Queen Elizabeth Woolwich

We have a very broad case mix at LGT, dominated by emergency admissions which make up 95% of our case load. Our ICUs are medical-surgical, with approximately 70-75% medical admissions, and 25-30% surgical admissions. Around 40% admissions are for Level 3 care, and around 60% for Level 2. There are 6 side-rooms for cases requiring isolation.Reasons for admissions are heterogeneous and commonly include sepsis, severe respiratory failure, AKI requiring RRT, liver failure, neurological emergencies, haem-onc emergencies including TLS and chemo/immunotherapy related toxicity and numerous surgical pathology.We use Dräger Evita V800 ventilators which can support numerous modes including APRV, Philips NIV, Airvo HFNO and Fresenius CRRT machines. Our main invasive CO monitor is PiCCO. We have a dedicated technician at both sites for teaching and equipment maintenance. 

We have excellent links with neighbouring tertiary centres with regional Severe Respiratory Failure, Shock, and Liver Failure pathways supported by the pan-London ACCESS critical retrieval team. Around 20 patients a year are retrieved for ECMO.

There is no split site working within this Unit

We have a very successful and active research department at LGT. Dedicated research nurses screen, consent and randomise patients to numerous NIHR portfolio clinical trials, supported by PIs and the RDN Co-Specialty Lead for South London who works in the department. We have several resident doctors (and other MDT colleagues) enrolled in Associate PI programs, which is valuable experience and instrumental in making us one of the most prolific sites for research delivery in the region. We are currently recruiting patients to the following studies:

MARCH:  mucolytics for ventilated patients with difficult secretions

T4P:   platelet transfusion threshold for invasive procedures

AWAKE-PRONE:   awake-proning for non-covid ARF

RELEASE:   early APRV for mod-severe ARF

GuARDS:   dexamethasone for mod-severe ARF

SIGNET:   simvastatin for organ donation outcomes in DNC

ABC:   post-ICU transfusion trigger for anaemia

i-Rehab:   remote rehabilitation for ICU survivors

VIP-3:   observational, family meetings and goals of care

GenOMICC:   observational, identify genetics of mortality

We have a Consultant FUSIC Heart lead and provide opportunities for supervised scans once a week with a number of FUSIC mentors. We have had residents complete the accreditation from start to finish in a 6-month rotation.

We commonly arrange theatre attendance for airway trained colleagues aiming to keep up to date with their skill set, and occasionally for those without airway training who wish to benefit from additional exposure.

It is usually possible for all residents to develop independent practice in CVC, vascath and arterial line insertion, alongside exposure to other procedures such as bronchoscopy, percutaneous tracheostomy and drain insertion under supervision.

Training in point of care ultrasound 

Opportunity to attend theatre for airway experience 

Interhospital transfers 

Acting up as an ICM Consultant (for Stage 3 trainees) 

We pride ourselves on teaching and resident development. In the last GMC trainee survey our teaching program had a 92% satisfaction rating from trainees. 

We run a comprehensive cross-site teaching program within the department, which includes:

Monthly teaching day – covering core topics within the ICM curriculum using multi-disciplinary teachers and a range of teaching methods including lectures, small group teaching, ventilator sessions, radiology reviews and 2 hours of simulation in the Simulation Suite at UHL. This is protected time, and if you are scheduled to be on-call we are usually able to cover your shift with a locum. If you come in on an off day, we provide TOIL

Monthly Case of the Week – residents are given the opportunity to dive into interesting cases and present to the rest of the group. Numerous cases have gone on to be presented in conferences and published as case reports, including several accepted to last years ESICM Case Book

Journal Club – fortnightly critical appraisal meeting, where a resident presents and appraises a recent paper with support from the department’s research lead

FUSIC Heart sessions every week for those on the course

There are numerous other opportunities for both teaching and learning. We strongly support bedside teaching and encourage residents to develop their own teaching skills.

We offer an Education SSY, which is supported by the Faculty Tutor and other faculty members, including those with formal Educational accreditation. This year we provided funding for the Education Fellow to complete the RCP Educator Accreditation during their SSY.

LGT offers numerous inhouse courses including ALS, eALS, APLS, EPALS, ATLS, NLS and MIMMS. 

We run M&M fortnightly, which is attended by various MDT members and facilitated by a Consultant. Residents are given the opportunity to prepare and present cases to enable their development in management and ability to review cases using an SJR format.

There are monthly Governance meetings that all residents are encouraged to attend, particularly those looking to enhance their exposure in management and leadership domains.

There is one en-suite room for resident’s use overnight, and a sofa-bed in the doctor’s room for the second resident. We have recently renovated the doctor’s office to include a new LED monitor with camera for cross-site teaching with UHL, a sofa bed and comfy seating area. 

There is a staff restaurant and access to hot food 24 hours a day, as well as a choice of coffee shops. 

Access to parking can be arranged with security at a fee.