The Royal London Hospital

• The Royal London Hospital (RLH) is a leading and internationally renowned teaching hospital based in East London.

• The Adult Critical Care Unit (ACCU) is a 44 bed Unit with an attached 12 bed surgical monitored unit. This busy ICU provides high quality care to over 3000 patients a year. We looked after over 700 critically unwell patients with Covid-19 during the first 2 waves of the pandemic (reaching 151 on the ICU at one point).
• The Royal London is the local hospital for the diverse population of Tower Hamlets- although we border the wealth of city, our local population has the worst income and child poverty in the country.
• The hospital, (also home to London’s Air Ambulance), is the busiest major trauma centre in the country. It is also a renal transplant unit, and a regional head injury, neurosurgery, stroke and thrombectomy unit.
• We are a tertiary referral centre for HPB, gynae-oncology and oral maxillo facial surgery- all of which adds to the interesting and varied case load that you will see here.
• All the critical care units across Barts Health Trust and the North East London regional network work supportively and collaboratively. This allows us to transfer patients between smaller and larger hospitals to access specialists services and also to maintain local critical care capacity.
• RLH ACCU provides an innovative and highly regarded education programme for our junior medical staff which include daily timetabled non-clinical time. It is curriculum linked and focussed on FFICM exam success. There is training on ICU equipment, a journal club, consultant-delivered talks and peer-to-peer sessions. All trainees will have the opportunity to present at our weekly M&M which has regular contribution from other specialist teams.
• There are frequent cross-site education events with Barts and Whipps Cross ICUs. For those who are interested in facilitating education, there are also opportunities on teaching programmes for medical students, nurses and AHPs. RLH ACCU has a burgeoning POC ultrasound training programme which includes FUSIC heart (formerly FICE) and FUSIC lung. There are weekly FUSIC heart cross-site governance sessions with Saint Bartholomew’s Hospital.
• Numerous additional training opportunities can be arranged, tailored to a trainee’s individual needs. These include leading the ward round, attending multidisciplinary MDTs, a neurosurgical/ACCU/radiology TBI MDT, tracheostomy ward rounds, trauma talks and MDT, advanced airway experience for non-anaesthetists, ICU follow up clinic, and experience on obstetric and renal HDUs.
• We have an internationally renowned research department and an active audit and QI programme. Supervised managerial and leadership experience can also be arranged.
• At the core of the RLH ACCU is an inclusive team of nurses, AHPs, psychologists, clerks, cleaners, techs, doctors and managers who relish a challenge. We love it here- we hope you will too! Please see our website for more information: http://accu.london
• There is split site working within this Unit

We are currently supporting:

• The MOSAICC trial: Sodium bicarbonate for acidotic AKI patients
• The SOS Trial: Hyperosmolar therapy for TBI
• The SIGNET trial: Statin therapy prior to organ donation.
• INTACT trial: Intravenous Iron to improve long term outcomes

We run:

• PROSPER: multi-dimension assessment of functional disability post critical illness
• ASICS II: Ketogenic feeding in critically ill patients with Multi-organ failure
• ASICS TBI: Ketogenic feeding in severe Traumatic Brain Injury
• HIPPO: Omegaven for the prevention of Hospital Acquired Infections.

The last three are set to start recruiting in 2025.

Aside from these trials and studies, we support a number of observational studies for PhDs, large data analyses and qualitative and implementation science research.

Minimum 5 residents at any one time- 2 airway trained, 3 non-airway/mixed

Each of the 5 rotas has 8 lines (1:8)

EDT/SPA for all resident doctors

4 consultants during the day, 1 of which is on-call overnight

The ACCU residents cover off-unit code calls (trauma and cardiac arrest) but not paediatrics

• Training in point of care ultrasound 
• Opportunity to attend theatre for airway experience 
• Exposure to paediatric emergencies – not routinely but can be arranged
• Interhospital transfers 
• Acting up as an ICM Consultant (for Stage 3 trainees) 

• Other: echo leads pablo.extremera-navas@nhs.net and julia.hadley@nhs.net

• Our ICU offers a comprehensive and dynamic educational programme designed to support the development of resident doctors into skilled and confident intensivists.

• Education sessions are scheduled every day—sometimes twice daily—providing a robust framework that encompasses the breadth of the FICM curriculum alongside practical, real-world knowledge essential for modern critical care practice.
• The programme is detailed each week in our education newsletter, which also shares key learning points from the previous week. Here’s an overview of the weekly structure:

Monday: A clinical simulation session addressing both common emergencies and routine ICU scenarios, helping build decision-making skills under pressure.

Tuesday: Journal Club, where trainees critically appraise recent literature and discuss its relevance to clinical practice.

Wednesday: Case-based teaching, featuring interesting and complex cases that provide insight into diagnostic and management challenges.

Thursday: Consultant-led teaching with expert speakers, including interdisciplinary contributors from other specialties. 

Friday: Equipment-focused teaching in the morning, followed by “Core Topics in ICU” which explore key themes from the FICM curriculum.

Additionally, our programme includes:

Communication skills training (as part of our simulation programme) to enhance interactions with patients and families.

Monthly cross-site FUSIC heart sessions, often case-based, with support available for trainees pursuing FUSIC Heart and Lung accreditation.

Bespoke senior training opportunities tailored to the needs of advanced trainees, covering topics such as ICU management, consultant job applications, and transitioning to life as a consultant.

A fortnightly, workplace based assessment clinic which runs virtually for our trainees to discuss their cases with an ICU consultant. 

Our educational approach is designed to be engaging, practical, and adaptable, ensuring all resident doctors leave with enhanced skills, knowledge, and confidence in intensive care.

• Weekly M&M on Monday afternoon
• Separate MDT trauma governance activities available to attend.
• We offer a bespoke leadership and management week to stage 3 trainees with opportunities to attend consultant level management and governance meetings amongst other experiences.

• We are a central London hospital with no routine access to car parking for staff or visitors.
• 4 rest rooms with beds and en-suite showers on/near the unit exclusively for ACCU doctors.
• Hot food until 3am most days in the staff canteen. 2 shared unit staff rooms with microwave and kitchen facilities.
• Access to non-clinical areas with trust computers during EDT.