Heart, Lung and Critical Care Clinical Group

This clinical group provides cardiovascular, respiratory and critical care services across 4 hospital sites – Royal Brompton, Harefield, St Thomas’ and Guy’s – and our private patient centre at Wimpole Street.

We aim to be global leaders in the specialist care of heart, lung and critically ill patients.

We are committed to delivering the clinical and academic benefits of our larger, merged services. This will be based on an absolute focus on achieving the best possible outcomes for patients across our local, regional and national specialist services. Our strategic priorities include:

• integrating our services down to sub-specialty teams into 3 divisions – cardiovascular, respiratory and critical care
• focusing our comprehensive clinical-academic respiratory service around integrated specialist multi- disciplinary teams and working with our partners in King’s College London and Imperial College London to increase the number of patients participating in clinical trials
• developing our innovative and high quality cardiovascular, vascular and cardiac surgical services, expanding minimal invasive procedures and robotic-assisted surgery
• enhancing our ambulatory services to support patients remotely and, by working with local health systems and public health, improving health equity and support to prevent heart and lung disease
• developing our digital health programme, including by improving data quality and through health analytics
• continuing to modernise and improve our hospitals

Inherited cardiac and respiratory conditions

Our services at St Thomas’, Harefield and Royal Brompton hospitals are some of the largest and most comprehensive in the UK. They are backed by our clinical genetic and genomic laboratory, by excellent imaging services (especially MRI); and by high-quality research output in conjunction with both Imperial College London and King’s College London.

Our strategy is to build on this expertise to develop better diagnostics and therapies for conditions arising from multiple genetic factors, such as asthma and coronary artery disease, and to support prevention across the wider population in south east and north west London.

Congenital heart disease

Our congenital heart disease services at St Thomas’ and Royal Brompton hospitals have delivered life-course care together for many years. This integrated service model has been emulated around the world, not only benefitting patients, but also generating up to a third of the world’s research output in this field. Our strategy is to build on this integrated model, working with transplant specialists at Harefield to develop a sub- specialty focused on transplantation for patients with congenital heart disease.

Interventional bronchoscopy

We are one of the top 3 centres in the world in using interventional bronchoscopy to deliver enhanced care for lung diseases such as emphysema, lung cancer, bronchiectasis, asthma and chronic obstructive pulmonary disease.

We will build on our expertise, for example in robotic navigational bronchoscopy, enabling the earliest possible diagnosis of lung cancer by taking biopsies from possible cancer lesions smaller than 1cm in hard- to-access locations within the lung. We are already the first centre in the world to trial ablation using an Ion robot as a therapy for such lesions.

Integrated respiratory medicine services

Our specialist respiratory and sleep services, including services to treat and support patients with asthma, emphysema, sleep and complex weaning problems, infection and immunological conditions, are nationally and internationally recognised.

We will explore co-designing and co-developing the consolidation of these services, under single leadership across all our sites, to improve patient experience and outcomes.

The combined severe asthma service will be the largest worldwide and includes sub-specialties such as occupational asthma, laryngeal dysfunction and obesity asthma. Bringing together our infection and immunity services will provide new opportunities for improved patient care through joint secondary immunodeficiency clinics with the transplant, haematology and chemotherapy services.

Critical care

Our 225 critical beds across 18 level 2 and level 3 critical care units represent 5-6% of England’s adult critical care capacity. Within these units, specialist respiratory and cardiovascular critical care provides around half of all extra-corporeal oxygenation (ECMO) treatment in the UK, as well as critical care for patients from the wide range of specialties provided by the Trust.

In developing our critical care services, we will leverage this breadth of expertise and scale, both to provide exceptional patient care and to offer an unusually broad range of career opportunities. For example, specialisation in kidney, pancreas, and lung and heart transplantation will help us to attract and retain clinicians from many key disciplines.