Critical Care

Introduction

Guy’s and St Thomas’ NHS Foundation Trust Critical Care Visiting Professional Programme (VPP) is designed to provide international visiting professionals with the opportunity to experience and learn from a multi-disciplinary Critical Care team working in a busy tertiary surgical and medical centre in London. All major surgical specialities are covered within the Trust excluding neurosurgery.

Guy’s Hospital is a major thoracic and renal transplant centre along with head and neck surgery (involving complex airway management), urology (including robotics) and orthopaedics (including major spine correction surgery).

St Thomas’ Hospital is a major elective and emergency site with an A + E and associated emergency services. A full range of emergency and elective surgery is supported including cardiac (open and cardiac catheter cases), vascular (including hybrid theatre), upper and lower surgery, obstetrics and gynaecology (7,000 births a year), reconstructive plastic surgery and orthopaedic trauma. The St Thomas’ site is one of five nationally commissioned ECMO (Extracorporeal membrane oxygenation) centres, accepting referrals from across South East England and beyond.

Our Visiting Professional Programme is a unique development experience that allows visitors to observe our leading critical care team in all its settings. The attachment will be tailored to the learning needs of the observer and can be designed to deliver either a broad or highly specific set of experiences. We are dedicated to broadening international professionals’ clinical expertise and enabling them to observe new skills that can be transferred back to their work place.

Programme aims

Overall programme aims

The programme is aimed at those who wish to extend their experience within a leading critical care team and who wish to gain an understanding of the way this is practiced and organised within the NHS and how it integrates with patient care pathways.

The programme aims to include:

• Direct experience and exposure to relevant areas within critical care that suit the applicants’ needs
• Opportunities to get involved with short quality improvement projects during your visit
• Opportunities to attend our in-house teaching sessions for intensivists
• Opportunities to attend our clinical governance meetings
• The opportunity to share knowledge and expertise with doctors, consultants and other members of the critical care multi-disciplinary team
• 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.

Format

The critical care programme is delivered to rotate through level 2/3 intensive care, level 1/2 high dependency care, Extra Corporeal Membrane Oxygenation (ECMO), the Outreach Team to manage deteriorating patients within the hospital, and the Post Critical Care Recovery Service. The programme will also provide exposure to relevant departmental teaching, multi-disciplinary meetings and research activities.

The observer will be nominated a supervisor to coordinate their individual programme and mentor progress each week.

Who can apply

This programme is intended for non-U.K. advanced trainee clinicians at the level of specialist registrar or consultant looking for exposure to a leading NHS critical care team.

Visitors can apply primarily for an observership (with no hands-on element) or a practical attachment programme.

Those wishing to apply for the practical attachment must have GMC registration. You can apply for GMC registration directly through the main GMC website. This is likely to take a considerable time to achieve and should be factored into an attachment application.

Programme duration

It is recommended to undertake a placement of between six weeks to three months for a typical observership Attachments could be from three months to one year. The experience can be tailored to the applicants needs from a generic overview of our critical care services to a specialised attachment to one specialised clinical area.

Critical Care service

Critical Care at Guy’s and St Thomas’ is one of the largest, most specialised and comprehensive critical care services in the NHS, providing a total of 29,371 bed days in 2016/17. The service cares for an unparalleled case mix; seeing patients from a wide range of socioeconomic groups and ethnic backgrounds with a broad range of critical illness and injury.  It is a core service within the trust strategy and treats patients across a complete pathway, from outreach, through to the commissioned follow-up clinic.

The critical care service is an enabler of many specialist pathways, with level 2 and 3 beds spread across both the Guy’s and St Thomas’ sites.

Guy’s and St Thomas’ is one of five ECMO centres in the UK, with a 24/7 consultant-led retrieval service. The team have been able to build strong relationships with the 4 other UK centres that are commissioned to provide ECMO support, and engage closely with referring centres to inform of best clinical practice and service updates.

Critical care also hosts the Outreach Team to provide assistance and care to deteriorating patients on the ward. This is medically staffed by senior trainees, and overseen by a consultant.

The critical care service is recognised internationally for supporting patients beyond the walls of intensive care and taking a holistic view of their recovery back to health. The department runs a well-established recovery clinic and peer support group, led by a multi-disciplinary team of critical care professionals. The recovery pathway has continued to grow year on year, with the services being accessed by more patients than ever before.

Critical Care Areas

• St Thomas’ hospital – Intensive Care 1 (ICU1) 15 beds
• St Thomas’ hospital – Intensive Care 2 (ICU2) 15 beds
• St Thomas’ hospital – Intensive Care 6 (ICU6) 11 beds dedicated ECMO unit
• St Thomas’ hospital – Victoria High Dependency Unit  (VHDU) 10 beds
• St Thomas’ hospital – Page High Dependency Unit  (PHDU) 4 beds
• St Thomas’ hospital – Doulton High Dependency Unit  (DHDU) 10 beds
• St Thomas’ hospital – Overnight Intensive Recovery (OIR) 11 beds
• Guy’s hospital – Guy’s Intensive Care Unit (GCCU) 13 beds

Adult Surgical services provided at Guy’s and St Thomas’

• ENT
• Head and Neck
• Maxfax
• Thoracic
• Endo-Urology
• Urology
• Renal
• Transplant
• Orthopaedics
• Pain Management
• Plastic surgery
• Gynaecology
• Gynaecology Oncology
• Cardiothoracic
• Vascular
• Upper GI
• Lower GI
• Breast Surgery
• Cleft
• Oral Surgery
• Ophthalmology
• Trauma services

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.