St George's Hospital


St George's Hospital is a teaching hospital in Tooting, London. Founded in 1733, it is one of the UK's largest teaching hospitals and one of the largest hospitals in Europe. It is run by the St George's University Hospitals NHS Foundation Trust. It shares its main hospital site in Tooting in the London Borough of Wandsworth, with St George's, University of London which trains NHS staff and carries out advanced medical research.
The hospital has around 1,300 beds and most general tertiary care such as accident and emergency, maternity services and care for older people and children. However, as a major acute hospital, St George's Hospital also offers specialist care for the more complex injuries and illnesses, including trauma, neurology, cardiac care, renal transplantation, cancer care and stroke. It is also home to one of four major trauma centres and one of eight hyper-acute stroke units for London.
St George's Hospital also provides care for patients from a larger catchment area in the South East of England, for specialities such as complex pelvic trauma. Other services treat patients from all over the country, such as family HIV care and bone marrow transplantation for non-cancer diseases. The trust also provides a nationwide endoscopy training service.

History

Early history

Following a disagreement between medical staff and the Board of Governors over the expansion of the Westminster Infirmary, a mass exodus of medical staff left, in 1733, to set up what became St George's Hospital. The Board of Governors had favoured a house in Castle Lane but the medical staff preferred Lanesborough House at Hyde Park Corner.
Lanesborough House, originally built in 1719 by James Lane, 2nd Viscount Lanesborough, was at that time located in open countryside. The new St George's Hospital was arranged on three floors and accommodated 30 patients in two wards: one for men and one for women. The hospital was gradually extended and, by 1744, it had fifteen wards and over 250 patients.
By the 1800s, the hospital was slipping into disrepair. The old Lanesborough House at Hyde Park Corner was demolished to make way for a new 350 bed facility designed by architect William Wilkins. Building began in 1827 and was completed by 1844.
By 1859, a critical shortage of beds led to the addition of an attic floor. This was soon insufficient and led to the creation of a new convalescent hospital, Atkinson Morley's in Wimbledon, freeing up beds at St George's for acute patients.
A medical school was established in 1834 at Kinnerton Street and was incorporated into the hospital in 1868. The Medical School, now St George's, University of London, was built in the south-west corner of the hospital site in Hyde Park, with the main entrance in Knightsbridge and the back entrance in Grosvenor Crescent Mews.
In 1948, the National Health Service was introduced and plans for a new site for St George's at The Grove Fever and Fountain Hospitals at Tooting were eventually agreed upon. In 1954, the Grove Hospital became part of St George's, and clinical teaching started in Tooting.

Relocation to Tooting

In 1973, building began on the new site. The new hospital and school buildings were now well advanced. The School was completed, as were two wings of the new hospital, which provided a total of 710 beds. In 1976, the Medical School opened at Tooting and, in 1980, St George's Hospital at Hyde Park Corner closed its doors for the last time.
In 1981, medical education in London was reorganised to recognise the movement of population away from the centre. There are now fewer, larger medical schools in London. The expansion of St George's, University of London has become part of this policy.
In 2004, neuroscience services located at Atkinson Morley Hospital in Wimbledon moved to the brand new Atkinson Morley Wing on the main St George's site. This addition to the hospital now also houses cardiac and cardiothoracic services which have moved from the old fever hospital wards. St George's today provides a total of over 1,000 beds making it one of the biggest in the country.
In April 2010 St George's Healthcare became part of the South West London and Surrey Trauma Network. All Accident and Emergency departments within the network continue to provide trauma services with St George's designated as the major trauma centre. It is one of a small number of A&E departments to benefit from Pearson Lloyd's redesign – 'A Better A&E' – which reduced aggression against hospital staff by 50 per cent. A system of environmental signage provides location-specific information for patients. Screens provide live information about how many cases are being handled and the current status of the A&E department. In October 2010 St George's Healthcare NHS Trust integrated with Community Services Wandsworth, after approval from NHS London.
In May 2014 the Trust's application for Foundation Trust status was approved by the NHS Trust Development Authority following a positive rating from the Care Quality Commission. In the last five years the trust has turned around a large deficit and repaid a debt of £34m. The TDA identified several areas that the trust will have to work on to ensure it gets through the final stages of FT assessment. These include improving its A&E performance against the four-hour waiting time target and putting together a robust operating plan for the next two years. From October 2014 the hospital's Accident and Emergency department has featured in the Channel 4 documentary series "24 Hours in A&E".
In August 2018 it was reported that the average death rate nationally among patients receiving cardiac surgery was 2%, but that the cardiac unit at St George's had experienced 3.7%. Toxic disputes between surgeons were blamed. Mike Bewick wrote a report claiming "inadequate" internal scrutiny of the department; also the surgeons were divided into "two camps" showing "tribal-like activity". Bewick stated, "In our view the whole team shares responsibility for the failure to significantly improve professional relationships and to a degree surgical mortality." The hospital maintained it was taking action.

Notable students and staff

Among those who have been associated with St George's are:
The old hospital was the subject of an impromptu poem by Letitia Elizabeth Landon.
The hospital is part of the long-running Channel 4 documentary series 24 Hours in A&E.