for diabetes and endocrinology:

Diabetes

Medical assessments of diabetes and complications
Joint diabetes renal clinic
Nurse specialist led clinics
Specialist dietician clinics
Diabetes ulcer clinic and Podiatry service
Psyhologist service
Structured group education programmes for type 1 (BERTIE) and type 2 diabetes (DESMOND)
Insulin pump service and continuous glucose monitoring reviews
Inpatient reviews
Telephone advice
Priority clinics for urgent reviews
Gestational diabetes
Inherited diabetes and other metabolic disorders
Andrology clinic

Endocrinology

Late effects clinic for long term follow up of survivors of childhood cancers
Incidentaloma and emergency endocrine clinic
Pituitary and adrenal endocrine disorders
Endo Gynae particularly focussing on Polycystic ovary syndrome, Gender dysfunction and Turner’s syndrome
Teenage endocrine gynaecological clinic
Long term Thyroid cancer follow up clinic
Multidisciplinary clinic for morbid obesity with assessment for bariatric intervention
Thyroid and other general endocrine disorders
Von-Hippel Lindau disease and paragangliomas
Multiple Endocrine Neoplasia

Genetic Endocrine Conditions

Antenatal diabetes
Continuous glucose monitoring
Foot Problems
Gestational diabetes
Insulin pumps
Preconception needs
. . .

E

Emergency Department (A&E)

St George’s Hospital’s busy, modern Emergency Department provides a 24-hour emergency service, 365 days a year, and sees around 150,000 patients.

Emergency Department Clinical Research Group

Follow us on Twitter @stgedresearch

The Emergency Department (ED) at St George’s leads and participates in a number of research projects through the work of the Clinical Research Group. The group is part of St George’s Translational and Clinical Research Institute, a joint initiative between the Trust and St George’s, University of London.

We have been awarded around £1.6 million in grants as investigators and run over 30 clinical trials.  In 2022/23 we enabled over 3500 patients to participate in research, more than any other Emergency Department in England.

The group is led by Professor Heather Jarman and brings together clinical staff and academics to find better care and treatments for patients and families in the ED. The research team has research fellows, nurses, and clinical staff who support the research  programme.

Our research group projects
The EDCO-M study is a multi-centre cress-sectional survey, funded by the CO Research Trust (previously the Gas Safety Trust). Having a carbon monoxide alarm installed in homes can help with early detection of carbon monoxide and reduce
the risk of exposure. We know that not everyone has a carbon monoxide alarm in their homes and we are trying to find out if there are differences in those who have alarms compared to those that do not so we can provide tailored information on carbon monoxide alarm use to those that need it.

ISRCTN registration: 12562718 [link to webpage]

SKILL-MIX ED: implementation of the non-medical practitioner workforce into the urgent and emergency care system skill-mix in England: a mixed methods study of configurations and impact. Mary Halter (Chief Investigator), Vari Drennan (Joint lead applicant), Heather Jarman (co-investigator), and other consortium members. Funded by the NIHR Health Services and Delivery Programme [link].

FRAIL-T: the frailty in major trauma study. Heather Jarman (Chief Investigator), and other consortium members. Funded by the Burdett Trust. ISRCTN registration: 10671514 [link]

The ED-CO study: a prospective enhanced surveillance study of carboxyhaemoglobin (CO) levels in patients attending the Emergency Department with symptoms suggestive of CO exposure. Heather Jarman (Chief Investigator), and other consortium members. Funded by the CO Research Trust (formerly the Gas Safety Trust). ISRCTN registration: 16329899 [link]
Research unit roles
Clinical Academic Lead: Professor Heather Jarman

The Clinical Academic Lead is the leadership position within the Clinical Research Group. This includes leading the group’s strategy, supervision of the academic staff working on research projects, and for the day to day operation of the unit in managing and coordinating clinical trials.

Researcher in Residence: 

The researcher in residence is an experienced post-doctoral researcher who supports the Clinical Research Unit’s own research program. They work with clinical staff to develop projects, support applications for research funding and provide mentorship to novice researchers.

EM Consultant – research link consultant: Dr Phil Moss

The EM Consultant research link is responsible for the development of new medical Principal Investigators and the planning of training for Clinical Fellows (Research).

Academic Clinical Fellow

The NIHR Academic Clinical Fellowship (ACF) is a clinical specialty training post in medicine that incorporates academic training.

Clinical Fellow (Research)

Our Clinical Fellows work in for 20% of their time in a research role alongside their work as doctors in the Emergency Department. In their research time they take an active part in a range of research related activities including developing their own projects.
Clinical study roles
Principal Investigators

The Principal Investigator (PI) is the senior nurse or doctor responsible for each research study. They work with the Clinical Research Nurses to make sure that each study is run safely and effectively.

Senior Clinical Research Nurse

The senior clinical research nurse is responsible for oversight of the studies taking place in the department. They provide leadership and management to the clinical research nursing team.

Clinical Research Nurses

Clinical Research Nurses play a vital role in the care patients taking part in research studies. Our nurses identify patients suitable to take part in studies and work with the patient’s doctor to provide information to help them decide if they want to take part. The research nurses carry out particular treatments, blood tests or collect information on what happens to a patient who is taking part in the study. We will often continue to see patients once they have been admitted to hospital to answer any questions and to ensure their safety and well-being. . . .

F

Find Us

Department Location

Department Of Genetics
Corridor 9
Lower Ground Floor
Jenner Wing

Getting Here

By Tube…

From Tooting Broadway (Northern Line).
Turn left onto Tooting High Street, and cross the road.
Turn right down Hoyle Road, walk to the end and turn left.
The main pedestrian entrance on Effort Street.

By Bus…

The following buses stop directly outside of the Hospital:
155, 264, 280, 493 & G1
The following buses stop on Tooting Broadway:
44, 57, 70D, 77, 127, 133, 155, 219, 264, 270, 280, 355, 493, G1, N44 & N155 (Follow directions from tube)

By Car…

The Closest major roads are:
The A3 from the West.
The M23/A23 from the South.
The A2 from the East.
The entrance is on Blackshaw Road.
(Use AA route planner for further details)

Further Details
Hospital Plan . . .

G

Gastroenterology

St George’s University Hospitals NHS Foundation Trust’s Gastroenterology and Hepatology Department specialises in the diagnosis and treatment of conditions of the gastrointestinal (GI) tract (the digestive tract from mouth through to anus, including the stomach and bowel), liver, pancreas, and biliary tract. The department has a very strong multidisciplinary ethos, with consultants, nurse specialists, and allied health professional colleagues from Gastroenterology and GI Surgery, Dietetics, Radiology, and Pathology working in partnership to ensure that patients and families receive the best care for their condition.

Our consultants have a wide range of specialty expertise, and the department offers a comprehensive range of diagnostic procedures, such as endoscopy, and specialist clinics, including inflammatory bowel disease, oesophageal, viral hepatitis, and complex nutrition.

St. George’s provides a regional Intestinal Failure Service, managing patients with complex nutritional conditions and those requiring home parenteral nutrition.

St George’s is a regional liver centre and manages the full spectrum of hepatology with the exception of liver transplantation and hepatobiliary cancer surgery. The department has excellent links with King’s Liver Unit, working together to provide treatment for hepatitis C, while communication with our local hospitals is optimised through a local network.
Outpatient Clinics

General Gastroenterology– Oesophageal, stomach, small and large bowel disorders and cancers
General Hepatology– Liver, gall bladder, pancreatic disorders and cancers
Inflammatory Bowel Disease (IBD) – Crohn’s Disease and Ulcerative Colitis
Viral Hepatitis – Hepatitis B, C, D, E and HIV co-infection

In addition the department provides:

Liver and GI Diseases in Pregnancy – joint care for such complex conditions is provided with the obstetrics department.
Rapid Access Jaundice Service – A quick access clinic for patients with jaundice.
Adolescent IBD Transitional Clinic – The department also holds transitional IBD clinics with the paediatrics department for adolescent patients who will soon be transferring to our adult service.
Clinical Assessment Service (CAS) – A consultant-led service where GP referrals along with baseline tests are reviewed and triaged by a consultant gastroenterologist.

Day Cases

A full range of endoscopic procedures (procedures using fibre-optic cameras to examine the gastrointestinal tract) are provided in our modern state of the art endoscopy unit:

Upper gastrointestinal (GI) endoscopy (examination and treatment of disorders of the oesophagus and stomach)
Colonoscopy (examination of the large bowel)
Flexible sigmoidoscopy (limited examination of the large bowel)
Endoscopic retrograde cholangiopancreatography (ERCP), (examination and treatment of the bile duct leading to the liver, gall bladder and pancreas)
Endoscopic Ultrasound (EUS) (ultrasound examination from within the bowel)

In addition the department provides:

National Bowel Screening Programme – the Endoscopy department at St George’s University Hospitals NHS Foundation Trust is the National Centre for Bowel Cancer Screening for the southwest London region.
Oesophageal Manometry Service – a specialist investigation of the oesophagus.
National Endoscopy Training Centre – the department provides endoscopy training courses for doctors and nurses.

We offer breath tests, fibroscans, venesections, liver biopsies and paracentesis.

Inpatients

The department’s consultants and junior doctors undertake the care of inpatients who have been admitted with gastroenterology or hepatology diagnoses, including patients with gastrointestinal bleeding.
Gastroenterology Trust Pathways
Pathway for the Management of Dyspepsia OGD

Pathway for the Management of Dyspepsia

Pathway for the Management of Gallstones

Pathway for the Management of IBS

A Quick Guide to Liver Function Testing Pathology

Pathway for the Management of Constipation in Adult Patients

Pathway for the Management of IBD in Merton

Pathway for the Management of Rectal Bleeding

St George’s Hospital
Location and facilities
Outpatients
Clinic A & D, Ground floor, Lanesborough Wing, St George’s Hospital

Endoscopy unit

1st floor, St James’ Wing, St George’s Hospital

Inpatients

Allingham Ward, 3rd floor, St James’ Wing, St George’s Hospital

Queen Mary’s Hospital
Contact details
St George’s Hospital

Outpatient appointments – 020 8725 0007
Switchboard – 020 8725 1000

Queen Mary’s Hospital

Outpatient appointments – 020 8487 0007
Switchboard – 020 8487 6000

The Nelson Medical Centre

Outpatient appointments – 020 3826 0826
Opening hours
Queen Mary’s Hospital

Monday 08.30 – 16.30

Tuesday 08.30 – 16.30
Wednesday 08.30 – 16.30
Thursday 08.30 – 16.30
Friday 08.30 – 16.30

The Nelson Medical Centre

Monday 07:00 – 20.00
Tuesday 07:00 – 20:00
Wednesday 07:00 – 20.00
Thursday 07:00 – 20.00
Friday 07:00 – 20.00
Saturday 08:00 – 12.00
Contact us
St George’s Hospital
Outpatient Appointments
Tel: 020 8725 0007
Queen Mary’s Hospital
Tel: 020 8487 6000
Call Centre – 020 8487 6290
The Nelson Medical Centre
Tel: 020 3826 0826
Meet the team
Gastroenterology
Consultants 
Dr Sophie Barker (UGI cancer lead)
Dr Christopher Groves
Dr Gareth Sadler (Director of Endoscopy)
Dr Jamal Hayat
Dr Kesavan Kandiah (Endoscopy Training Lead)
Dr John Louis Auguste (Director of Bowel Cancer Screening)
Dr Penny Neild (Care Group Lead for Gastroenterology)
Dr Kamal Patel (IBD Co-Lead)
Professor Richard Pollok
Dr Andrew Poullis (IBD Co-Lead)
Nursing team
Fiona Donovan, Lead Inflammatory Bowel Disease Clinical Nurse Specialist
Susana Ruiz Sanchez, Inflammatory Bowel Disease Clinical Nurse Specialist
Margarida Alves, Inflammatory Bowel Disease Clinical Nurse Specialist
Asha Tacouri, Inflammatory Bowel Disease Clinical Nurse Specialist
Mark Soomaroo, Inflammatory Bowel Disease Clinical Nurse Specialist
Kirsty McCartney, Lead Upper GI Cancer Clinical Nurse Specialist
Jessica Batchelor, Upper GI Cancer Clinical Nurse Specialist
Hayley Aparicio, Upper GI Cancer Clinical Nurse Specialist
Yannesa Balbin, Upper GI Cancer Clinical Nurse Specialist
Emma Pindard, Lead Nutrition Clinical Nurse Specialist
Jessica Hamlin, Nutrition Clinical Nurse Specialist
Kathryn Atkins, Clinical Nurse Specialist
Angela Joyce, Gastrointestinal Advanced Nurse Practitioner
Jane Muomah, Gastrointestinal Clinical Nurse Specialist

Dietetics
Megan Drake, Principle Dietitian
Rishi Kanabar, Principle Dietitian

Gastrointestinal (GI) Physiology
Alice Henderson, Lead GI Physiologist
Anna Wolak, GI Physiologist

Pharmacy
Sonia Mehta, IBD Specialist Pharmacist

Hepatology
Consultants
Dr Sarah Clark (Care Group Lead for Gastroenterology)
Professor Daniel Forton, Associate Medical Director (Research), Clinical Lead South West London Hepatitis ODN
Dr Markus Gess (visiting Consultant from Kingston Hospital)
Dr Sarah Hughes
Dr Arjuna Singanayagam
Dr Metin Yalcin

Nursing team
Sally Thomas, Lead Nurse for Hepatology
Nick Tatman, Hepatology Clinical Nurse Specialist
Shiny Jaimes, Viral Hepatitis Clinical Nurse Specialist
Jonathan Durban, Viral Hepatitis Clinical Nurse Specialist
Laura Latham, Hepatitis Clinical Nurse Specialist
Sally Pannifex, Alcohol-related Fatty Liver Disease Specialist Nurse

Pharmacy
Helen Boothman, Lead Hepatology Pharmacist

Referrals

To see a specialist in Gastroenterology and Hepatology, or to have an Endsocopy procedure, a referral letter is required from the patients’ GP. This may also be booked from the GP’s practice by the e-Referrals Service.

Patient Information Leaflets

High Resolution Oesophageal Manometry and pH Studies (PDF) . . .

General Intensive Care

The General Intensive Care service cares for the most severely ill patients in the hospital. The service is able care for, diagnose and treat virtually any acute illness. It uses an array of enhanced physiological monitoring systems, organ supportive therapies and complex treatments that necessitate a high staff to patient ratio of a highly skilled, multi-professional team.

Specialities Covered

General Surgery
General Medicine
Trauma and Orthopaedics
Respiratory
Urology
Oncology
Haematology
Maxillofacial
Ear, Nose & Throat
Communicable Diseases
Renal
. . .

General medicine

General medicine is the medical specialty concerned with the diagnosis, management and non-surgical treatment of unusual or serious diseases. The General Medicine Care Group provides a range of specialist medical care for inpatient and day cases and services such as acute medicine (emergency admissions), gastroenterology, endocrinology, diabetes, respiratory medicine, rheumatology, and cardiology.

The Care Group has four acute general medicine wards, including two Acute Medical Units. Overall we are responsible for 169 beds.

The General Medicine Department at St George’s Hospital covers Allingham, Marnham, Rodney Smith wards (based in St James Wing) and Dalby ward (based in Lanesborough Wing). There are two Acute Medical Unit wards – Richmond and Amyand, both based in St James Wing. The department is staffed by dedicated multidisciplinary teams, serving primarily the local residents of Wandsworth, Merton and Lambeth. . . .

Genomics - South West Thames Centre for Genomics

The South West Thames Centre for Genomics is based at St George’s University Hospitals NHS Foundation Trust provides a specialist service to people living in South West London, Surrey, and West Sussex.

The Clinical Genetics service comprises a team of clinical staff, including consultant geneticists, genetic counsellors, and specialist registrars.

In addition, our St George’s Genomics Service is a UKAS accredited medical laboratory, No. 8127 and provides a comprehensive diagnostic analytical and reporting service for a range of genetic disorders.

The service offers specialist genetic advice, diagnosis, and counselling to families and individuals who have or might be at risk of developing inherited disorders, including cancer. This includes giving advice regarding the availability of carrier screening and prenatal testing techniques.

The Department provides care for patients at the site most convenient for them; 60 per cent of patients are seen at a clinic local to their home. Clinic appointments are held at St George’s Hospital and at 17 other hospitals within the region.
The department also provides a number of highly specialised, disease specific clinics, including two nationally recognised services: Tuberous Sclerosis clinic and the Primary Lymphoedema. Further regional specialist clinics include those for patients with endocrine and growth disorders, paediatric conditions, and neurodegenerative disease.
The department is a lead training centre for specialist registrars, genetic counsellors, and clinical scientists. It also provides advice and training for GPs and other health professionals about inherited disorders.
 Map of SW Thames Clinical Genetics Referral Region

Contact details
General Contact

Department of Clinical Genetics
South West Thames Centre for Genomics
St George’s University Hospitals NHS Foundation Trust
Blackshaw Road
London
SW17 0QT

General (non-cancer) secretaries telephone number: 020 8725 2805
General (non-cancer) enquiries (NOT REFERRALS) by email to Genetic.Secretaries@stgeorges.nhs.uk

Cancer secretaries telephone number: 020 8725 5333

Cancer enquiries by email to Cancer.Genetics@stgeorges.nhs.uk

Prenatal enquiries (INCLUDING prenatal referrals) to prenatal.genetics@stgeorges.nhs.uk. More information on prenatal referrals here.

 

Appointments team contact details

Telephone number: 020 8725 3343
Email: genetic.appts@stgeorges.nhs.uk

Clinical Staff

Consultant Geneticists:

Dr Frances Elmslie – Clinical lead
Prof Kate Tatton-Brown
Dr Suzanne Alsters
Dr Tessa Homfray
Dr Matina Prapa
Prof Sahar Mansour
Dr Esther Dempsey
Dr Meriel McEntagart
Dr Nayana Lahiri
Dr Katie Snape
Dr Heidre Bezuidenhout
Dr Avgi Andreou

Genetic Counsellors:

Kelly Kohut – Lead Genetic Counsellor
Cathryn Moss
Andrea Forman
Elizabeth Winchester
Beth Coad
Alice Youngs
Heidy Brandon
Harriet McMillan
Ginny Attard
Lily Barnett
Gaya Connolly
Venessa Miller
Alekhya Ashokan
Emma Charlton
Laura Coulier
Sarah Cable
Beth Gilman
Andrew Pestaille
Ellen Colvin

Referrals

 Clinic appointments are available on referral basis.
All referrals should be addressed to the consultant staff at St Georges.
Appointments will automatically be made at the patient’s closest hospital unless they are best served by a specialist clinic.
Specific referral criteria may apply.
Appointments by telephone and video are available, where appropriate

Waiting Times

The majority of our clinics are held on a monthly basis. The time from referral to appointment will vary depending on the clinician the patient is due to see, and the nature of the appointment.

If the referred patient is pregnant, they will either be contacted by telephone within 48 hours of referral receipt, or invited to an in-person appointment within a week of referral receipt.

Referral Address

We encourage all referrals to be sent electronically via ERS or to genetic.appts@stgeorges.nhs.uk

Our postal address is (but referrals by post are discouraged and often causes delays to the patient being assigned an appointment):

Department of Clinical Genetics
South West Thames Centre for Genomics
St George’s University Hospitals NHS Foundation Trust
Blackshaw Road
London
SW17 0QT

All prenatal referrals should be sent via email to prenatal.genetics@stgeorges.nhs.uk with the urgent referral form attached.

Referral advice

If you are unsure whether it is appropriate to refer your patient, please see our guidance on appropriate referrals. There are certain conditions we do not see in clinical genetics and will be rejected. If the referral guidance does not answer your query, questions can be sent via the ‘Advice and Guidance’ service.

Any questions in relation to a patient already known to us should go to:

Genetic.Secretaries@stgeorges.nhs.uk – for any non-cancer related cases
Cancer.Genetics@stgeorges.nhs.uk  – for any cancer related cases

We can accept referrals for patients whose GP surgery is within one of the following postcodes:

CR0 – CR9
KT1 – KT24
SM1 – SM7
SW1E
SW4, SW8, SW9
SW11 – SW20 (except SW16)
TW1 – TW2
TW9 – TW20 (except TW13 & TW14)
RH1 – RH20
TN8, TN16
GU1 – GU12
GU14 – GU31
GU33, GU46, GU47, GU95
BN5 – BN6
BN11 – BN18
BN41 – BN45
BN99
PO9, PO10
PO18 – PO22

. . .

Gynaecology

The Gynaecology service investigates, diagnoses and treats conditions related to women’s reproductive health.

We provide specialist care and clinics in the following areas:

Colposcopy
Early Pregnancy Unit
Emergency gynaecology ( via Acute Gynaecology Unit)
Endometriosis
Fertility
Gynaecological cancer
Gynaecology Same Day Emergency Care (SDEC)
Hysteroscopy
Myoma (Fibroids)
Pessary Clinic
Pregnancy Advisory Service

Our Gynaecology service is managed by a team of consultants and specialist nurses and hold clinics at both St George’s Hospital and Queen Mary’s Hospital (Roehampton).

We provide both emergency and planned elective treatment for gynaecological conditions.

Many clinics operate on a one-stop basis where conditions are diagnosed and treated in one visit.

We have a joint Gynaecological Cancer Centre with the Royal Marsden Hospital. . . .

H

Haemophilia Centre - Travelling Abroad Information

If you are travelling abroad with haemophilia it is always useful to be aware of the nearest haemophilia centre.

European Haemophilia Network (EUHANET) will help you locate the nearest five European haemophilia centres

Global Treatment Centre Directory – lists haemophilia centres and haemophilia organisations worldwide

If you are carrying medications it is worthwhile ensuring that you have a travel letter from the centre to ensure that you are not stopped by customs. You should also carry your haemophilia card which was issued from the centre. You may choose to wear a bracelet or pendant which lists your medical details. This gives medical staff the basic information regarding your diagnosis as well as providing the telephone numbers of the centre. MedicAlert is a registered charity providing a life-saving identification system for individuals with hidden medical conditions.

Please make sure your travel insurance covers your condition. . . .

Hand Therapy

Welcome to the Hand Therapy team at St Georges Hospital.

Hand therapy is the art and science of evaluating and treating injuries and conditions of the upper limb . We use a number of therapeutic interventions to help return a person to their highest level of function.

The hand therapy team at St Georges Hospital is made up of specialist Physiotherapists and Occupational Therapists who have been trained to work with a variety of hand conditions and injuries.

We encourage our patients to carry out their own treatment programmes as independently as possible and to be responsible for their rehabilitation. Our aim is to enhance patients’ recovery and assist with an optimal return to function. . . .

Hand Unit

The Hand Unit is a GOLD rated department. We were the first outpatient area to secure gold in the ward accreditation scheme. The scheme assesses wards and outpatient areas against a wide range of criteria from infection control through to quality of care and the environment we treat patients in.

What we do

Based at St George’s Hospital, we are a consultant led unit with a patient-centered and multi-disciplinary approach to helping people manage their hand and wrist problems. We treat acute injuries and long term conditions. The team consists of six plastics hand consultants and two orthopaedic hand consultants. They are supported by a nursing team including an advanced nurse practitioner and four nurse specialists and a therapies team made up of a clinical specialist hand therapist, nine therapists and one therapy technician.

We treat a variety of conditions including but not limited to:

Arthritis
Carpal tunnel syndrome and other nerve compressions
Complex wound care
Dupuytren’s disease
Ganglion and other cysts
Localised burns to the hand
Hand and wrist abnormalities in children
Hand Trauma

Fractures
Ligaments
Infections
Muscle injuries
Nerve injuries
 Tendon injuries

Trigger finger
Wrist instability and pain

Hand Trauma Clinic

We have a nurse practitioner led hand trauma clinic five days per week, with a consultant hand surgeon available for complex injuries requiring senior review. Patients aged 16 and over with acute injuries will be referred to this clinic from the Emergency Department or GP. During the clinic, the injury will be assessed and diagnosed. Small procedures may be carried out in the Hand Trauma Clinic. More complex procedures will be scheduled on our hand trauma operating lists. These are usually performed as day case procedures via the Day Surgery Unit.

Consultant Hand Clinic

Each of the consultants has a hand clinic one day per week, seeing a mixture of new patients and follow ups. Please see individual profile pages below for more detailed information about our team.

Hand Therapy

Our dedicated hand therapy team have clinic rooms in the Hand Unit and work alongside the consultant hand clinics and Hand Trauma Clinic. They provide on the day appointments for urgent cases and have scheduled appointments in their main department in St James Wing. Please see the Hand Therapy page for more information on the service they provide.

Steroid Injection Clinic 

We have a weekly service providing steroid injections to joints under x-ray guidance for the treatment of painful arthritic joints. This service is led by the advanced nurse practitioner (ANP) in the Hand Unit as a daycase procedure under local anaesthetic. Patients can book further steroid injections directly with the ANP following their first successful injection, saving time and appointments in the consultant hand clinic.

BSSH

Please see more information and patient information leaflets on The British Society for Surgery of the Hand’s website

https://www.bssh.ac.uk/patients/

. . .

Heart valve centre

The cardiothoracic unit heart valve centre is a multidisciplinary group of cardiologists, echocardiographers, radiologists, anaesthetists and surgeons, proficient in diagnosing and treating all cardiac conditions and disorders, including diseases of heart valves, aorta and arrhythmias (abnormal heart rate and rhythm).

Our cardiac surgeons perform all types of aortic, mitral, and tricuspid valve surgery in adults.

St. George’s Healthcare’s heart valve centre is one of the most advanced cardiovascular care centres in the United Kingdom and Europe and is equipped with the latest technologies and expertise tailored around the needs of our cardiovascular patients and their families.

We are also dedicated to innovation and research, practising new and less invasive cardiac therapies for our patients. It is this commitment to education and research, combined with the very best surgical and medical care available, that makes our Centre renowned as the one of the most advanced heart valve treatment centres in the United Kingdom and helps towards excellence.

Every year, more than 600 heart valve procedures, with or without other procedures, are performed at St George’s Healthcare. These include transcatheter aortic valve implantations (20-30 per year) and valvuloplasties (20 -30 per year). To ensure high quality of care, the department of cardiac surgery at St George’s University Hospitals NHS Foundation Trust has been at the forefront of monitoring quality care, with detailed attention to results and complications. Our results are reported to the Society for Cardiothoracic Surgery in Great Britain and Ireland annually.

All forms of surgery for the heart valve, with or without surgery on the coronary arteries, and other associated procedures, are performed routinely. The field of cardiac surgery continues to develop, and at St George’s Healthcare the very latest techniques are all routine practice.
Why choose us?
St George’s Healthcare is a centre of excellence for the treatment of heart valve disease. The cardiothoracic team at St George’s University Hospitals NHS Foundation Trust is dedicated to providing the highest quality, safest and the most up-to-date care for our patients.

Our experienced team of doctors, nurses, technicians and other staff work closely to provide the safest and most individualised care for the patients.

Our ethos is to provide excellent care with minimum delay for patients. . . .

Hepatology CAS

The Hepatology clinical assessment service (CAS) is our service in which your referral is assessed by one of the consultant specialists in the liver, pancreas and biliary system, with aim of streamlining your patient journey. Based on the information provided by the referring doctor or nurse, we will arrange investigations or tests we feel would be necessary before your first appointment with us, such that when you see us, we have more information available to facilitate a more rapid diagnosis and management plan.

The Hepatology CAS appointment is a virtual appointment in which the consultant, CAS specialist nurse and patient co-ordinator sit together to review your referral, case records and arrange tests. This is not an actual appointment which you need to attend. Once we have reviewed your referral, our CAS nurse or patient co-ordinator will contact you either by post or telephone to let you know our initial plan. In some instances, we may contact your GP either for more information, or occasionally, we may feel the referral is better directed to another hospital service or department.

For more information on our Hepatology CAS service, please see our patient information leaflet. . . .

I

Integrated Sexual Health

The Wandsworth Integrated Sexual Health (WISH) service
__________________________________________________________

Please note: From 1 October 2017, responsibility for the running of Wandsworth Integrated Sexual Health Services (not including services for patients with HIV) will transfer to Central London Community Healthcare NHS Trust (CLCH). Services for patients with HIV will continue to be provided by St George’s.

For more information on other services in south west London please go to: www.swish.nhs.uk or www.gettingiton.org.uk

For more information of the Central London Community Healthcare NHS Trust service from 1 October, please see their website here: www.shswl.nhs.uk

. . .

J

James Lind Alliance Outpatient Service Delivery Priority Setting Partnership

Update from the PSP – December 2023

The final step of our PSP is complete. Our final workshop was successfully completed in December 2023 in Central London. We gathered patients, carers, clerical staff and healthcare professionals to decide on the top 10 priority questions on how best to delivery care through outpatient services. Stay tuned in the new year to discover the top 10.”

Is  it possible also to remove the email address mentioned on that page (outpatientjla@sgul.ac.uk) as I am leaving my current job this month and won’t have access to emails anymore.

 

Update from the PSP – October 2023

Our Outpatient Service Delivery PSP launched its second survey in October 2023. We ask patients, carers/family members, managerial staff, and healthcare professionals in England to choose and rank the 10 most important questions they want answered in future research about how best to deliver care in outpatient services. After gathering the questions we received from our first survey, we now need your help to choose the 10 questions you find most important to answer first by researchers. After gathering your priority questions, we will move to a final workshop where we will agree on the top 10 priority questions. For more information, check our James Lind Alliance Outpatient Service Delivery webpage and our Twitter account.

Link to the survey.

Our Outpatient Service Delivery PSP closed its first survey at the end of March 2023. 210 people from different regions of England responded to the survey. We had a wide range of responses from patients, carers, healthcare professionals, clerical, and managerial staff. In addition to collecting surveys online, we organised face-to-face visits to outpatient clinics in different trusts.

We visited outpatient departments in the North West, East of England, West Midlands, and London. We are thankful for every trust, association, and colleague who helped us to promote the survey and share our project to increase the number of responses and their diversity. We are currently at the stage of analysing the data and organising the questions we received. We will keep posting updates on our web pages and Twitter account.”
More on the Survey
Our Outpatient Service Delivery PSP has been collecting survey responses since November 2022. We have received answers from different regions of England. We have a wide range of participants from patients, carers, healthcare professionals, clerical, and managerial staff. Our Steering Group monitors the responses on a regular basis and updates the data summary every two weeks. Our Steering Group members are promoting the survey among their colleagues, contacts, and networks.

Our PSP is also organising face-to-face visits to outpatient departments in hospitals and to primary care practices. Our first visit outside of London was to the North West of England. This visit helped us move this project forward and increase our responses. The survey will remain open till the end of March to allow us more time to organise face-to-face visits, promote the survey and increase our response rate.
Introduction
Outpatient appointments account for 85% of hospital activity and are fundamental to the running of the NHS. The way outpatients’ services are delivered in the future is going to change, for several reasons including new technology such as video calls and wearable devices, changing health conditions, such as the increase in type 2 diabetes and asthma. Changes to outpatients’ services need to be informed by good evidence and research. This project is looking for your ideas for the important questions about delivering outpatient services in the future.

The scope for this website and our project is only for research purposes focusing on future upcoming studies.

If you have an outpatient appointment query, please refer to the contact numbers listed on your correspondence from the trust.

About us

Our steering group include patients/carers representatives and healthcare professionals. We meet regularly and agree on all aspects and content of each stage of our project with the input and recommendation of the James Lind Alliance (JLA). Details about the members of our team are detailed in this section below “Members of our steering group”.

Our James Lind Alliance Priority Setting Partnerships

The goal of the JLA is to bring together patients, carers, and healthcare professionals to identify and prioritize the top ten unanswered questions about a particular topic in health care. These ten priority questions will be the focus of future research projects. The opinions of people who use health care services and those who treat and care for them provide important perspectives about people’s concerns and preferences.

Our Priority Setting Partnership (PSP) will focus on children and adults who live in England and attend outpatients’ appointments.  The scope for our PSP is the entire outpatient journey, from the initial GP visit to the follow up and referral appointments. Our PSP aims to identify the most important questions to shape the future of how outpatient services are delivered. Finding answers to these questions through research will help to ensure that outpatient services are delivered in the ways that meets the needs of patients and health and care professionals.

The first phase of our PSP is to ask patients, carers, and health and care professionals and managerial/clerical staff to fill out a survey with questions they want answered in future research. The second phase is to check whether these questions were previously answered by research. Then, another survey will be sent to shortlist the questions. The final stage is a one-day workshop that will gather patients, carers, health and care professionals and managerial/clerical staff to share their experiences and knowledge and agree on the final most important ten questions that will be the focus of future research.

Our objectives

The top ten questions that we will gather at the end of our PSP will be published and promoted for funders and researchers. This research will help shape the way in which outpatient services are delivered in the years ahead.

Members of our steering group

Clinical representatives
 

Ben Bridgewater – Health Innovation London

 

Ben Bridgewater is Chief Executive of Health Innovation Manchester. Prior to joining Health Innovation Manchester, Ben worked for global technology company DXC Technology as the Director of the Healthcare and Lifesciences Global Build Advisory Team. Until January 2016, he was a cardiac surgeon at the University Hospital of South Manchester for 18 years. Ben also provided clinical leadership for the UK national cardiac audit programme, as well as leading analyses that provides UK hospital and cardiac surgery mortality rates to the public.

Caroline Knox – Deputy General Manager OPD SGH 

 

Caroline has worked at St Georges University Hospitals NHS Foundation Trust for 18 years and been involved in the delivery of Outpatient Services for the past 13 years holding the position of Deputy General Manager for Outpatient Services since 2019.  She was a project manager on their Electronic Document Management project digitising patient records into an electronic solution to support the achievement of a single clinical note at the point of care. When she is not working for the NHS, she volunteers in the Army Cadet Force and holds a Reserve Forces Commission of Captain and holds the position of Company Training Officer.

James Friend – Digital Strategy London Region NHS England

James is a highly experienced commercial and health services executive director with a passion for using data to identify and track opportunities for transforming ways of working to improve healthcare outcomes, clinical productivity, and patient experience as well as healthcare product research and development.

 

Max Carter – Programme Director: NHS North West London CCG

Natasha Curran – MD Health Innovation Network South London

Natasha is Medical Director at the Health Innovation Network, south London’s Academic Health Science Network and leads the Implementation and Involvement team of the Applied Research Collaboration South London. Natasha is a Consultant in Pain Medicine at University College London Hospitals and an Expert Adviser to NICE and journals such as BMJ Open.

 

Naz Jivani – General Practice The Groves Medical Centre & Clinical Lead Kingston Borough

Naz has been a GP for 26 years, and developed an interest in Musculoskeletal Medicine in 1997. He finished his Masters in Sports Medicine in 2003 and has been part of the Orthopaedic Foot and Ankle Team since then. He has recently relinquished his role as Primary Care Borough Chair for Kingston, and is currently South West London Clinical Lead for Trauma and Orthopaedics, Musculoskeletal Medicine and Outpatient Transformation.

 

Sarbinder Sandhu – Urology Consultant Kingston Hospital
Sarbjinder trained at the Royal Free Hospital in London and gained his higher surgical training in the North Thames Region and the Royal Marsden Hospital. He obtained his MD degree on research into Prostate Cancer.

He is currently Chief of Surgery and Planned Care at Kingston Hospital. Previously, he was the Lead Clinician for both Cancer Services and Urology at Kingston Hospital. He runs General Urology Clinics for St. George’s Hospital and Kingston Hospital (at Queen Mary’s Hospital) and Oncology Clinics in the Sir William Rous Unit at Kingston Hospital

 

Simon Clayton – Corporate OPD SGH

Simon is the Health Records Manager of St George’s University Hospitals NHS Foundation Trust based in South West London with 7 years of experience in the NHS. His role consists of providing knowledge and expertise to service users on record management good practice as well as having overall responsibility for the St George’s health records service.

He is passionate about improving the patient experience through increasing process efficiency in the NHS by employing good documentation, communication, training, and utilisation of IT tools.

 

Toby Smith – Patient Groups and AHPs

Professor Toby Smith is Professor in Musculoskeletal Research (University of East Anglia). He also holds a clinical role at the Norfolk and Norwich University Hospital NHS Foundation Trust as a Physiotherapist in Trauma and Orthopaedics.
Toby’s clinical and research interests centre on the management of older people with musculoskeletal disorders.He has a particular interest in the rehabilitation of people following hip fracture and lower limb trauma and orthopaedic surgery. Toby’s methodological expertise are in the conduct and reporting of clinical trials. He leads or is a team member for a number of national, multi-centre trials, investigating both surgical and non-surgical interventions for people with a variety of musculoskeletal disorders. He has published over 300 peer-review papers

Patient and carer representatives
 

Clive Moore Ceaton – Patient Representative

Clive was diagnosed with Prostate Cancer in 2016 and treated by having a Prostatectomy. Shortly after this, he started getting involved in Public and Patient involvement and engagement as a person with lived in experience. He now serves on many panels and is always trying to get across the importance of the public voice and the need for equality, diversity, and inclusion.

Margaret Ogden – Patient Representative</

Margaret is a PPI member from Co Durham. She has been doing PPI for 15 years covering health, public health, and social care. She has been involved in 4 PSP workshops – retention in clinical trials, malnutrition, wounds, and occupational therapy. She is currently doing two projects with Oxford on PSPs. She also does PPI in education – working with year 1 medical students on primary care.

Rashmi Kumar – Patient Representative</

Rashmi is a full-time carer for elderly mother, living at home, suffering from long-term multiple conditions. He is responsible for management of her health and social care needs which helped to better understand health, psychological and social challenges patients and families face and how with little support health and quality of care can be improved.

Rashmi is a Trustee of large Patients Participation Group Network and the Chair of PPI Involvement Advisory Group at the National Institute for Health and Care Research Applied Research Collaborations, South London, bringing together NHS Services, local providers of care services, local authorities, universities, and charities.

Saba Raza-Knight – Specialty Trainee in Neurosurgery, Royal Preston Hospital

 
I am a neurosurgery specialty trainee in the North West of England. I am also a parent of two young children and recently commenced the Royal College of Surgeons’ Emerging Leaders Fellowship.

PSP Lead

Caroline Hing

Professor of Orthopaedics 

Caroline trained in Medicine at University College London. She completed her Orthopaedic and Trauma training on the Pott Rotation based at Barts and The London Hospitals with a further period of training at the Norfolk & Norwich University Hospital whilst completing an MD. She is a Professor of orthopaedics at St George’s University London with research interests in osteoarthritis and trauma. She is a clinical director for corporate outpatients, and she leads for research in orthopaedics in the trust.

 

James Lind Alliance Adviser and Chair of the Steering Group

Suzannah Kinsella

 
Suzannah is the JLA Adviser for the Outpatient Service Delivery PSP. She chairs the steering group meetings and gives guidance on the JLA method and principles. Suzannah Kinsella joined the JLA team in April 2019. Other PSPs she has worked on include: Stroke; Childhood Neurological Conditions; Psoriatic Arthritis and Community Nursing and Skin Cancer Surgery. She is currently advising PSPs on spinal muscular atrophy, burn injury and diabetic retinopathy. She is a social researcher who specialises in deliberative public engagement and public dialogue research</

PSP Information Specialist

Marie-Claire Rebeiz – Information specialist

Marie-Claire is the researcher in residence at St George’s University of London. She studied medicine and now has interest in a wide diversity of research subjects. Her current research focus is related to outpatient care, population health and healthcare inequality.

Related pages
The Outpatient Service Delivery PSP

Outpatient Service Delivery PSP Protocol 

Outpatient Service Delivery PSP Terms of Reference

Outpatients – St George’s University Hospitals NHS Foundation Trust

Contact us
Address:

St George’s University Hospitals NHS Foundation Trust
Blackshaw Road
Tooting
London
SW17 0QT

Email address: outpatientjla@sgul.ac.uk . . .

L

Liver (Hepatology)

You will be referred to us if there is a concern regarding your liver, pancreas or biliary system. We manage a wide range of conditions including cirrhosis, alcohol-related liver diseases, fatty liver, autoimmune conditions, biliary conditions, metabolic liver disease and cancers of the liver, gallbladder or pancreas.

We are a regional referral unit for complex liver and pancreaticobiliary diseases, and viral hepatitis, seeing patients from South West London hospitals. We work very closely with the King’s College Hospital for patients where liver, pancreas or biliary surgery, including liver transplantation, is being considered.

The historical routine waiting time to be seen in clinic was 3-6 months, but the introduction of a new model of streamlining assessment and investigations once your GP has referred you to us, called the Hepatology Clinical Assessment Service (CAS) has resulted in a more rapid evaluation (see Hepatology CAS leaflet).

Outpatient clinics include four general liver clinics per week at St. George’s including Monday mornings, Tuesday and Wednesday afternoons, and a monthly clinic on a Wednesday afternoon at Queen Mary’s Hospital (Roehampton). Additionally, there are two viral hepatitis clinics at St. George’s on Tuesday afternoons, and a Stable Cirrhosis clinic on Monday morning. Clinics are run by consultants, registrars, specialist nurses and specialist pharmacists.

The coronavirus pandemic taught us that in some cases, telephone consultations are better or acceptable alternatives to being seen in person. This is left to your clinician’s discretion and judgement. Please carefully look out for any communications about your clinic appointments, and we would advise signing up to the St. George’s patient portal where you can access clinic information and documents (link for patient portal inserted here).

In addition to our out-patient work we have a dedicated in-patient hepatology service with a daily review of patients with liver, pancreatic and biliary related diseases by a consultant liver specialist. A Gastrointestinal and Liver Day Unit (GALDU) also enables patients to be assessed or receive treatment without the need for admission.

Our role as a teaching hospital means we are responsible for training medical students, trainee doctors and allied health professionals. We also have an active research programme including participation in national and international studies, for which you may be approached to take part. . . .

Lymphoedema

This is a tertiary referral national service providing expert assessment, diagnosis, treatment and continued support for those with lymphoedema. Patients with lymphoedema of all causes are treated, including primary lymphoedema (adults and children), and secondary to other problems (e.g. cancer-related lymphoedema, chronic venous oedema, lipoedema). The aim is to restore people with lymphoedema to as high a level of independence as is possible within the limits of their capabilities. Since lymphoedema is a chronic condition, the need to provide ongoing support is acknowledged.
The service also acts as a centre of excellence, providing advice and support to other lymphoedema services and health care professionals around the country and internationally. There is a strong link with the genetics and research department, in order to further knowledge and understanding of this condition.

Services Offered:
Consultations:

Primary lymphoedema (genetic/inherited types, and lymphovascular malformations)
Secondary lymphoedema
Rapid access appointments for patients with cancer-related lymphoedema
Complications of lymphoedema e.g. recurrent cellulitis
Lipoedema & lipodystrophy

 Diagnostic Investigations:

Lymphoscintigraphy
Genetic screening
Research investigations (MR Lymphangiography (MRL), ICG lymphography)

Day Case Management:

Education and skin care advice for patients with lymphoedema
Intensive treatment with compression bandaging
Compression hosiery

Inpatient Management (dependent on CCG funding):

Intensive treatment with daily manual lymphatic drainage & compression bandaging.
Liposuction in combination with intensive postoperative lymphoedema care (currently only available for patients with lymphoedema i.e. not available for lipoedema).

. . .

M

Macmillan video call 1-2-1 information session request form

Macmillan video call 1-2-1 information session request form

Major Trauma Centre

St George’s Hospital is the major trauma centre for the south west London and Surrey trauma network covering a population of around 2.6 million. St George’s receives and treats approximately 120 patients every month as a result of trauma.

The idea behind trauma networks is that ambulance crews are trained to take patients to the nearest hospital with appropriate facilities and expertise on-site to treat their injuries. This means that patients with the most severe injuries are identified and taken quickly to St George’s, often bypassing the nearest hospital Emergency Department. St George’s has all the specialist facilities and staff to care for patients with serious life-threatening injuries, such as stabbings, gunshot wounds and following serious road traffic accidents.

The major trauma team is responsible for oversight of the provision of care to patients brought to St George’s with severe injuries. . . .

Make a Tertiary Referral

DIAL: 0208 672 1255

BLEEP: 7064

Monday to Thursday 07:30 to 16:00 & Friday 10:00 to 16:00:

Your call will be answered by the Pelvic CNS (Simon Smith)

All other times (& when the Pelvic CNS is on leave):

Your call will be answered by the On-call T&O team

Your referral will then be discussed & vetted & you will be asked to complete a referral proforma in FULL electronically.

A copy of the up to date proforma can be sent to you, as needed.

Your fully completed referral should then be sent as an attachment to:

pelvicreferrals@stgeorges.nhs.uk

The list below denotes patients who ARE NOT suitable for tertiary referral.

1)        Polytrauma / Major Trauma triggering secondary transfer process

2)        Haemodynamic instability due to pelvic / acetabular injuries

3)        Neurological instability due to pelvic / acetabular injuries

4)        Irreducible or unreduced hip dislocations

5)        Open pelvic fractures (urological, gynaecological, perineal, colorectal, abdominal, groin or buttock soft tissue trauma resulting from pelvic injury)

6)        Open book pelvic fractures

7)        Vertical shear pelvic fractures

These groups require urgent transfer to YOUR designated Major Trauma Centre (please be aware that this may not be St. George’s Hospital).

The Pelvic Team, led by the Pelvic CNS, will then pick up, review, action & officially respond in writing (using our existing outcome proforma to ensure a detailed plan is communicated) to all referrals, usually with 72 hours. . . .

Maternity

Online Self Referral for Maternity Care at St George’s
Welcome to St George’s Maternity Unit. We look forward to caring for you and your baby during pregnancy, birth and afterwards.

Follow this link if you are pregnant and would like to have your baby at St George’s to complete the online self referral form – completing this will start the pathway to get a booking appointment with a midwife. You can use this form before contacting your GP.

This form can also be completed by healthcare professionals e.g. GP’s to refer patients to our maternity care pathways.

Please try to complete before 7 weeks of pregnancy (OR as soon as you know you are pregnant after that gestation, OR as soon as you decide on a transfer of care). Once the referral has been processed, you will receive a letter with a midwife appointment. This can take 2-3 weeks.
Early Pregnancy Service
For pregnancies less than 14 weeks

020 8725 0093
If you are less than 14 weeks pregnant and have any concerns e.g., abdominal pain or vaginal bleeding, please contact us for information and advice on our Early Pregnancy Answerphone Service Monday – Saturday, number above. Leave your name, phone number and pregnancy concern and the nurses will respond to your answerphone message in the afternoon every day except Sundays. Please visit their webpage here for more information. If you have urgent concerns please go to A&E.
St George’s Maternity Helpline
For pregnancies more than 14 weeks

020 8725 2777
Please call this number if you are more than 14 weeks pregnant and have concerns about yourself or your baby (during pregnancy, labour or in the 6 weeks after birth). It is staffed by midwives who can offer advice, reassurance, and clinical support 7 days a week.

What Language Do You Need? (Translation Services)
If English is not your first language, please let us know if you require an interpreter. We can provide a face to face interpreter for outpatient care, and we always have telephone translation services available 24 hours a day in all settings.

Maternity Unit Tour
We have created this maternity tour video to show you the unit, how to get there and what to expect. We hope this is helpful for you.

Feedback from our service users can be found on NHS Choices.

 
Temporary Changes To Birth Centre at St George’s University Hospital Maternity Unit
July 2023: Our absolute priority is to ensure the safety of all our patients and to achieve the best possible outcomes. Unfortunately, this may mean that we will not always be able to offer our full range of birthing options. At times, we may need to temporarily close our Birth Centre to redirect our staff to other areas of clinical need in order to maintain safety across the unit.

Please be assured that we will make every effort to keep the Birth Centre closed for the shortest time possible, whilst we maintain midwifery-led care in the Delivery Suite.

We are very pleased to announce, that we will soon be opening our new water birth facilities in the Delivery Suite, so that we can continue to offer this choice of birth for all.

Thank you for your understanding and patience. If you have any questions or concerns, please do not hesitate to contact us.

If you need additional support please contact our Consultant Midwife on maternity.experience@stgeorges.nhs.uk
ENTONOX Statement
July 2023: Entonox is the ‘laughing gas’ used in labour. It is breathed in by the labouring person and does not affect the baby. It has a very short-lasting effect with each breath. Some people only use this form of pain relief in labour.

This issue concerns risks associated with levels of nitrous oxide gas to which staff may be exposed to, as reported in the press.

At St George’s University Hospitals, there are currently no plans to stop any use of Entonox (Nitrous Oxide & Oxygen).

The assessments of the occupational levels of Nitrous Oxide exposure in staff for the past year have assured us that our current upgraded ventilation system has significantly reduced staff exposure levels and we continue to regularly monitor staff exposure to ensure their safety and wellbeing.

In addition, we are working closely with our Estates teams to introduce formal active extraction (scavenging) of nitrous oxide into all areas of maternity by upgrading some of our rooms and using specialised hoses on Entonox breathing systems. This, combined with a specialised destruction unit, will further optimise the safety of nitrous oxide use both to the staff and the environment.

Vaccinations Recommended in Pregnancy
We strongly recommend all pregnant women receive the Pertussis (Whooping cough) and Flu vaccines to safeguard both themselves and their babies.

The incidence of Pertussis cases has been on the rise, making it crucial for expecting mothers to get vaccinated against whooping cough, preferably after their anomaly scan, around 20 weeks into pregnancy.

This vaccination serves as a protective shield for your newborn before they receive their own vaccines from 8 weeks.

Equally important is the flu vaccine, which can be administered until March 31st, 2024. We will commence a new flu campaign from September 2024 onwards.

Pertussis and flu vaccines are available at our dropping clinic for your convenience (Vaccines in Pregnancy – St George’s University Hospitals NHS Foundation Trust (stgeorges.nhs.uk)

We encourage you to discuss this decision with your midwife or GP.

Protecting yourself means protecting your baby – take the step towards a healthier pregnancy today”
Social Media
We have an active Instagram and Facebook account with regular updates on our service as well as useful videos, information and pictures. Be sure to follow us on Twitter here! @stgmaternity

What our service users say:
“I want to reassure you that your staff are doing a fantastic job despite the huge demands placed on them.”

“My husband and I will be forever grateful to the individuals involved and the NHS for the extremely high level of care provided”

“The team were absolutely brilliant, I cannot thank them enough”  . . .

Mental Health and Wellbeing

Our Mental Health and Wellbeing webpage – a central resource for all issues related to mental health and wellbeing in St George’s Hospital.

It is a wholly indefensible statistic that people with serious mental illnesses die on average 15 to 20 years earlier than the general population, acting as a stark reminder that good mental health care is everybody’s business. Whether you have concerns about someone who you are looking after, would like to know a little more about mental health or would like to improve your own psychological wellbeing we do hope that the contents contained in this webpage will prove a useful source of information.

O

Occupational health

The Occupational Health Service recognises that its employees are its greatest asset. Our goal is the prevention of work-related ill-health and the support of those at work with health problems or disabilities. We provide a wide range of occupational health services to all employees.

The service is provided by a multidisciplinary team of highly qualified and experienced clinicians, including; doctors, nurses, an ergonomist and administration staff.

Services provided
Fitness for work assessments.
Advice on sickness absence management.
Advice on stress management and mediation.
Counselling services.
Assessment for long-term disability benefits or ill-health retirement.
Vaccination services.
Management of needlestick injuries.
Health Surveillance.
Policy development.
Health promotion.
Tailored ergonomics advice.
Workplace assessments.
Training and education.

Contact number:
020 8725 1661

  . . .

Offender Healthcare Services

St George’s provided primary care and substance misuse healthcare services at HMP Wandsworth until August 2019.

On 1 September 2019, the running of these services at HMP Wandsworth transferred to Oxleas NHS Foundation Trust.

For further information about forensic and prison services run by Oxleas NHS Foundation Trust, please visit: http://oxleas.nhs.uk/archive/forensic-and-prison-services/ . . .

Outpatients

October 2023: Our commitment to keeping in touch and streamlining our waiting lists
We are keeping in touch with our patients more, in particular with patients who have or who are waiting for an outpatient appointment or a procedure.

We are checking with all our patients that they still wish to remain on our waiting lists for a follow up appointment.  We know that some patients are under the care of more than one hospital, or their condition may have improved, and they no longer need treatment.

More information is available here 
Outpatients at St George’s
There are more than 1,000 outpatient clinics at St George’s University Hospitals NHS Foundation Trust each week where patients see doctors or specialist nurses for assessment, diagnosis, advice or treatment. The Trust has a centralised Outpatient Clinic Service which manages appointments on behalf of the majority of the Trust’s clinical services.
Need to change or cancel your outpatient appointment?
You can change or cancel your appointment at St George’s Hospital online via our appointment amendment form

When a GP refers a patient to the hospital, this request is received by the Central Booking Service which logs the referral and ensures all the necessary information is there for the clinical services to decide which clinic a patient should attend. The letter inviting a patient to book an appointment at the relevant clinic and the letter confirming the appointment time are sent out by Outpatient Clinic Service along with a patient information leaflet.

The Outpatient Clinic Service also coordinates the provision of nurses to support the clinics and ensures that a patient’s medical records, referral letter, test results and other relevant information are at the clinic.
Outpatient service survey
Have your say to improve your healthcare

We’re working hard to improve things in our Outpatients department. This means improving your experience as a patient – from getting an appointment at St George’s, to when your GP refers you. We’re looking at areas such as how we communicate with you, your actual appointment and the information and support we give you afterwards.

That’s why we are asking you for your views on specific areas we need to improve. We are trying to build a new-look service that is built around what works best for patients, as well as helping St George’s see people more quickly and efficiently. We would appreciate you taking a few minutes to complete this brief survey, which looks at some specific areas.

Click here to take our online survey!
Location
Clinics are held in a number of different locations across the hospital. The letter confirming an outpatient appointment should include details of which wing of the hospital to go to.

  . . .

P

Pharmacy

St George’s pharmacy department provides and supervises the use of all medicines prescribed within the Trust. This key role, known as medicines management, begins with coordinating the way in which medicines are selected, purchased and delivered to the hospital. It includes overseeing the way that they are prescribed and given to patients and means reviewing each patient’s prescription regularly to ensure medicines are being used in the best way. The pharmacy department also manufactures bespoke medicines on site, improving access to specialist medicines for patients.

The pharmacy department provides a 24/7 service to patients with high standards of care reflected in its regular high scores for performance audited on a national and local basis.

Clinical pharmacy teams, consisting of pharmacists and pharmacy technicians, provide advice to those prescribing medicines throughout the hospital to ensure that patients receive the best quality treatment for their care. They also provide advice to patients on how to best use their medicines. All patients have their medication reviewed and adjusted for optimal therapy and all wards are visited daily. Cutting edge pharmacy practice developed at St George’s has been presented at national conferences.

A dedicated medicines information facility, based in the main pharmacy in Lanesborough Wing, provides support for healthcare staff and patients who have questions about medicines. Staff and patients phone the centre, which has a telephone helpline for patients.

Dispensary staff members provide advice and ensure that prescriptions are dispensed efficiently and accurately.

The department’s purchasing team ensures that medicines are purchased at the best prices available and that the quality and availability of products are maintained. The department takes part in many clinical trials to research the use of new medicines or new ways of using existing ones.

Pharmacy staff ensure the safe use and storage of medicines wherever they are used in the Trust

Patient representatives attend meetings of the patient experience group. The role of the representatives is to oversee the processes that are in place to maintain good clinical governance and protect the interests of patients.

Map of St George’s Hospital
Formulary and NICE technology appraisals
The St George’s University Hospitals NHS Foundation Trust formulary is managed by South West London Joint Formulary Committee (JFC). The JFC is a multi-disciplinary team with representation from primary and secondary care. The JFC has a robust system for the evaluation of new medicines and assessment of therapeutic practices, guidelines and policies.

All medicines are assessed by the committee for their efficacy, safety, cost effectiveness and patient acceptability prior to being approved for use within the trust as well as across South West London. Any medicines with a governance or safety concern will be reflected onto the formulary accordingly.

For further information, please click below.

South West London Formulary (swljointmedicinesformulary.nhs.uk) . . .

Pregnancy and Mental Health

Below you will find useful links to information in relation to pregnancy and mental health.
Anxiety UK – advice and helpline

https://www.anxietyuk.org.uk/blog/health-and-other-forms-of-anxiety-and-coronavirus

Mind – Coronavirus and your wellbeing

https://www.mind.org.uk/information-support/coronavirus-and-your-wellbeing/#TakeCareOfYourMentalHealthAndWellbeing

Mental Health Foundation – Looking after your mental health during coronavirus outbreak

https://www.mentalhealth.org.uk/publications/looking-after-your-mental-health-during-coronavirus-outbreak

OCD Action – skype/phone support groups

https://www.ocdaction.org.uk/support-groups/online2

Place2Be Talking to children about coronavirus

https://www.place2be.org.uk/about-us/news-and-blogs/2020/march/coronavirus-information-for-children

RCOG – Advice for pregnant women

https://www.rcog.org.uk/en/guidelines-research-services/guidelines/coronavirus-pregnancy/covid-19-virus-infection-and-pregnancy . . .

Prehabilitation before surgery with our Get Set 4 Surgery programme

Welcome to our information pages on prehabilitation at St Georges.
Prehabilitation is all about good preparation for your body and mind prior to surgery.  In the time before your surgery, you can take simple steps to improve your physical and mental health.  This will reduce your risk of complications and improve your wellbeing now and in your recovery.

We are running our weekly classes live online, via Microsoft Teams, or face-to-face.  Please speak to your clinical team to be invited to one of our sessions, or email us : surgeryschool@stgeorges.nhs.uk

We have put together some resources to help you make the most of the time you are waiting for your surgery.  You can use this time to improve your health and wellbeing, so your surgical recovery is better- think of it as preparation time rather than waiting time.

 
Watch our video introducing the Get Set 4 Surgery session, with advice on prehabilitation- taking simple steps before surgery to improve your recovery:

Prehabilitation: Simple steps to avoid complications

Improve your diet: Eating a varied diet, rich in fruit and vegetables means you will have all the nutrients you need to heal after your surgery. Aim for a normal body weight.
Cut down or stop drinking alcohol: Drinking more than 4 units per day (equivalent to 2 pints of beer or large glasses of wine) doubles your risk of complications after surgery.  Cutting down on alcohol will improve the health of your liver, which is vital for healing after surgery.
Smoking: this will dramatically reduce your risk of chest infection and other complications. The hospital ‘stop smoking’ service can help you, click here for more details.
Increase your activity levels: this will help you to eat better, sleep better and improve your general wellbeing. In addition, this will ensure your heart and lungs are fitter for anaesthesia and surgery.

Start today, and do something you enjoy.  For instance, try walking, gardening or even exercising within your own home using your furniture or stairs.

Something is better than nothing.  Every change you make today has the potential to improve your recovery after surgery.
 
Watch our 10 minute video from the Get Set 4 Surgery team on improving your diet before surgery and tips on reducing your alcohol intake:

 
Watch our 7 minute video on increasing your activity levels before surgery:

The NHS Fitness studio website has 24 instructor led online videos for a range of fitness levels.  High Interval Intensity Training (HIITs) is short bursts of vigorous exercise, and thought to be particularly helpful before surgery.  There are examples of 10-minute cardio exercise plans in the NHS fitness Studio

The free NHS Active 10 smartphone app can help set and track simple activity goals.

The free NHS One You smartphone app can help you to with a better diet and drink less alcohol. . . .

Private Patient Service

St George’s welcomes private patients from the UK and abroad. We offer a wide range of advanced treatments and diagnostic procedures and our world-renowned consultants are leaders in their respective fields, treating conditions simple to complex.

To help support private patients who are having treatment at St George’s we have a dedicated Private Patient Office located on the Ground Floor of Atkinson Morley Wing. The team will do everything they can to make your time with us as comfortable as possible.

St George’s does not have a dedicated private patient unit, however we will always endeavour to provide a single patient room wherever possible.

To talk to us about your admission, treatment and services please call the private patient office.

Contact details
Tel: 020 8725 3578/3579

Monday to Friday 9am -5pm

Email: private.patients@stgeorges.nhs.uk

Funding of Your Treatment

Self-funding – If you are self-funding your treatment this will need to be paid for in advance of treatment commencing.  We accept most major credit cards, cash, bank transfers and personal cheques with a banker’s card.
Medical insurance – If you have private medical insurance, we advise you to confirm with your insurer that your treatment is covered and get authorisation before making an appointment.
Sponsored patients – If you are being sponsored by an international embassy, you will need to ensure we are provided with a letter of guarantee before your appointment to cover your treatment.

DoH Guidance on Private Patients &Overseas Visitors using NHS Care

  . . .

R

Recovery

After your operation you should always follow the advice given by the staff looking after you, which will help you make a speedy recovery.

Deep breathing exercises: After the operation breathing often becomes shallower, which means only the upper part of your lungs expands. As the lower areas don’t expand enough, there is an increased risk of you developing a chest infection. To prevent this you must do regular deep breathing and supported coughing to expand the lower parts of your lungs and clear out secretions.

Get more mobile: It is also important that you sit out of bed and start moving around as soon as possible. By doing this you will help loosen any secretions in your lungs and prevent other problems, such as pressure sores, deep vein thrombosis and constipation.

This is vital for anyone who has had lung surgery no matter how small or large the operation. If you have had a thoracotomy incision or need extra assistance you will be seen daily by a physiotherapist.

Shoulder exercises and posture: You will be shown how to do shoulder and posture exercises by the nurses or physiotherapist. These will prevent joint stiffness on the side of your operation. Good posture is also important to prevent back problems later on.

Nutrition: It is important that you are well nourished before your operation so that your body has resources to help it to heal well. If, before you come into hospital, you have lost weight without trying to do so or feel your appetite is poor, please tell the nurses. They can arrange for you to see a dietitian.

Most people find that they lose their appetite or feel sick for a couple of days after an operation. Tell your nurse if you are having problems with this. The dietitian will be able to give advice about foods that you may be able to manage or supplements. If nausea is a problem, your doctor can prescribe some anti-sickness medicines.

Wound care: Your wound and the dressing will be checked daily by the nurses. While you still have a chest drain you will not be able to have a bath or shower. Once the drain is removed you may bathe but it is still important to keep the wound clean and dry. If you are concerned about your wound or dressings at any stage, please tell the nurses. . . .

Rehabilitation service

Vitali Unit
Part of the Douglas Bader Rehabilitation Centre, the Vitali Unit provides the necessary outpatient services, clinics and resources needed to enable the rehabilitation of patients so that they can achieve their optimal level of function, mobility and health status. The centre also offers services for the management of patients with complex rehabilitation needs, including neurological rehabilitation, prosthetics and special seating. . . .

Renal

St George’s University Hospitals NHS Foundation Trust provides a complete range of inpatient and outpatient nephrology services for those with kidney conditions living in South West London.  The unit is also the kidney transplantation centre for patients in South West London, Surrey and Sussex.

The service has 20 inpatient beds on Champney’s Ward which is currently located on 4th floor Lanesborough wing of St George’s.

Care closer to home is offered in partnership with Fresenius Healthcare with community/satellite haemodialysis units located in North Wandsworth and Colliers Wood.

Outpatient services are offered at the following locations:

St George’s University Hospitals NHS Foundation Trust
Kingston Hospital
Queen Mary’s Hospital, Roehampton
St John’s Therapy Centre, Wandsworth

Our plans for a new Renal centre
Kidney care in South West London, Surrey and beyond will soon be transformed under exciting new plans for a specialist renal unit designed to treat the most seriously ill patients.

The proposed state-of-the-art facility – based at St George’s Hospital  – will be used by patients who currently receive care at St George’s and St Helier hospitals and will be one of the largest renal services in the UK. Find out more about our plans.  

Find out how you can become a Patient Partner for the Renal Development Programme by clicking on the links below. 

Renal Patient Partner leaflet

Role description and application form . . .

Respiratory Medicine

Our respiratory medicine service diagnoses and treats a wide range of respiratory diseases and problems. We see patients from South West London and sometimes further afield. Our mission is to deliver outstanding and accessible clinical services that are continually developed and refined in response to the needs of the people we serve and our team includes respiratory specialists, nurses, physiotherapists and physiologists.

Further information about each service component is provided below.

Asthma
Chronic obstructive pulmonary disease
Interstitial lung disease and sarcoidosis
Lung cancer*
Pleural disease and ambulatory procedures clinic
Bronchiectasis and lung infections
Tuberculosis (TB)
Sleep-related disorders and domiciliary CPAP service
Domiciliary non-invasive ventilation service
Occupational and environmental lung diseases
Pulmonary hypertension
Flexible bronchoscopy, endobronchial ultrasound and rigid bronchoscopy
Full lung function testing including bronchodilator reversibility
Nurse-led respiratory clinics including Oxygen assessment, Nebuliser trial service and hypoxia altitude simulation test (‘fitness to fly’)
CDC clinics

Safety Notice regarding ResMed magnetic masks (Issued 4 December 2023)
ResMed has issued an urgent warning to patients currently using Continuous Positive Airway Pressure (CPAP) therapy with masks equipped with magnetic clips.

ResMed has expressed concerns that masks with magnetic clips may pose a threat to individuals with metallic medical implants, including patients, bed partners, and caregivers involved in the fitting of the masks. The magnetic clips, when near certain medical implants, could adversely affect their functionality, leading to serious health implications.

The affected medical implants include, but are not limited to, pacemakers, implantable cardioverter defibrillators (ICD), neurostimulators, and various magnetic metallic implants and devices placed in different parts of the body. A comprehensive list of the implants at risk can be found on the ResMed website.

Patients who are currently using masks with magnetic clips and have metallic medical implants are urged to take immediate action. They are advised to contact the Respiratory Physiology Service at St George’s University Hospitals NHS Foundation Trust by calling 020 8725 2909 or emailing Resp.External@stgeorges.nhs.uk. The hospital will facilitate the transition to an alternative interface within the next three months to ensure patient safety.

In the interim, affected individuals are advised to maintain a minimum distance of six inches between the magnetic clips and their metallic implants, including those of bed partners and caregivers. Alternatively, if patients possess an older mask with non-magnetic clips, they are encouraged to continue using it until a suitable replacement is provided.
Asthma
The Asthma clinic sees patients with asthma of varying severity and aims to provide an accurate diagnosis of the different variants of this condition. Advice on avoidance strategies and treatment with local (inhaled) and systemic therapies are key parts of the service. Management of patients with anaphylactic tendencies, cough and associated disorders is also available. A nurse-led clinic is run once or twice a week to complement the medical clinic. Skin prick testing, bronchodilator reversibility assessment and serological (immunological) tests are also available. We have a service for severe asthma patients on injectable biologic therapies wo are reviewed regularly in our severe asthma clinic and are discussed in our regular MDT

Lead consultant – Dr Jane Evans
Chronic Obstructive Pulmonary Disease
A multi-disciplinary team provides comprehensive care for COPD patients who access our services as out-patient referrals or through emergency hospital admission. The team works collaboratively with community COPD nurses running a once monthly MDT and has strong links with primary care, encouraging joined-up care for COPD patients. Routine referrals are seen within 2-4 weeks. A specialist nurse or doctor is available to provide advice for patients or healthcare professionals on all aspects of COPD or to see urgent referrals on week days. Our services provided include diagnosis, education and self-management plans, management of severe or complex COPD (including nebulised antibiotics for chronic infection, support for home non-invasive ventilation, links with secondary pulmonary hypertension service and palliative care), nebuliser and oxygen assessment as well as access to structured pulmonary rehabilitation. St George’s has an active clinical research programme that aims to improve care for COPD patients.  We also run a severe COPD MDT to assess patients for surgical intervention for emphysema, such as lung volume reduction surgery or endobronchial valve insertion.

Our COPD clinics are in St George’s Hospital and Nelson Health Centre.

Lead consultant –  Dr Sachelle Ruickbie
Interstitial Lung Disease (ILD) & Sarcoidosis
The dedicated Sarcoidosis and ILD twice weekly clinic offers a state-of-the-art evaluation and treatment programme. The core service comprises specialist Chest physicians trained in ILD collaborating with thoracic radiologists, pathologists, rheumatologists, cardiothoracic surgeons and pulmonary hypertension physicians in an interdisciplinary manner. Diagnostic modalities provided include high-resolution CT scanning using the latest multi-detector row scanners, bronchoscopic examination with bronchoalveolar lavage and EBUS, full lung function and exercise testing, echocardiography, right heart catheterisation and thoracic surgical biopsy.  We run regular rheumatology ILD clinics for management of patients with complex  Connective Tissue disease associated ILD and vasculitis. Patients with multi system sarcoidosis have access to Cardiac MRI, and we provide joint cardiac sarcoidosis clinics in association with cardiologist. Complex Neurosarcoid patients are managed jointly with expert neurologists and  discussed in regular neuro sarcoid MDT.  We have access to specialist ILD MDT at St Mary’s Hospital Imperial healthcare NHS Trust. Patients have access to antifibrotics (Nintadib and Pirfenidone) in collaboration with St Mary’s Hospital if required.

Lead consultant – Dr Raminder Aul
Rapid Access Lung Shadow Clinic (for urgent lung cancer referrals)
We offer a complete diagnostic and therapeutic thoracic malignancy service. Patients with suspected lung cancer (either symptoms or radiological suspicion) are fast-tracked for the consultant-led Rapid Access Lung Shadow Clinic. We have access to CT scans, PET scans, image-guided biopsies, flexible and rigid bronchoscopy and EBUS (endobronchial ultrasound sampling). Our weekly MDT meets every Monday morning to discuss cases prior to a specialist joint oncology clinic with thoracic surgeons, medical and clinical oncologists. In addition, CT scans and clinics are conducted at Queen Mary’s Hospital and patients are brought to St George’s for more specialist diagnostic tests and treatment as needed.

Lead consultant – Dr Adrian Draper
Pleural disease and ambulatory procedures clinic
We have a specialist nurse 5 day/ week ambulatory service, managing procedures and diagnostic investigations such as trucut biopsy, pleural aspirations, drain placement and indwelling pleural catheters. There is a weekly consultant led clinic, Dr H Meredith, and pleural MDT to review the patients seen.

Referral to the pleural CNS is currently via bleep 7809 and/or via e mail to Farinaz Noorzad, Pleural CNS, and Dr Helen Meredith via trust email

Lead consultant – Dr Helen Meredith
Bronchiectasis and lung Infections
Patients with bronchiectasis are prioritised to the bronchiectasis clinic.  Our services provided include diagnosis, education and self-management plans, management of severe or complex bronchiectasis (including nebulised hypertonic saline and nebulised antibiotics for recurrent exacerbations, palliative care), nebuliser and oxygen assessment as well as access to structured pulmonary rehabilitation. We work closely with the respiratory physiotherapists to provide care. Blood tests for infective markers including fungal serology, sputum induction, diagnostic bronchoscopy, HIV testing and immune function testing are available.

Lead consultant – Dr Anne Dunleavy
Tuberculosis Service
The TB service at St Georges Hospital provides specialist inpatient and outpatient services and care for the clinical diagnosis and management of TB patients. We are the tertiary referral centre for multi-drug resistant TB and provide specialist care for patients with TB meningitis and co-infection across South- West London.

The medical team is lead by Dr Anne Dunleavy alongside Dr Angela Houston, Dr Catherine Cosgrove,  Dr Amber Arnold and the Respiratory and Infectious Disease Consultants.

The TB specialist nursing team consists of 5 specialist nurses and an outreach worker and they deliver a number of services for TB patients; nurse led clinics for patients receiving treatment for active and latent TB, screening clinics for contacts of TB (adult and paediatric), occupational health contacts, new entrant screening clinics and screening for patients prior to receiving biologic treatments. We have a rapid access clinic for patients with symptoms of active TB who are referred from the community or other tertiary services. We work with inpatient teams to support the care of inpatients on TB treatment.

Patients with cavities on their chest x-ray should be seen withing 24hours of referral and those with suspected pulmonary TB within 5 days.

Lead Consultant- Dr Anne Dunleavy
Domiciliary Non-invasive Ventilation Service
The domiciliary non-invasive ventilation service is a multi-disciplinary team that runs a clinic on 3 days of the week providing assessment of patients, planning of further investigations and commencement with NIV treatment when indicated. The frequency of review depends on the underlying condition and is required to ensure the treatment is effective and symptoms are managed. We will assess and treat patients with obesity hypoventilation syndrome, neuromuscular, musculoskeletal and sleep disorders as well as respiratory disease.

Referrals to the NIV team can be made via internal referrals or for urgent review please contact the respiratory StR on call.

Lead consultant – Dr Nicola Walters
Sleep Disordered Breathing
There are clinics three days a week dedicated to the assessment and investigation of patients with sleep-disordered breathing. We undertake home sleep studies on patients with suspected Obstructive Sleep Apnoea Hypopnoea Syndrome (OSAHS). For those in whom the diagnostic sleep study is positive, they may be offered continuous positive airway pressure (CPAP) therapy and follow up is provided within the department. Close links with the Ear, Nose and Throat (ENT) team, orthodontists and bariatric surgeons ensure that alternative therapeutic options are made available where such approaches are more appropriate. The sleep service is supported by the respiratory physiologists.  The sleep service at St George’s Hospital is predominantly for sleep disordered breathing.  We are also able to investigate central sleep apnoea and periodic limb movement disorder.

Other sleep disorders such as narcolepsy and parasomnias cannot be assessed here and should be referred to other local services (usually Guy’s Hospital, Royal Brompton Hospital or Queen Victoria Hospital in East Grinstead).  Insomnia referrals should go to either Royal London Hospital for Integrated Medicine, Great Ormond Street, London or Queen Victoria Hospital in East Grinstead.

Lead consultant – Dr Nicola Walters
Pulmonary Hypertension (PH)
The PH programme is a large multidisciplinary service interfacing with colleagues in anaesthesia, cardiology, cardiothoracic surgery, haematology, intensive care, radiology, respiratory medicine and rheumatology. It concentrates on the diagnosis and management of patients with suspected pulmonary hypertension associated with cardiac, pulmonary and haematological disorders including thromboembolic and sickle cell disease. In addition to inpatient care, there are 2-3 out-patient clinics per week and a weekly right heart catheterisation service. All referrals and requests for inter-hospital transfers can be made directly to Professor Madden or his team. There are joint MDT meetings with the pulmonary hypertension service at the Royal Brompton Hospital to offer expert care to a large cohort of patients.

Lead consultant – Prof Brendan Madden
Flexible bronchoscopy, endobronchial ultrasound and rigid bronchoscopy
For flexible Bronchoscopy or EBUS the referral process for inpatients is via Respiratory Spr on call, the procedure list runs on a Monday afternoon

Endobronchial ultrasound bronchoscopy runs every week Wednesdays and Fridays. Any admin or clinical queries will be responding to Monday – Friday 9am – 5pm

For external referrals for EBUS please use email: ebus@stgeorges.nhs.uk  or Tel: 020 8725 1956 (please leave a voicemail)
Lung Function Testing
The lung function service is part of respiratory physiology and provides a broad range of diagnostic investigations for adults experiencing symptoms that may indicate a breathing condition. These include full pulmonary function testing (flow volume loop, gas transfer and body plethysmography), bronchodilator reversibility, muscle strength testing, impulse oscillometry, skin prick allergy testing, field exercise testing and bronchial challenge testing. Procedures are performed on outpatient and inpatient adults. The physiology service is active in teaching and training and will have clinical physiology students for large periods of the year, therefore a student may observe or perform the test under supervision (consent is obtain prior to undertaking the test).
Oxygen Assessment, Nebuliser Trials and Hypoxia Altitude Simulation Testing
There are regular nurse led clinics to assess whether patient require domiciliary oxygen and / or ambulatory oxygen therapy.  Evaluation for portable oxygen devices can also be undertaken. The Respiratory Nurses can also assess the need for and response to nebulised antibiotic therapy, including the provision of equipment.

The Hypoxia Altitude Simulation Test is for patients who are due to go on holiday and there is a concern about their oxygen levels during the flight.  The test simulates flight conditions and the need for supplementary oxygen can then be assessed.  The test should be booked at least 8 weeks in advance.  Please note, the hospital does not provide oxygen therapy for the flight or for overseas.  This needs to be arranged with the airline and local medical facilities. . . .

S

Senior health

Senior health is a branch of General medicine that is concerned with the clinical, preventative, remedial and social aspects of illness in old age.

The challenges of frailty, complex co-morbidity, different patterns of disease presentation, slower response to treatment and requirements for social support call for special medical skills.

Presentations of illness in old age are often non-specific. Geriatricians focus on falls, immobility, incontinence and confusion as well as adverse drug reactions.

The gold standard treatment for frailty is a comprehensive geriatric assessment. This involves close inter-disciplinary working with nurses, therapists, pharmacists, dietitians, social workers and many other health professionals in order to develop a coordinated and integrated plan for treatment and long-term follow-up.

The Senior health service provides a comprehensive range of  services ranging from acute services to rehabilitation and outpatient clinics. 

These services currently include:

Acute senior health inpatient care based on three wards at St George’s Hospital
Orthogeriatric liaison work and rehabilitation
Older Persons assessment and liaison services (OPAL) in the acute medical unit and emergency department
Inpatient rehabilitation services on Mary Seacole ward at Queen Mary’s Hospital
Inpatient rehabilitation services at Ronald Gibson House
Outpatient clinic at St George’s Hospital
Outpatient clinic at St John’s Therapy Centre and Queen Mary’s Hospital (Wandsworth)
Outpatient clinics at the Nelson Centre; Holistic assessment and rapid investigation-HARI
Day Hospital service at St John’s Therapy Centre and the Bryson Whyte Rehabilitation Unit at Queen Mary’s Hospital
Wandsworth community ward/complex care team MDT input
Access to specialist advice for GP’s via the Kinesis system
Dementia and Delirium liaison services

The department is also in liaison with colleagues in the Department of Psychiatry of Old Age based at Springfield Hospital.
HARI – Holistic Assessment Rapid Investigation
HARI is a multidisciplinary ambulatory service for adults with complex medical and rehabilitation needs based at the Nelson Health Centre. Patients can be referred who are registered under a Merton GP.

Read more about HARI here: https://www.clch.nhs.uk/services/holistic-assessment-rapid-investigation
OPAL – Older Persons Assessment and Liaison Service
The OPAL team is base in the acute medical unit and in reaching into the emergency department. The OPAL team is a team of senior specialist nurses, geriatric consultants and support from physiotherapy and occupational therapy.

Optimal care for elderly patients requires knowledge of age-related physiological changes, complex co-morbidities, multidisciplinary team work and advanced care planning.

Our population is ageing and multimorbidity and frailty is rising. Recognising and managing frailty proactively is key and the cornerstone of managing frailty is comprehensive geriatric assessment (CGA). We need to use clinical judgement and personalised goals when deciding how to apply disease based clinical guidelines in the management of older people with frailty

The OPAL team aims to identify patients with frailty early on in their presentation to hospital, initiate CGA and generate a realistic personalised care and support plan.

The OPAL team work aims to reduce avoidable admissions/prolonged admission of frail older people  where possible, as well as to help zone patients to the most appropriate area of admission and to provide guidance on discharge from the point of admission.

The OPAL team will refer patients to specialist community pathways and services on discharge where appropriate and link with social care links voluntary sector support.

During admission to the acute medical unit the OPAL team aim to support early mobilisation of patients to reduce risk of deconditioning, to manage expectations of patients/carers, to explore an individuals values  and priorities and to improve continuity of care for the frail elderly.

Contact details: Alison Fitzgerald, OPAL Lead Nurse
Bleep: 7172/7173
Email: opal@nhs.net
Orthogeriatric Liaison Service
Fragility fractures carry significant morbidity and mortality. Patients who sustain hip fractures are also very likely to have numerous serious medical comorbidities. In 2007, the British Orthopaedic Association published The Care of Patients with Fragility Fracture (the “Blue Book”) in conjunction with a number of other professional organisations including the British Geriatric Society. This outlines the best practice in care of this patient group. 
Orthogeriatric liaison involves geriatric input into the care of older patients with hip or other fragility fractures during their inpatient stay alongside orthopaedic care. Currently these patients are on Gunning and Holdsworth ward (5th floor St James wing). During the orthogeriatric assessment, pre-existing or acute medical conditions are addressed, as well as falls risk and bone health. The team have well established links with rehabilitation services. 
St George’s Hospital is one of four London major trauma centres. Since 2017 the Orthogeriatric team have been involved in the care of older patients admitted with major trauma, providing comprehensive geriatric assessment to those patients with pre-existing medical co-morbidity and multiple acute injuries. . . .

South West London Adult Critical Care Network

The SWL Adult critical care network is a system and collaboration of healthcare facilities, professionals, and resources dedicated to providing specialised and intensive care to critically ill patients. Our network involves St. George’s hospital, Croydon Health services hospital, Epsom and St Heliers, The Royal Marsden and Kingston Hospital, medical professionals (such as intensivists, nurses, and respiratory therapists), and advanced medical technologies.

The network is as a multi-organisational, multidisciplinary forum, fostering the exchange of collective knowledge, experience, and best practices within the healthcare sector. We play a pivotal role in overseeing the development and execution of the network’s program objectives, with a specific focus on monitoring data flows in Intensive Care Units across the SWL to enhance service delivery.

Offering clinical advice to the broader Integrated Care System (ICS) and London Cell – NHSE, we guide investment decisions related to critical care services. Additionally, we review and provide guidance on national and other critical care service-related directives for stakeholders in the SWL. Our proactive approach includes developing a network plan for winter pressures and surge situations, aligning with broader sector winter planning initiatives.

We share best practices across the ICS and region, establish standards for effective service delivery, and interface with relevant forums to ensure alignment of work plans and address shared risks and issues. Our commitment involves identifying, resolving, and escalating any system or local challenges that may impede service delivery.

Contact us 

Telephone: 0208 725 4164

Leadership team and key personnel

David Williams, Director of Acute Provider Collaborative
James Marsh Deputy, Group CEO gesh
Emma Duffy, Deputy Director of System Oversight & Emergency Planning
Dr Pascale Gruber, Clinical Lead
Susan Reynolds, Lead Nurse
Tessa Savanhu ,Network Manager
Magda Karydi, Admin Support

Network member organisations

St George’s University Hospitals NHS Foundation Trust
Epsom & St Helier University Hospitals
Kingston University Hospital
The Royal Marsden NHS Foundation Trust
Croydon Health Services
. . .

Southwest London Post-Covid Specialised Assessment Service

COVID-19 rapid guideline: managing the long-term effects of COVID-19
. . .

Specialist Medicine

Clinical infection, dermatology, gastroenterology, hepatology, genetics and rheumatology.

St George's Breast Education Centre Faculty

At St George’s Training Centre we are lucky enough to have access to a large multidisciplinary team of national and internationally renowned experts in the field of breast diagnostics and treatment. We maintain links with the professional disciplines within the main hospital through shared personnel and multi-disciplinary involvement, which contributes to and enriches the training we offer.

The partnership with Kingston University and St George’s Hospital Medical School, through the School of Radiography furnishes access to additional educational expertise.

Our Faculty and Associated Faculty includes:

Education Faculty
Nursing Faculty
Radiography Faculty
Radiology Faculty
Surgical Faculty
. . .

Stop smoking service

Background
Smoking is the leading cause of preventable death and illness, with second hand smoke causing significant short and longer term risks to health. In addition, Smoking materials are a primary source of ignition and cause fires.

The NHS has a duty to promote healthy behaviours and to protect people from harm. Everyone working, visiting, receiving care or living on NHS premises has a right to be in a completely smokefree environment.

Smokefree Policy
St Georges University Hospitals NHS Foundation Trust is a designated smokefree site – this means smoking is not permitted anywhere on trust grounds including car parks and gardens.

Any person wishing to smoke should leave the hospital grounds to do so. This applies to patients, visitors and staff.

The smokefree policy aims to protect all patients, staff and visitors to the trust from dangers of second hand smoke.

Coming into hospital
Please do not bring tobacco or smoking material with you.

If you are coming in as a planned admission please speak to your local pharmacist, GP or stop smoking service about obtaining Nicotine Replacement Therapy (NRT) for use while you are here for;

support to quit, or
temporary abstinence if you are not ready to try and quit

Some (but not all) types of NRT are available from the wards – please speak to the staff or ask for a referral to the smoking cessation team for additional information or support while you are in hospital.

Benefits of stopping smoking
Giving up smoking before any planned hospital treatment is the most effective thing you can do to speed up your recovery.

For both planned and emergency admissions – stopping smoking once you have been admitted can shorten your stay and reduce the risk of complications.

After 20 minutes

Pulse rate returns to normal.

After 8 hours

Nicotine and carbon monoxide levels in blood reduce by more than half and oxygen levels return to normal.

After 48 hours

Carbon monoxide will be eliminated from the body. Lungs start to clear out mucus and other smoking debris.

After 48 hours

There is no nicotine in the body. Ability to taste and smell is improved.

After 72 hours

Breathing becomes easier. Bronchial tubes begin to relax and energy levels increase.

After 2-12 weeks

Your circulation improves.

After 3-9 months

Coughs, wheezing and breathing problems improve as lung function increases by up to 10%.

After 1 year

Risk of heart disease is about half compared with a person who is still smoking.

After 10 years

Risk of lung cancer falls to half that of a smoker.

After 15 years

Risk of heart attack falls to the same as someone who has never smoked.

For more information, please go to: www.nhs.uk/live-well/quit-smoking/

Services available
Stopping smoking with support and supervised use of medications increases your chances of successfully quitting by four times.

The hospital stop smoking service team can provide more advice and information before, during or after your admission. Call us on 020 8725 4234.

Ask your ward staff to refer you if you would like to be seen on the ward during your admission. Note to staff: patients can be referred using ICLiP, just search in Orders for ‘Smoking Cessation’.

Out-patients or Pre/Post admission
You can attend one of the stop smoking support clinics:

Drop in clinics available to all visitors, out-patients and staff at the trust.
Providing FREE  friendly advice, support and encouragement with specialist trained advisors.
A choice of medications available free or on prescription.

St Georges Hospital
Ground Floor
Atkinson Morley Wing
Every Wednesday and Friday
10am to 3pm
Queen Marys’ Hospital
Ground Floor
Cardiology Outpatients
Every Tuesday
10am to 3pm

For more information call:

 020 8725 4234 or 07775 020 248 (during clinic times only) or
Wandsworth stop smoking team on 0800 389 7921

Other services
Stop Smoking London Helpline: 0300 123 0044 (Monday to Friday 9am to 8pm – Saturday & Sunday 11am to 4pm).

London wide stop smoking portal: london.stopsmokingportal.com – Information on local London borough services can be found here.

All stop smoking services should provide information and access to treatments for stopping smoking.

Further information on treatments available can be found at:

www.nhs.uk/smokefree/help-and-advice/prescription-medicines
www.nhs.uk/conditions/stop-smoking-treatments/

Or you can discuss the available options with your local stop smoking service or pharmacist

Further information sources

Smokefree
NHS Choices
ASH (Action on smoking and Health)
. . .

Surgery

Children’s, general, maxillofacial, plastic, pre-operative and vascular surgery.

T

Therapies

Therapy Services at St George’s Hospital are based around an integrated focus with multi-professional teams designed around patient care groups. Qualified therapists range from juniors and seniors through to advanced clinical specialists and consultant practitioners who operate at a higher level within particular specialties, for example, running clinics. Juniors are newly qualified therapists who rotate through a number of clinical specialties to gain a broad general experience for up to approximately two years before progressing onto a more senior role. We also have a growing workforce of assistant practitioners known as therapy technicians and an integrated administration team. The service treats patients as inpatients and outpatients, or in their own homes. In all cases, the therapy teams aim to ensure that there is a smooth and comprehensive handover to any ongoing community services that the patient may require at the end of their hospital care. Therapists, with the consent of the patient, also aim to ensure that they communicate with family and carers as appropriate throughout the patient’s treatment programme. While a large proportion of the therapy services are based at St George’s Hospital, we also provide outpatient services in satellite clinics at GP practices and St John’s Therapy Centre in Battersea. The Neurorehabilitaiton service, provides rehabilitation for patients with neurological conditions such as head injury and stroke. This specialist rehabilitation team comprising therapists, nurses, doctors, and clinical psychologists is managed by a clinical services manager who has a therapy background. . . .

Thoracic surgery

This is the surgical speciality that involves the bony thorax, consisting of ribs and sternum, as well as the pleural cavity, consisting of the pleura, lungs and pericardium. It also deals with surgical diseases of the mediastinum such as the thymus gland. A large proportion of thoracic surgery is involved in the diagnosis and treatment of cancers such as lung cancer and mesothelioma. Surgery on the heart and aorta are carried out by cardiac surgery.

The majority of operations are carried out using minimally invasive techniques (keyhole surgery) such as VATS (video assisted thorascopic surgery) and RATS (robotic surgery). Most of the work is elective (planned surgery) however urgent and emergency work is carried out including surgery for patients who have sustained chest trauma.

All the information about coming into hospital for a thoracic operation can be found in these pages. This information has been written by the staff of the cardiothoracic unit to give you information about coming into hospital for your lung operation.

We hope you will find this information helpful before you come into hospital and after you go home. The doctors and nurses will explain your operation and care in more detail. If you would like more information or have questions, please ask a member of staff caring for you. . . .

Trauma and orthopaedics

Orthopaedic surgeons deal with traumatic injuries to the bones and joints and diseases of the skeleton, the commonest of which is osteoarthritis. The joints involved with posture and movement include the spine, hips, knees, ankles, feet, shoulders, elbows, wrist and hands. As well as looking after problems with the bones, we also deal with problems involving the muscles, ligaments and nerves, including sports injuries.

St George’s University Hospitals NHS Foundation Trust Trauma and Orthopaedic Department provides both elective (planned) and emergency services. We have a team of 13 consultants with special interests covering the whole range of orthopaedic conditions. The department incorporates the largest pelvic and acetabular fracture unit in the South of England, providing specialist services not available in other hospitals.

The pelvis makes up the “hip girdle” and the acetabulum is the socket of the hip joint. Three consultant surgeons specialise in this field of surgery and the Pelvic Unit also has specialist nurse support. St George’s University Hospitals NHS Foundation Trust makes a significant contribution to research in this growing area of expertise.

Other tertiary referral units within Trauma and Orthopaedics at St George’s University Hospitals NHS Foundation Trust include hip and knee reconstruction, children’s orthopaedics and spinal surgery. A newly formed Hand Unit comprising orthopaedic and plastic surgeons will look after patients with traumatic hand and wrist injuries and diseases of the same structures, including rheumatoid and osteoarthritis. All of the St George’s University Hospitals NHS Foundation Trust surgeons have close links with the Department of Rheumatology.

A number of the consultants operate at the southwest London Elective Orthopaedic Centre (SWLEOC). Opened in 2004, this is a purpose-built 65 bed unit on the site of Epsom Hospital with excellent transport links.

Now known as the Elective Orthopaedic Centre, this is the busiest joint replacement unit in the United Kingdom and one of the busiest in the world. St George’s patients needing hip replacement, knee replacement, ligament reconstruction, shoulder and foot surgery will generally undergo surgery in the Centre and then be followed up after surgery back at St George’s University Hospitals NHS Foundation Trust. We are also moving some spine surgery to the Elective Orthopaedic Centre. . . .

Treatment

Surgery on the heart valve involves repair or replacement of the damaged valve or valves. An operation to repair a valve involves reconstruction to ensure that it works well. There are three different types of artificial valves, if a replacement is needed:

Bioprosthetic valves are generally known as “pig valves”, being mainly made from animal tissue which are treated with chemicals to avoid rejection. Therefore, the patient does not require anti-rejection medication.

Mechanical valves are made of metal or synthetic material which requires the patient to receive anticoagulation. That is, they have to take regular medication to thin the blood and prevent blood clots.

Biologic valves are made from human heart valves obtained from donors which have been treated in the laboratory. They are often referred to as homografts.

If a replacement valve is not required and repair is possible, this may involve using a ring, which is not a complete artificial valve. . . .

Tuberous Sclerosis Complex (TSC) Clinic

COVID-19 guidance for people living with TSC
About Tuberous Sclerosis Complex (TSC):
Every month, 10 babies are born in the UK with TSC.  An estimated 1 million people world-wide have TSC.  Some will be diagnosed with TSC very early in life whilst others may not be diagnosed until later childhood, adolescence or adulthood.  TSC can vary in the extent to which it affects individuals – most people with TSC do not have all of the features associated with a ‘classical’ presentation.

What is TSC? 
TSC is a genetic condition that can lead to growths in various organs of the body, but those most commonly affected are the brain, eyes, heart, kidney, skin and lungs. These growths may also be referred to as tumours but they are not cancerous.  When they cause problems it is mainly because of their size and where they are in the body. TSC growths have different names depending on which organ they are found in. These growths can result in a range of associated complications, including epilepsy, learning disabilities, behavioural problems – including hyperactivity or an autistic spectrum disorder, skin abnormalities – (ash leaf spots, fibroadenomas and shagreen patches, chronic kidney disease (CKD), breathing difficulties, the build-up of fluid on the brain (hydrocephalus), and/or bleeding from the growing tumours themselves particularly tumours in the kidney, termed angiomyolipomas (AMLs).

TSC is present from birth, although presentation may be much later in life.  It is estimated that around 1 in every 6,000 babies are born with the condition.  A mutation in either the TSC1 or TSC2 genes is implicated in around 80% of cases.  Although it is an autosomal dominant condition, only 25% of cases appear to be traceable from a parent to an affected child. In the remaining 75% of cases, development of TSC appears to be due to a de novo mutation.

The impact of TSC varies considerably, with some people being relatively mildly affected (they may not even know they have TSC) and others being more significantly affected. This impact may be evident in the early years, or not until adulthood. Thanks to research findings and with improved medical care, people with TSC can expect to live healthier lives with a normal life expectancy, in most cases.

Treatments for TSC
Different interventions may be appropriate for tumours caused by TSC, including surgical, radiological and pharmacological options.

Therapeutic options for any patient are carefully evaluated and patients and their families are counselled carefully about their options as part of our service.

TSC Clinics at St George’s Hospital
The multi-systemic nature of TSC necessitates the involvement of a multi-disciplinary team of Consultants, specialist nurses and counsellors from diverse specialities including Clinical Genetics, Renal Medicine, Urology, Interventional Radiology, Neurology, Paediatrics, Chest medicine, Dermatology, Psychiatry and Learning Disability.

We communicate regularly to discuss interesting cases and the most appropriate management.

TSC-Genetics Clinic
(Monthly, 2nd Monday of each month, Suite 2, Outpatients Department, Queen Mary’s Hospital, Roehampton)

The TSC-Genetics specialist clinic at St George’s Hospital has been running since 1993 initially as one of two National referral centres, which has been at the forefront of research into treating the condition.  The clinic is run by Dr Frances Elmslie (Consultant Geneticist), Dr Chris Kingswood (Consultant Nephrologist and Medical Advisor to the UK Tuberous Sclerosis Association), Dr Nicholas Annear (Consultant Nephrologist), our TSC Clinical Nurse Specialist, Lydia Israel, and our Genetic Counsellor, Ginny Attard. The clinic now forms one of the seven regional referral centres, recognised nationally by NHS England and approved to prescribe Everolimus in TSC since June 2016.

TSC-Genetics Clinic lead: Frances Elmslie

TSC-Renal Clinic
(Monthly, 4th Friday of each month, Neurology Outpatients, Ground Floor AMW)

A new monthly TSC-Renal clinic has been set up to more closely monitor patients who are commenced on Everolimus for side-effects and complications.  The clinic is led by Dr Chris Kingswood and Dr Nicholas Annear.  Dr Kingswood is the world’s leading expert in the treatment of renal TSC in children, and is a also a respected world voice on treatment in adults; he has led several studies and co-authored several publications in this field, notably Exist-1, Exist-2, and several review articles.  He has also co-led an International renal group in considering International guidelines for this indication in children.  Blood tests and serial imaging using MRI/CT/Ultrasound (where necessary on the general anaesthetic MRI list) frequently form part of the diagnostic and monitoring process.

TSC-Renal Clinic leads: Dr Nicholas Annear, Consultant Nephrologist / Dr Chris Kingswood, Consultant Nephrologist

Contact us:
Ms Lydia Israel
TSC Clinical Nurse Specialist
Tel: 020 8725 1688

Ms Ginny Attard
TSC Genetic Counsellor
Tel: 020 8725 0334

TSC-Genetics Secretary

Jesitha Sivanathan
Tel: 020 8725 0572

TSC-Renal Secretary
Abiola Banjo
Tel: 020 8725 2890

New referrals to:
email: TSCreferrals@stgeorges.nhs.uk
Fax: 020 8725 3444

Post:
 TSC Clinic
SW Thames Regional Genetics Service
St George’s University of London
Cranmer Terrace
London
SW17 0RE

Patient Information and Support:
The Tuberous Sclerosis Association (TSA) provides an excellent resource for patient information and support: http://www.tuberous-sclerosis.org/ . . .

Twins Trust Centre for Research and Clinical Excellence

The Twins Trust Centre for Research and Clinical Excellence is a collaboration between St George’s and the Twins Trust.

We are proud to provide excellent antenatal, fetal medicine, labour and delivery, and neonatal services to families of multiple pregnancies, and offer expertise, training and support to other health care professionals who seek advice on the management of these pregnancies.

The video below shows Professor Asma Khalil celebrating the launch of UK’s first Twins Trust Centre for Research and Clinical Excellence:

 

  . . .

U

Urology

The Urology Department provides acute and elective services to St Georges Hospitals and to an extensive tertiary network of NHS, private and overseas hospitals. Within its cancer network, it has the largest number of cancer patients in the Trust. Cutting edge surgical technology, including the Da Vinci® robot, are employed to deliver a high standard of care to patients with kidney, bladder and prostate cancer. European recognised robotic centre. The penile cancer team has the largest network of its kind in the UK and has the largest contemporaneous series of penile cancer patients worldwide.

W

Wandsworth Children’s Social Services Occupational Therapy (CSS OT)

Who we are
The Wandsworth Children’s Social Services Occupational Therapy (CSS OT) service is a statutory service for children and young people (aged 0-17 years) with a disability or long term condition, living in Wandsworth Borough Council.

The aim of the service is to support a child or young person and their carers to manage everyday tasks.  To do this we may recommend changes to the way that the task is done or adaptations to the environment.

The CSS OT service is based at Queen Mary’s Hospital in Roehampton, working closely with the Children’s Community Occupational Therapists also based there.

We can be contacted by telephoning 0208 725 3632, or email cssot.referrals@stgeorges.nhs.uk
How to refer
The CSSOT is a self-referral service.
To be eligible, the child or young person has to have a long term physical, and/or neurological condition that is hampering their ability to manage independently within their home environment.  This may include:

Moving and handling concerns (from being lifted and carried).
Access issues into or around the home, including the child’s bedroom, toilet, washing facilities, or the garden.
Postural management; identifying need for help with seating at home.
Severe learning disabilities and / or challenging behaviour at home that puts the child and/or their care giver at high risk of injury or is having an effect on meeting siblings’ essential needs (and development).

All referrals are screened, and must be completed in full.
What happens at an assessment?
To enable us to identify a child or young person’s needs and abilities in all activities of daily living (ADL), a CSS OT will conduct an assessment with your child at home. The assessments are carried out through clinical observations, seating assessment, equipment demonstrations and discussion.  Areas of assessment will include, but not be limited to; getting in, out and around the home, bed, bath, and chair, how the child washes or is facilitated to wash and dress; and eating and drinking.  Dependent on outcome of initial assessment, further assessment may be required, to ascertain how to best meet some of the identified needs.

Recommendations may include:

Support to review and change the way that a task is performed, including advice and teaching alternative ways of doing things to increase independence
Provision of equipment, to enable safe access to bathing or toileting facilities – including bath-boards, bath seats and bath steps, and commode chairs.
Provision of complex and/or specialist equipment, to facilitate activities of daily living – including washing, play and toileting.
Minor adaptations – including grab rails or mop-stick style stair rails
Offering advice on managing mobility and transfers safely, including the completion of manual handling risk assessments, care plans and demonstrations, this may include the recommendation of hoisting equipment or adaptations to install this.
Recommending housing adaptations which may include ramps, step lifts, stair lifts, through-floor lifts, door widening, ceiling track hoists, and level access showers. For adaptations to be undertaken, permission of the property owner is required. Funding and the on-going maintenance of such works will be dependent on who owns the property.
Referring to the Richmond and Wandsworth Home Improvement Agency (HIA) to facilitate the ‘necessary and appropriate’ and ‘reasonable and practicable’adaptations to the property, this may include the management of the Disabled Facilities Grant (DFG).
Referring to other appropriate agencies when necessary, including Social Work Teams, Child and Adolescent Mental Health Services, and other therapeutic services.
Signposting to other services that may be better suited to meeting your child’s needs.

Please be aware that specialist equipment is provided on a loans basis – for as long as it’s needed and the young person is living in Wandsworth.   We ask that we are contacted when such items are no longer in use so that these items can be collected and reused. 
What we don’t do
The Children’s Social Services Occupational Therapy team do not assess for the following:

Needs relating to housing overcrowding issues. You will need to contact the Wandsworth Housing department for this specific need.
Home safety aids or equipment that are readily available and non- specialist.

Additional services and relevant information
As you will no doubt be aware, due the current situation with Covid-19 and in line with Government advice, we are all adapting the way we work with our families to ensure we work in a safe way for the protection of all. We can confirm that we are still operating and delivering therapy support however possible, as long as it is safe and appropriate to do so.

We recognise that families will still need help and advice during this difficult time and while we endeavour to answer individual queries during this time, we request that families do contact the cssot.referrals@stgeorges.nhs.uk inbox which is being monitored by a member of the team. Non-urgent queries will be recorded but may not receive an immediate response.

In order to reduce unnecessary contact and follow government social distancing guidance, we have put together a list of a few useful resources which you can find below:

In case your query is urgent, or a piece of CSSOT issued equipment has ceased working contact the Social Services OT team via email on: cssot.referrals@stgeorges.nhs.uk
If you need to contact the 0-25 team you can do so by emailing: 0-25DisabilityTeamDuty@richmondandwandsworth.gov.uk or calling the duty number on : 0208 871 7192  /  07947 321 047
If you are concerned that a sling is not safe to use, you are advised to stop using it and to use a backup or school issued sling. Check all slings before use. If you do not have a backup sling then please email us on: cssot.referrals@stgeorges.nhs.uk
If you have a Care and Independence sling and require assistance with how to hoist from bed to chair, including wheelchairs using the GAIR sling then please see the attached video: https://www.youtube.com/watch?v=z1TKVJmokUo
For ceiling track hoist or through floor lift repairs, please contact your housing association or the manufacturer directly, contact details should be located on the hoist or lift.
If your query is around a pending adaption or repair of a recent installation please contact the Richmond and Wandsworth Home Improvement agency on: 0208 487 5185 or email them on HIAMAR@richmondandwandsworth.gov.uk
Mobile hoist or equipment repairs can now be requested directly through Medequip – please contact 0207 231 6816 or email Medequip on: mandela@medequip-uk.comMedequip website https://www.medequip-uk.com/contact/south-london
Broken bathing equipment will not be treated as urgent and you will be advised to strip wash in the interim.
If your hospital bed requires repair, please contact the prescriber.  If you are unsure who this was, and the bed has a ‘Medequip’ sticker on it, you may be able to contact Medequip on 0207 231 6816 for this information.
Medequip Emergency Out-of-hours can be contacted on Tel No: 0208 573 2871 or email them on: mandela@medequip-uk.com – Medequip website https://www.medequipuk.com/contact/south-london
If you have a Geberit AquaClean Care wash dry toilet and requires assistance with how to use the device, please see the attached toilet demonstration video: https://www.youtube.com/watch?v=-AlV5GYeg1M&feature=youtu.be&app=desktop
If you have a Jiraffe HTS (Rifton) toilet chair and require assistance with adjustments then please see the video here: https://www.youtube.com/watch?v=8zhFPPRyGz0
If you experience any issues with your R82 Xpanda seating system then please contact the Occupational Therapy office via email: cssot.referrals@stgeorges.nhs.uk to let us know and we will endeavour to contact you to inform you of next steps. Alternatively, you may wish to contact the manufacturer directly and you can do so via telephone on: 0121 561 2222 or email: uk.enquiries@R82.com
For any information regarding Coronavirus and patients and visitors to George’s hospital then please use the website link attached: https://www.stgeorges.nhs.uk/newsitem/coronavirus/
. . .

Sorry no results were found for your query