Accident and Emergency (A&E)

Programme aims

The programme is aimed at those who wish to extend their experience in a leading A&E department and who wish to gain an understanding of the way this is practiced and organised within the NHS.

The programme aims to include:

• Direct experience and exposure to an outstanding* Emergency Department. Including Resuscitation, Urgent Care Centre, Children’s A&E and Emergency Medical Unit
• There are ample opportunities to get involved with short quality improvement projects during your visit
• Opportunities to attend our in-house teaching sessions for A&E doctors
• Opportunities to attend our multidisciplinary team meetings (MDM)
• The opportunity to share knowledge and expertise with doctors and consultants
• The opportunity to develop and extend visitors’ work portfolios by gaining experience of observing one of the largest teaching hospitals in Central London, whilst gaining direct insight into the workings of the NHS

A Certificate of Attendance will be awarded to visitors upon the end of their programme.

Who can apply

This programme is intended for non-U.K. doctors looking for exposure to a NHS emergency department.

Visitors can apply for an observership programme. Those wishing to apply must have GMC registration. You can apply for GMC registration directly through the main GMC website, alternatively The Royal College of Physicians run a medical training initiative which facilitates GMC registration and provides sponsorship for a Tier 5 visa. You can find out more about their Medical Training Initiative by visiting their website.

Programme duration

It is recommended to undertake a placement of a minimum of 12 weeks. You will get exposure to various areas in the department including our emergency medical unit. 

A&E service

We offer three distinct emergency department (A&E) services:

• A&E and Urgent Care Centre at St Thomas’ Hospital
• Urgent Care Centre at Guy’s Hospital
• Children’s emergency department

We see approximately 150,000 patients per year, making us one of the busiest emergency departments in London. We also see around 100 ambulances every day.

Emergency department (A&E)

Treating serious injuries, accidents or sudden illness

We aim to provide gold-standard emergency care and improved health outcomes for all our patients through education, research, and leadership development. *In 2016, the emergency department got an ‘outstanding’ rating from the Care Quality Commission inspection.

We treat patients who have suffered a recent injury or accident or who have developed a sudden illness. All A&E departments use a priority system where the most seriously ill patients are seen first.

We may direct patients somewhere else if:

• the nurse thinks that patients condition is not an accident or an emergency
• patients have certain symptoms that mean they need to be seen in one of our specialty areas.

If a patient has a minor injury or illness, they will be directed to our Urgent Care Centre. This is staffed with GPs and emergency nurse practitioners.

If a patient has a more complex condition, they will be seen by one of our emergency doctors.

Specialty areas

If patients have been referred by their GP or another hospital to a particular team, they will have to register at A&E first. Although the team will be expecting them, they may not be able to see them immediately. 

Patients may be redirected to specialty services within our Trust such as:

• Eye Casualty – for patients with an eye problem
• Burrell Street – our free and confidential specialist sexual health service
• Antenatal Day Assessment Unit – for women with pregnancy-related problems over 18 weeks gestation
• Early Pregnancy and Gynaecology Unit – for women with gynaecological problems or pregnancy-related problems under 18 weeks gestation
• Children’s A&E – there is a separate team of children’s nurses and doctors (for children under 16) within A&E

St Thomas’ Emergency Floor development

The Trust has invested over £20 million to rebuild the A&E department at St Thomas’ and redesign the whole ‘pathway’ of emergency care for our patients. This work is currently due to complete in Spring 2018.

Urgent Care Centre

These centres treat patients with less serious injuries. One is based in St Thomas’ Emergency Department (A&E), the other is based at Guy’s Hospital.

What we do

The urgent care centre at Guy’s Hospital offers an alternative to the emergency department (A&E) for a range of minor injuries and urgent medical problems.

It is a walk-in NHS service for patients whose condition is urgent enough that they cannot wait for the next GP appointment (usually within 48 hours) but who do not need emergency treatment at the emergency department (A&E). It is staffed by a GP working alongside emergency nurses.

We have facilities to x-ray limbs for suspected fractures and prescribe medicines, however the service is not set up to do blood tests, chest X-rays or more complex imaging such as CT or MRI scans. The unit will usually treat patients with less serious injuries more quickly than the emergency department (A&E).

We treat minor injuries and illnesses including:

• broken bones
• bites
• burns and scalds
• infections
• minor illnesses in children and adults including fever, infections and rashes
• sprains
• wounds.

This service does not replace a patient’s own GP. A patients GP is ideal for most treatments as they hold medical records and have a broader picture of their health. He or she can also refer patients to specialist services for less time-critical conditions.

Services not offered:

• repeat dressings (please see the GP practice nurse)
• repeat prescriptions (unless in an emergency, when a short duration may be prescribed)
• sexual health (please see local sexual health clinic)
• dental pain or emergencies (please see local dentist or call 111 for emergency dental services)
• non-urgent specialist referrals.

Patients will usually be seen more quickly in this unit rather than in the emergency department (A&E). How long patients wait to be seen depends on:

• the seriousness of their condition
• how many patients with more serious or urgent needs arrive in the unit while patients are waiting.

When patients are seen

When patients arrive, patients will be assessed immediately by a senior nurse or doctor and patients may be referred on for more appropriate treatment. This could be A&E if patients are seriously ill, or it may be to their GP or pharmacist if patients do not need to be treated at the urgent care centre.

Example Timetable

Fees

A course fee per week will be applied; this fee excludes accommodation and travelling expenses. To find out the fee amount please email vpp@gstt.nhs.uk

Please note

Clinicians are able to offer bursaries or discounted placements on an individual basis. This is at the discretion of the Directorates of GSTT and does not affect the terms and conditions of the Visiting Professional Programme agreements