Services

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.

Members of our department include Dr Judith Dinsmore (Past President of the Neuroanaesthesia & Critical Care Society of Great Britain and Ireland), Dr P Razis (Past President of the Neuroanaesthesia Society of Great Britain and Ireland), Dr Nick Fletcher (Past President of the Association of Cardiothoracic Anaesthetists and Critical Care) and the late Dr JP Van Besouw (Past President of the Royal College of Anaesthetists).

We strive to improve the quality of care that we deliver to patients through our advanced educational services, research and training opportunities. In August 2015 we were awarded Anaesthesia Clinical Services Accreditation (ACSA) by the Royal College of Anaesthetists and have been re-certified in 2019. We are also accredited for our vascular and cardiac anaesthetic services, covering 193 quality standards. We were the 4th hospital nationally to be accredited when ACSA was first introduced, reflecting our dedication to delivering and maintaining a high quality of care to our patients.

There are always interesting job opportunities, please check NHS jobs for the latest offers or get in touch with us directly.

 
Links

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ArmA-PS Arm - Activity, Participation, Symptoms Form

Guidance for completion of the ArmA-PS:

Section A asks about ‘caring’ for your affected arm either by yourself using your unaffected arm or with help from a carer or a combination of both of these.

Section B asks what you can do with your affected arm or using both arms.

For each of the activities listed, please tick the most appropriate box in the table.

The amount of difficulty that you or your carer experience in doing the task, based on your activity over the last 7 days. Please estimate if you do the task but have not done so in the last 7 days (e.g. for cutting finger nails).
If you have not tried to do the task in past 3 months then tick the ‘Not Attempted’ box.

If you are unable to complete the questionnaire independently, you may:

Receive assistance from a carer or professional to act as a scribe
Receive assistance from a carer or professional to facilitate understanding and completion question by question
A carer may complete the questionnaire on your behalf based on difficulty in performance of the tasks

For further information please contact the Gait Laboratory Team at Queen Mary’s Hospital

Thank you for taking the time to complete this questionnaire

References

This questionnaire is adapted from the original Arm Activity Measure (ArmA) designed by Ashford et al. 2014.

Ashford S, Slade M, Nair A, Turner-Stokes L (2014) Arm Activity measure (ArmA) application for recording functional gain following focal spasticity treatment. International Journal of Therapy and Rehabilitation 21(1): 10-17.

Royal College of Physicians, British Society of Rehabilitation Medicine, Chartered Society of Physiotherapy, and Association of Chartered Physiotherapists Interested in Neurology (2009) Spasticity in adults: management using botulinum toxin. National Guidelines. Royal College of Physicians, London.

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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. This will be explained to you.

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.

Birth will then take place by placing a Ventouse (suction) cup on the top of the baby’s head- and at the same time as you push the doctor will gently pull with the contractions, which will help bring your baby lower through the birth canal and then be born.

Alternatively assessment by the doctor may suggest that birth by placing forceps gently on the side of the baby’s head is the best way to help the baby be born.

Very occasionally first the ventouse and then the forceps may be used to help your baby be born. (Very rarely following an attempt at an instrumental birth the  baby is not successfully lowered through the birth canal and then proceeding to an Emergency Caesarean Section is advised).

For both types of instrumental birth, it may be possible that the doctor advises that an episiotomy ( a small cut in the perineum ) is done to make a bit of extra space for the baby to come out and prevent a complex tear occurring.

Following the birth you may notice some swelling, marks or bruising on the baby’s head – from ventouse;  or on the side of the head/face/cheeks from forceps birth. All these marks usually start disappearing within the first few days. . . .

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.

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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.
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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 . . .

Cardiovascular

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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

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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. . . .

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

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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.

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Diagnostic services

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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. . . .

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 . . .

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. . . .

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. . . .

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

. . .

James Lind Alliance Outpatient Service Delivery Priority Setting Partnership

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 . . .

Join our Skills Development Network

. . .

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).

. . .

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. . . .

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.

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

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.

  . . .

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

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

  . . .

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. . . .

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
. . .

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

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. . . .

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
. . .

Surgery

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

TEST QUESTIONNAIRES

. . .

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:

 

  . . .

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.

Vacancies

A list of all St George’s vacancies can be found on:

The NHS Jobs website. . . .

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/
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