A Consultant and a Transformation Manager from St George’s were recently invited to speak at a prestigious conference – Urgent & Emergency Care: Preparing London for Winter 2022/23 – to share their experience of setting up an innovative new emergency surgery pathway.

Coming up with innovative solutions to make patient flow more efficient is essential as hospitals experience such a high demand for their services, particularly emergency care services.

Cleo Kenington, Consultant and Nye Bevan Unit lead, and Verity Croll, Transformation Programme Manager from St George’s University Hospital were invited to the conference, recognising the incredible transformation project work they’ve done in Same Day Emergency Care and patient flow.

The Nye Bevan Unit team launched a General Surgery Same Day Emergency Care (SDEC) pathway in December 2021. Now established, an evaluation has shown significant benefits for the Trust and patients.

With a project team including matrons, nurses, consultants, management, transformation and clinical directors of the emergency department and surgery, the pathway they have developed has helped to:

  • deliver an immediate reduction in overnight admissions for general surgery
  • reduce the length of stay on Nye Bevan Unit, supporting better patient flow

Cleo Kenington, Consultant and Clinical Lead for the Nye Bevan Unit for emergency surgical assessment, said:

“Patients don’t want to stay in hospital if it’s not necessary, and we know that actually being in hospital is not necessarily better for recovery, so it has been great to have support from the team to develop this service to improve the care that we can deliver while at the same time saving money for the hospital.”

The pathway means that approximately five patients per day are seen in each morning session. It also means that patients are seen by a consultant general surgeon early in their patient journey, which is beneficial in terms of safety and reducing delay, and not having to stay in hospital unnecessarily improves patient experience.

Unnecessary admissions are also reduced through the pathway, resulting in a more efficient hospital system and importantly a reduced burden on staff.

Since the SDEC pathway was launched, the average length of stay has shown a promising fall in the Emergency Surgical Assessment Unit (Nye Bevan). This has a demonstrable financial benefit as the cost of an acute hospital bed overnight is estimated at £340, so there is a significant cost avoidance by enabling these patients to safely go home and return the next day.

Verity Croll, Transformation Programme Manager, said:

“We’re really pleased that the data shows this SDEC pathway has achieved its aims, and we’re looking at ways to improve it further. We’re very grateful to everyone that has been involved in this project.”

The Nye Bevan unit, based in St James’ Wing at St George’s, is a purpose-built emergency surgical assessment unit, with a minor procedures room and two emergency clinics as well.

The SDEC pathway is the provision of same day care for emergency patients who would otherwise be admitted to hospital.


Notes to editors

About St George’s University Hospital NHS Foundation Trust

St George’s University Hospital NHS FT is the largest healthcare provider and major teaching hospital for south west London, Surrey and beyond – and one of the largest healthcare providers in the UK – serving a population of 3.5 million.

St George’s is part of a hospital group, the St George’s, Epsom and St Helier University Hospitals and Health group.

St George’s Hospital – one of the country’s principal teaching hospitals – is shared with St George’s, University of London, which trains medical students and carries out advanced medical research.

St George’s is one of 11 adult and children major trauma centres in the UK, one of eight hyper acute stroke units and one of the biggest and busiest of the eight heart attack centres in London.

It is also an accredited centre of excellence for trauma, neurology, cardiology, cancer and blood pressure services and is the national centre for family HIV care and bone marrow transplantation for non-cancer diseases.

St George’s children’s services are rated outstanding by the CQC.