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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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Article: Specialist Nurse in Critical Care Recovery

What does the Specialist Nurse in Critical Care Recovery do? This speicalist nurse works with patients who are recovering from critical illness, to support them and their families along their recovery journey. The critical care recovery service at GSTT aims to support patients with their transition from ICU to the wards and then eventually home, to help reduce the burden problems that patients recovering from critical illness can commonly experience. There are three main aspects to...

Article: Speech and Language Therapist

What does a Speech and Language Therapist do on the wards? Speech and Language Therapists are trained in assessing and treating swallowing and communication problems. Why might a patient need to see a Speech and Language Therapist after Intensive Care? It is not uncommon for patients who have spent time on a breathing machine (ventilator) to develop short term problems with swallowing or with their voice. Temporary changes to the sound and strength of the voice can occur, with it...

Web Link: Voice changes in ICU (dysphonia)

This video explains the voice changes some patients have after being on mechanical ventilation (breathing machine).