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Hospital wards

Recovery from critical illness is a journey that begin in the intensive care unit (ICU) and in most cases patients will go to the hospital ward before getting home.

The journey can vary depending on the levels of care needed and sometimes specialist input may be required to support recovery and rehabilitation. Many patients will go to one of the high dependancy units (HDUs) before getting to the hospital ward.

Moving from the Intensive care unit (ICU) to the High dependency unit (HDU)

Most patients (around 80%) will recover from critical illness and the improvement in their condition will be monitored continually by the ICU doctors, nurses and other members of the ICU team. When you no longer require your breathing to be supported by a mechanical ventilator (breathing machine), the ICU doctor will consider moving you to the high dependency area (HDU) at St Thomas's, which is on the 10th floor in the East wing of the hospital. If you are cared for at Guy's, on the Guy's critical care unit (GCCU), you will remain in GCCU until you are ready to step down to the ward. There is no HDU at Guy's so this care is given on GCCU. 

HDU at St Thomas's hospital

While in the HDU at St Thomas' Hospital, less intensive care and further recovery is needed before being ready to step down to the ward. The main factor affecting whether you need to stay on the HDU is the amount of nursing care and input from other members of the specialist clinical team e.g. physiotherapist.

Transfer from Guy's and St Thomas' ICUs to your local ICU or HDU

Many patients live in Kent, Surrey and Sussex and come to Guy's and St Thomas' Hospital for specialist treatment, (ECMO, major heart and vascular surgery) when there is no longer a need for this specialist input, but more time and support in ICU/HDU is required, then transfer to your local hospital will be planned. The transfer from the ICU at Guy's or St Thomas's to the local ICU is planned based on which hospital you originally came from or where your local hospital with the necessary specialist doctors for your ongoing care are are based.  

Medical conditions requiring specialist centres

Some conditions require specialist rehabilitation and these include:

  • injuries to the brain
  • stroke
  • limb amputation
  • long term breathing difficulties that require support from a ventilator (breathing machine).

Brain injuries require specialist input in neuro-rehabilitation centres and transfer to these highly specialised centres requires the neurology, stroke, occupational therapy, physiotherapy team to plan and liaise with the regional units

Stroke rehabilitation occurs on Mark ward at Guy's and St Thomas'.

Long term breathing conditions requiring mechanical ventilation are cared for on the Lane Fox Unit (LFU) located in the South wing of the hospital on the ground floor. The LFU supports the REMEO unit in Redhill, Surrey where some patients with long-term breathing conditions are transferred for ongoing care. 

Major Limb amputation is mostly performed at St Thomas' Hospital. Shortly after amputation, when you are medically well and if ready to complete an intensive amputee rehabilitation programme, we will transfer you to our specialist Amputee Rehabilitation Unit where you will participate in therapy every day. The unit has 12 beds and is located at Lambeth Community Care Centre in Kennington, London. 

Getting to the hospital ward

This can be a real mixed bag of emotions for patients and families. While ward transfer is a sign of improvement and a step closer to going home, patients and families have to adjust to less monitoring and having fewer staff at close hand. 

For some people, it is only once they come to the ward, and “body and mind” are working a little better, that they feel ready to start trying to make sense of what they remember happening while in ICU. Some people don’t remember their time in ICU at all, some remember it in brief flashes, some remember things very vividly – all of which can be scary and confusing.

In this section, we've provided some general information and advice on common physical and psychological issues during the ward stage of recovery, the types of staff involved in your care (who they are and what they do) and what to expect in terms of planning your home.


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Web Link: A-Z of health conditions

Many people who come into Intensive Care have pre-existing health conditions. Part of your recovery will likely include understanding and dealing with those conditions too. This link will take you to an NHS page with information on 100's of conditions, symptoms and treatments. It's not exhaustive, but we hope you find it helpful.

External Video: Bob describes his experience on the ward

In this video clip, Bob (a former Intensive Care patient) talks about his recovery on the general wards, after being transferred out of Intensive Care.

Article: Breathlessness

Is it common to feel breathless after Intensive Care? Breathlessness after Intensive Care is very common. Why do I feel breathless? The time you spent in Intensive Care may have caused weakness in your muscles, including those that help you breathe, so they are a bit weaker and have to work a bit harder to help with your breathing. Also while in Intensive Care you can quickly lose your ability to exercise, so while running for a bus may have made you breathless before, after...

Document: Breathlessness-breathing exercises

This booklet outlines some of the breathing techniques that can be used to help breathlessness. Try out the different approaches. Controlled breathing can be particularly useful if you are feeling very breathless.

Document: Breathlessness-positions that might help

This booklet describes some of the positions that people find useful when managing breathlessness. Try the different positions and find the one you find the best. Different people find benefit from different positions.

External Video: Common psychological problems in ICU video by the Faculty of Intensive Care Medicine (FICM)

It is very common for patients who have suffered a critical illness to experience psychological issues. This 59 sec video briefly explains this

Article: Coping with transfer to the ward

It's not always easy or even possible to prepare patients for transfer out of Intensive Care and onto the general wards. Intensive Care beds are in great demand and it's often impossible to predict when a bed might be needed for someone else. Although we try to avoid it as best we can, this sometimes means that patients are transferred out with little warning. From one to one care to "one of many" Patients often tell us that transfer to the wards can be a bit of a...

Article: Critical illness related weight loss

Patients can lose a lot of weight during their time in Intensive Care (sometimes up to 20% of their weight on admission) and often have issues with eating after transfer to the general wards. This can happen for many reasons; some are physical, some psychological and others are to do with hospital routine (e.g. being presented with food at very different times to when you would normally eat). Eating enough and well is an important part of your recovery. Your dietitian will do her/his best...

Article: Dietitian

What does a dietitian do on the wards? Dietitians works closely with the ward staff to make sure patients get enough nutrition to help their recovery. Dietitians provide advice and guidance on all types of nutrition, from tube feeding (either through a tube in the nose into the stomach (Nasogastric tube) or a tube straight into the stomach (gastrostomy tube), or directly into the bloodstream (Parenteral nutrition)) to eating normally. If eating isn’t quite back to normal or people...

Article: Doctors

What does the Doctor do on the wards? When the patient is in the ICU, they are their care is led by ICU medical team. When the patient leaves the ICU the medical care transfers back to the team of specialists that saw the patient when they were first admitted to the hospital. They may be medical or surgical doctors depending on the clinical condition. The patient will be looked after by a team of doctors led by a specialist consultant. All patients will be seen every day by the team...