Emergency department (A&E)

Treating serious injuries, accidents or sudden illness 


Is the emergency department (A&E) always the best place for treatment?

Watch this video to find out if you should come to A&E.

With many conditions people can be more appropriately treated elsewhere – as a result patients may wait in A&E when it would be easier and more convenient to see a local GP, a local pharmacy or get an appointment with your GP.

call-111If you have been suffering from a medical problem for more than 48 hours you should first try calling your GP surgery or NHS 111.

If you have a minor injury or illness, you may find it easier to visit your local pharmacy or go to the Urgent Care Centre at Guy's Hospital. The Urgent Care Centre at St Thomas' Hospital is part of the Emergency Department (A&E).

About the emergency department (A&E)

We aim to provide gold-standard emergency care and improved health outcomes for all our patients through education, research, and leadership development. In 2016, the emergency department got an 'outstanding' rating from the Care Quality Commission inspection.

We treat patients who have suffered a recent injury or accident or who have developed a sudden illness. All A&E departments use a priority system where the most seriously ill patients are seen first. stethoscope

We may direct you somewhere else if:

  • the nurse thinks that your condition is not an accident or an emergency
  • you have certain symptoms that mean you need to be seen in one of our specialty areas.
  • How the emergency department (A&E) works

    1. Streaming
      If you arrive at the pedestrian entrance, you will be greeted by a nurse who will ask you a few questions, give you a numbered ticket and direct you to the reception.
    2. Registration
      The receptionist will call your ticket number and register you.
    3. Nurse assessment
      Some people need more assessment after registration. A nurse will call you by name to assess the seriousness of your condition. They may also arrange for some tests.
    4. Treatment
      You will be sent to one of the treatment areas. Not everyone is treated by the same doctors or nurses. Your treatment depends on your condition.

      If you have a minor injury or illness, you will be directed to our Urgent Care Centre. This is staffed with GPs and emergency nurse practitioners.

      If you have a more complex condition, you will be seen by one of our emergency doctors.

      Please remember that waiting times can differ between treatment areas and specialists, so other people may be called more quickly than you.

    Watch our video about visiting A&E and give us your feedback about our service.

  • Specialty areas

    If you have been referred by your GP or another hospital to a particular team, you will have to register at A&E first. Although the team will be expecting you, they may not be able to see you immediately. You may be redirected to speciality services within our Trust such as:

    • eye casualty - for patients with an eye problem
    • Burrell Street - our free and confidential specialist sexual health service
    • antenatal day assessment unit - for women with pregnancy-related problems over 18 weeks gestation
    • early pregnancy and gynaecology unit - for women with gynaecological problems or pregnancy-related problems under 18 weeks gestation
    • children's A&E - there is a separate team of children's nurses and doctors (for children under 16) within A&E. Go straight to the separate children's waiting and treatment area. 
  • Going home

    We will send your GP a letter with details of your visit to A&E. The doctor/nurse who treated you will also give you a copy of the letter before you leave. 

    If you need to attend the fracture or plastics clinic, our reception staff will book you an appointment immediately. Please make sure we have given you an appointment card before you leave. If you need any other clinic, you will be contacted over the next few days. Please make sure we have your correct contact details.

    We are unable to provide transport home for most patients. If you want to order a taxi, there is a free phone in the A&E waiting area. St Thomas' is well served by public transport - see our travelling to St Thomas' page.

Violent or aggressive behaviour

Our staff should be able to carry out their work without fearing for their safety.We do not tolerate threatening or aggressive behaviour towards staff. Anyone who behaves in this way or who damages hospital property will be asked to leave by our security staff.

If appropriate, we will take legal action and press for the maximum penalty.

Emergency Floor development update

The Trust is investing £20 million to rebuild the A&E department at St Thomas’ and redesign the whole ‘pathway’ of emergency care for our patients.

resuscitation-receptionThis project is now more than 75% complete. It will ensure that the 140,000 patients who visit our Emergency Department (A&E) each year are cared for safely and efficiently in a better environment – it also aims to improve the patient journey for the sickest patients who require admission from A&E to intensive care and inpatient wards.

An improved resuscitation area opened in September with larger treatment cubicles and dedicated trauma and isolation rooms.

The final phase of the Emergency Floor rebuild project will include a new Majors area and a new Clinical Decision Unit – both are due to open in Spring 2018.

Learn more about the Emergency Floor development (pages 12-13) (PDF 5Mb) and download the Emergency Floor map (PDF 45Kb). 

All emergency care services will remain open throughout the redevelopment, which started in March 2014 and will be completed in 2018. 

Facts and figures about the emergency department (A&E)

  • we have one of the NHS’s busiest A&E departments, with 140,000 attendances in 2012-13. That’s around:
    • 380 patients a day in total
    • 185 patients a day seen for serious issues/conditions
    • 125 patients a day are seen in our Urgent Care Centre (UCC) which deals with urgent, but minor injuries
    • 60 young patients a day are seen in children's A&E
    • 105 ambulances a day
    • 27 patients a day are admitted to the Emergency Medical Unit (EMU)
    • seven young patients a day are admitted to Evelina London from children's A&E
  • we currently have the top performing A&E in South London
  • Monday is usually the busiest day of the week
  • a significant proportion of our patients are vulnerable – they may be homeless, have mental health issues, or drug/ alcohol addiction.

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