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General Surgery

General Surgery is divided into the following specialist groups, colo-rectal and minimally invasive surgery, major/minor vascular surgery, Hepatobilary and pancreatic surgery, upper GI and minimally invasive surgery, trauma, surgical admissions and HDU, breast and endocrine surgery, one-stop minor surgery service and the pre-admission unit.

Colo-rectal and minimally invasive surgery

Following the government’s national guidance on improving the outcome of colorectal cancer a multidisciplinary team has formed with surgical specialists, gastroenterologists, oncologists, radiotherapists and radiologists together with the relevant specialist nurses.

This specialty is supported by a clinical nurse specialist in colorectal cancer and stoma therapy.


Major / minor vascular surgery

The Trust is working with neighbouring hospitals to provide a networked vascular service across East London. This will include a full range of scanning and nurse specialist services.

With the support of the High Dependancy Unit (HDU) it is now possible for the specialty of vascular surgery to admit and perform a higher number of Abdominal Aortic Aneurysms than was ever possible before.


Hepatobilary and pancreatic (HPB) surgery

The Hepatobiliary and Pancreatic (HPB) Centre is one of the largest for treating pancreatic and liver cancer in England. The centre, has been nominated as one of only four cancer centres in London by the Specialist Commissioning Group of London, uses innovative techniques to provide quality care to patients. It was, for example, the first in the UK to use radiofrequency ablation of liver parenchyma, a technique that uses radiofrequency to cut through the liver during surgery, with excellent results. In two out of three studies, the benefits of this technique over conventional methods were reduced blood loss and transfusion requirements.


Upper GI and minimally invasive surgery

Upper GI surgery has been carried out The Royal London Hospital for many years. Run from Rachel Ward at The Royal London, it provides the ‘bread and butter’ general surgery that goes on in the department of General Surgery and treats patients with complex upper GI conditions. The Trust works in conjunction with Newham General to provide a joint upper GI service.



In association with the Helicopter Emergency Medical Service (HEMS) and Accident and Emergency department, the directorate provides a comprehensive trauma team incorporating general surgeons, orthopaedic and plastic surgeons. There are always two teams available on call 24-hours a day, every day of the year.

Integrated trauma service – UK’s first dedicated trauma ward

Harrison Ward at The Royal London Hospital became the UK’s first poly-trauma ward service in July 2005. The 15-bed ward, which aims to set a new national benchmark of care, caters for trauma patients whose injuries are affecting two or more of their vital functions, but who do not require more intensive care.

Trauma patients are unique as, by definition, they are likely to have multiple injuries and will have a relevant specialist looking after each of their injuries. In addition to their various specialists, they will now have a team – led by the Trust’s trauma lead clinician, Consultant Surgeon Mike Walsh – overseeing all of their injuries and co-ordinating their care.

This co-ordinated approach has many benefits, both for patients and staff. The patient has continuity and a recognised point of contact with an overview of all of their injuries and care. Centralising poly-trauma patients in one ward will also improve the coordination of theatre sessions and diagnostic imaging, and the patient’s length of stay is likely to be shorter as a result. The ward also provides training and teaching benefits, and could potentially improve staff retention rates.

From the clinician’s point of view, the multidisciplinary ward round will be on one ward now rather than numerous wards around the hospital. There will also be improved co-ordination for audit and evaluation for research purposes.

The dedicated trauma service on Harrison Ward was developed as a result of an internal audit, which recommended the co-location of poly-trauma patients to provide them with more co-ordinated care and reduce their length of stay. The audit also resulted in the appointment of a dedicated Trust trauma lead and a trauma nurse co-ordinator, who casemanages seriously injured patients, liaises with clinical teams, educates ward nurses and assists with data collection, as well as developing care pathways with individual specialties and therapies.


Surgical Admissions and High Dependency Unit

Harrison Ward is a 48-hour short stay ward for surgical admissions. Its main function is to prevent unnecessary utilisation of the beds on other wards within the directorate, therefore enabling the directorate to admit more non-emergency cases.  

Harrison also contains five surgical HDU beds, which are available for emergency and non-emergency cases.

Nursing staff on Harrison come from a range of acute surgical specialties in order to manage the large cross-section of surgical injuries that are admitted there.


Breast and Endocrine Surgery

The Breast and Endocrine Unit provides diagnostic and treatment services for both symptomatic, screen detected breast disease and endocrine patients. Patients who require thyroid/endocrine surgery are generally referred as tertiary referrals from the Endocrine Department at The Royal London, although GP referrals are also received.


One-stop minor surgery service

The service for removing small lesions under local anaesthetic has been redesigned to ensure it is most convenient for patients and streamlined. This ‘one-stop’ service removes the need for unnecessary outpatient and pre-admission visits.


Pre-Admission Unit

Many patients who are to be admitted for surgery will be assessed in the Pre-Admission Unit so that pre-operative investigations can be performed before admission and therefore reduce length of stay.