One Message
The monthly staff briefing
from the Chief Executive
Get ready for change
Dear Colleague,
Change can mean different things to different
people. Some view it with suspicion while others
embrace change and see it as an opportunity to
try something new. For my part, I think change is
to be welcomed and when standards of patient
care improve as a result, there can be little room for
argument.
The reason I have chosen change as the theme
for this month’s One Message is because it is
happening here and now at St George’s and the
results will help to shape the future of our clinical
services for many years to come.
Saving lives
Last month, Healthcare for London launched
a major public consultation outlining plans to
introduce world-class specialist stroke centres and
major trauma networks across the capital. It has
been estimated that the changes could save over
500 lives a year and reduce disability for thousands
of others.
The case for changes to stroke and major trauma
care in London is compelling. The underlying fact
is that too many Londoners are missing out on the
best clinical care and the capital has fallen behind
international standards.
There is no doubt that if the Healthcare for London
stroke and trauma plans do proceed then they will
be a real boost for St George’s and send out a clear
Our values + Treat all signal that we mean business. The development
people with respect and of trauma and stroke services are both part of our
long-term business strategy which also includes
dignity + Deliver care in plans for vascular diseases, cancer and children’s
partnership with others services.
+ Continually strive for
A vision for the future
excellence + Ensure
probity and transparency
The consultation, which is part of Lord Darzi’s ten-
in spending public money year vision for the capital, will look at the location
+ Be an exemplary and coverage of potential sites for eight specialist
employer + Be committed stroke and four major trauma centres.
to education, training and
St George’s is one of the proposed major trauma
research + Be open and centres and would form part of a network that
honest with each other
February 2009
would increase the ability of the NHS in London to
respond to a major incident such as a train or plane
crash.
The Trust is also one of eight proposed specialist
regional hyper-acute stroke units, whereby it would
continue to provide a 24/7 local stroke unit while
developing Transient Ischaemic Attack (TIA or
‘mini stroke’) services to provide rapid diagnostic
assessment and fast access to a specialist.
Pioneering stroke services
The consultation about changes to stroke services
coincides with a new report by the Stroke
Association which highlights St George’s as a
beacon of good practice.
Launching the Getting Better report in early
February, Jon Barrick, Chief Executive for The
Stroke Association, said: “Just over a year ago the
Government issued the National Stroke Strategy
which set out the blue print for good stroke care. St
George’s is a brilliant example that we hope will be
copied everywhere as it highlights a well organised
and efficient hospital that saves many lives.”
Stroke is caused when the blood and oxygen
supply to the brain is cut, causing cells to
die, resulting in brain damage. Nearly 11,000
Londoners suffer a stroke each year and of those
around 2,000 will die as a result.
If accepted the Healthcare for London proposals
will re-design stroke services to reduce the deaths
and disability caused by stroke. A patient would be
taken directly to a hyper-acute stroke unit where
they will receive expert care, including access to
a CT scan and thrombolysis (clot-busting drugs),
if appropriate for the patient, within 30 minutes.
Once stabilised, within 72 hours, patients will be
moved to a stroke unit within the same hospital, or
at a local hospital closer to home.
The strategy also aims to prevent strokes by
introducing 24-hour assessment services for
patients suspected of having a TIA so they can get
faster diagnosis and treatment.
 Assuming the outcome of the consultation agrees
with the proposals, it is expected that the new
stroke services will start to take shape over an 18-
month period from autumn 2009.
Establishing a major trauma centre
Under plans for trauma services, St George’s would
become a major trauma centre at the heart of a
network of trauma centres based at surrounding
hospitals in south west London and surrey. The
proposals recommended that the South West
London and Surrey Trauma Network would be one
of four such networks dealing with an estimated
1,600 major trauma cases a year.
Preparing the way
The background to trauma development was
explained to staff who attended January’s
Leadership Forum meeting. These meetings
provide an opportunity for clinical and managerial
staff to come together to discuss major service
developments and to think about how any change
will impact across the Trust and what needs to
be done to ensure that change is brought about
successfully. In terms of trauma, the meeting
considered the impact on a number of areas
including staffing, co-ordination of care, trauma
ward, communications, discharge planning and
repatriation.

The best evidence shows that dedicated major
trauma centres with expert teams of professionals
are able to save more lives. By establishing major
trauma services, specialist clinical skills can be
developed and retained. Patients with serious
injuries including severe head injuries, penetrating
injuries to neck and chest, limb amputations
and paralysis would have immediate access to
specialist care and the most appropriate treatment.
As a result, more people who survive serious injury
have greater potential to resume their normal lives.
If the plans go ahead, St George’s will become
a major trauma centre by April 2010, at the
heart of a clinical network, stretching into
the Home Counties, serving some 2.6 million
people. Healthcare for London is also working on
proposals for major trauma care for children and
burns.
Have your say
I know that many of our staff live locally and have
family and friends in the area. I would encourage
those of you who are local to engage in the
consultation and play your part in setting the
future direction of St George’s.
The communications team has prepared two short
briefing documents, available via the intranet, that
provide staff with an overview about how the
proposed changes will impact of our trauma and
stroke services. Full details about the Healthcare
for London consultation are also available via the
Trust website www.stgeorges.nhs.uk.

David Astley
Chief Executive

Our values + Treat all

people with respect and
dignity + Deliver care in
partnership with others
+ Continually strive for
excellence + Ensure
probity and transparency
in spending public money
+ Be an exemplary
employer + Be committed
to education, training and
research + Be open and
honest with each other