Integrated and Specialist Medicine Clinical Group

This clinical group provides secondary, tertiary and community healthcare services, including urgent and emergency care, dental hospital and adult medical services.

The clinical group delivers clinical support services that underpin all clinical services in the Trust.

Our directorates are acute and general medicine; medical specialties; specialist ambulatory services; dental services; integrated local services; pharmacy and medicines optimisation; clinical imaging and medical physics; and therapies and rehabilitation.

The breadth of expertise across the clinical group means that we can support patients when they need us most. Our multi-professional teams, rooted in local communities, help to keep people healthy and independent. Our specialist services deliver the most complex and leading-edge healthcare, education and research. Our clinical support services use the latest science and technology, from artificial intelligence (AI) to gene therapy, to provide new treatments and faster routes to diagnosis.

To deliver this vision, our strategic priorities are:

• delivering outstanding clinical services
• modernising ambulatory and outpatient care
• providing joined-up, preventative care across our communities
• realising the potential of all our staff and students, ensuring they thrive in inclusive and supportive environments
• listening to our patients, the communities we serve and our people
• maximising the opportunity around new technology, including digital, to improve patient outcomes, and staff and patient experience
• leading clinical research and education and working with our partners

Genetics – the future of medicine

Our genetics service is at the centre of the national transformation in personalised and precision medicine. We are leading the integration of genomics into healthcare across 9 acute hospital trusts and 3 integrated care systems in the south east, serving a population of nearly 5 million. Patients can expect equity of access to genomic testing, improved treatments, tailored health screening and personalised disease prevention.

For example, pre-implantation genetic testing can ensure individuals with a genetic disease, can avoid passing it to their children. Molecular therapies can change the prognosis of inherited conditions, transforming lifespan and quality of life. Genomics help to treat cancers that respond poorly to current treatments, as well as identify people at increased risk of cancer and reduce their risk of developing this. Genomics can identify families at high risk of many health problems across all age groups, from congenital and developmental problems to causes of high cholesterol and sudden cardiac death.

By working with local teams to train staff and integrating genomic testing into diagnostic, treatment, screening and prevention pathways in hospitals across the region, we will embed Genomic Medicine, so that by 2030 it will be known simply as Medicine.

Interventional radiology – at the leading edge

We are at the forefront of innovation in interventional radiology, which specialises in minimally invasive and targeted, image-guided treatments instead of treatments that would have required surgery in the past. It offers reduced risk for patients, and requires less recovery time.

We already offer a wide range of simple and complex interventional radiology procedures covering vascular, non-vascular and cancer specialties, both in adults and children, and we are internationally recognised as being at the forefront of bringing new techniques, devices and medical research into clinical practice.

We are leading the way in interventional oncology, being the first centre in the world to gain accreditation from the International Accreditation System for Interventional Oncology Services. We provide diagnostic, palliative and curative procedures such as ablations and embolisation of tumours. Our interventional radiology department, in collaboration with the clinical teams in Evelina London Children’s Hospital, is one of the few in Europe that offers minimally invasive image-guided treatment to children.

Our team is highly research-active and has led the way in developing new procedures and pathways, which other institutions have learnt from and adopted to provide optimum clinical care. Our clinical education programme includes one of the largest fellowship programmes in the country and hosts trainees from across the world.

Virtual wards – scaling up our successful @Home service

Our @Home service was launched 10 years ago, providing acute ward level care for people in their own homes, taking referrals directly from GPs and reducing inpatient stays in our hospitals. The service is provided by a multi-disciplinary team of nurses, allied health professionals, doctors, social workers, support workers and pharmacists.

For patients, @Home reduces the risks of hospital acquired infections, helps patients maintain their daily routines and keeps them close to their families and loved ones. We now have up to 250 patient contacts a day. We will increase capacity and expand the range of pathways supported, working even more closely with GPs.

By using innovative remote care technology, and by working closely with new partners, we can provide out of hospital care that matches or surpasses the quality and safety of inpatient care. Advanced technology will also ensure our population are increasingly healthy, safe and cared for in their own home where possible.

Investing in research and therapies in dermatology

The St John’s Institute of Dermatology is one of Europe’s leading dermatology centres. It provides dermatology services within south east London and national tertiary services, including for severe inflammatory skin conditions, skin cancer and rare genetic skin diseases.

The Institute delivers internationally-leading skin research affiliated with King’s College London, contributing to improved understanding of disease mechanisms, drug delivery and innovation in patient care. It will focus on translational research, designing and testing new immunotherapies for skin cancer, and using new gene therapy techniques to tackle the most severe skin diseases.

Internationally renowned training in dermatology is provided by the Institute through King’s College London and DermAcademy. This includes the St John’s Diploma, the world’s first and only part-time fully online distance learning qualification in specialist dermatology. We strive to continue to be at the international forefront of dermatology care, research and education through specific investment in the Institute.