St John's Hospital
Emergency Department
St John's Hospital opened in 1989 in Livingston, a new town 20 miles west of Edinburgh. The hospital provides for most common adult and paediatric specialties as well as mental health, but not acute general surgical or trauma/orthopaedic admissions which are centralised in Edinburgh. SJH also has the supra-regional plastic surgery and burns unit, oral and maxillofacial as well as ENT surgery.
The Emergency Department underwent a £2.75m rebuild and expansion that also created the 14 - bedded ED Observation Ward, officially opened by Scotland's First Minister in 1994. The department comprises interior-designed modern adult and paediatric clinical facilities, staff offices, teaching and rest areas. We are a medium-sized ED treating around 50,000 patients per year of whom 1:4 are children. Around 60% patients present with injury, 17% with medical illness and 8% with surgical problems; 2000 patients per year require immediate treatment and resuscitation and 1:5 patients is admitted.
SJH offers a friendly and efficient working environment. Within the ED and ED Observation Ward there is a very strong ethos of multidisciplinary teamwork and respect for everyone's contribution; there is a drive to provide excellent care for each individual patient. Although we are often very busy there is the opportunity to tailor care for a particular patient, often much harder to accomplish in larger more frenetic EDs and hospitals. The local population is demonstrably grateful for the ED service provided for them locally which makes working at SJH ED very satisfying.
Clinical staffing includes 24 hour ENP and 12 hour orthopaedic technician services. From March 2014 there will be 10 EM consultants based at SJH, who all have the opportunity to work elsewhere in Lothian either at RIE or RHSC EDs or in toxicology, adult or paediatric ICM. There is a full complement of junior staff (FY2, GP ST2s, clinical development fellows) plus specialty doctor sessions and sometimes specialty training registrars in EM based at SJH. The consultant rota is annualised as recommended by the College of EM (CEM) which ensures fairness as well as the flexibility to fit work around life to some extent. There is consultant cover in the ED from 9am to 11pm daily.
Teaching and training in the SJH ED includes programmes for undergraduate nursing and medical students (Edinburgh and international) as well as an hour a week for the trainee medical staff and one on management topics for EM registrars. There is a lively weekly ED radiology meeting for all clinical staff and students to attend. In addition trainees attend the monthly regional core EM training afternoon or weekly EM ST4+ training afternoon as appropriate. The Vice Chairman of the Scottish Board of CEM and the Training Programme Director of the SE Scotland specialty training committee for EM are based at SJH, another consultant is also working towards an MSc in medical education. Other special interests include paediatric EM, toxicology, medical informatics, clinical guidelines, minor injuries and two consultants are examiners for CEM fellowship.
