Service overview - Plastic surgery and burns (St Andrew's Centre)

The St Andrew's Centre is home to the world reknowned specialist burns and plastic surgery service. In 2014, St Andrew's celebrated its 40th year as a leading specialist centre.

The regional plastic surgery service now covers a population of 3.2 million and the regional burns service services a population of 9.8 million.

St Andrews takes its name from the hospital in Billericay where the burns and plastics unit was originally located. St Andrew's Hospital started life as a Victorian workhouse and become the regional plastic surgery and rehabilitation unit following the opening of a new general hospital in Basildon. The centre is now known for it's excellence throughout the world.

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We have introduced video appointments to help us carry on seeing patients during the current coronavirus pandemic.

Many of our services are now using this resource. Please click here to read more and to watch a short video, which will help you understand how these video appointments will work.

Broomfield Hospital - Plastic surgery and burns

The St Andrew's Centre is home to the world reknowned specialist burns and plastic surgery service. In 2014, St Andrew's celebrated its 40th year as a leading specialist centre.

The regional plastic surgery service now covers a population of 3.2 million and the regional burns service services a population of 9.8 million.


Children's Burns Service 

Mid Essex Hospital is home to the internationally-renowned St Andrews Burns Centre which provides care to children with the most complex burn injuries from across London and the South East of England and serves a population of 21million.

The St. Andrews Burn Centre includes the Burns Intensive Care Unit, Children’s Burns Ward, Adult Burn Ward, and Burns Outpatients.

Luckily, serious burn injuries affect only a small number of children, and to ensure staff caring for them have the knowledge and experience to do so the children are treated in supra regional centre’s such as St. Andrews, where a children’s burns specialist multi-disciplinary team can take care of the child.

Burns Intensive Care is designed to provide advanced treatment for the child with a burn injury. Children who need highly skilled medical attention, including close observation and the use of sophisticated monitoring equipment and comprehensive skin treatments are admitted to Burns ITU.

In each room, there is a monitor that records the child’s heart rate, blood pressure, respirations and pressure in the heart. Other specialised equipment may also be used to care for your child.

The purpose built Children’s Burns Ward opened in the summer of 2010. It can take children up to the age of 16years primarily from the South East of England, but occasionally from anywhere in the country if there is a shortage of burns beds. We can accept all types of burn injury including scalds, flame, chemical and electrical burns, as well as skin loss conditions such as scalded skin syndrome.

The philosophy of the Unit is to provide the highest standard of burn injury care to the child, the parents and others who are directly or indirectly involved both during and after hospitalisation. Treatment is under constant review and updated subject to relevant research.

The ward has four side rooms and a four bedded bay for inpatients, a treatment room and a treatment bathroom. The ward has inpatient children and children who are returning for dressing changes and various therapies.

Because of the complex nature of burns and their physical and psychological impact on patients and their families, the service utilises the expertise of many different specialists. All admissions are assessed by a burns nurse, burns surgeon, occupational therapist and physiotherapist. We also have play specialists, nursery nurses, hospital school team, dietician, psychotherapy team, chaplaincy team, social worker and pharmacists as part of our team.

The doctors, nurses and therapists plan care for the individual child and family from the time of admission, through to discharge and then ongoing for as long as required. The Children’s Burns Ward offers the latest in burn dressings, specialised wound care, and plastic and reconstructive surgical techniques, but treatment is guided by minimising pain and trauma for the child.

At the Children’s Burns Ward, we know that being in the hospital with an injury can be very stressful for both the child and the family. We also know that no one knows the child as well as the parents. That’s why we take a family-centred care approach, and work in partnership with children/ young people and their families in determining treatment plans. 


Children’s Burns Unit Specialist Services 

Physiotherapy
Occupational Therapy
Psychology
Play Specialist and School Team
Burned Children’s Club 


Visiting 

At the Children’s Burn Ward, your child’s health and recovery are our primary concerns. We realise this is a stressful time for you, so we want to provide as much support as possible. Depending on the severity of the burn injury, your child will be staying in the Children’s Burn Ward (E225) of the St. Andrews Centre, or in the Burns Intensive Care Unit (E220)

Only two visitors per child are allowed at any one time. Parents may visit at any time over 24hours. One parent may stay overnight. Other visitors may visit with parents’ permission from 10am to 8pm. Parents may call at any time to check on their child’s condition:

Burns Intensive Care Unit on 01245 516037/8

Children’s Burn Ward on 01245 516973/4 


Infection Prevention 

In an effort to minimise the spread of infection, you will be asked to use the alcohol gel on entry and exit, and wear an apron whilst in the room to cover your clothes while visiting. Please wash your hands with soap and water before leaving the patient’s room and place aprons in the bins provided. Notify the nurse if you have a cold or other communicable disease before entering a patient’s room. Please do not visit if you have diarrhoea or vomiting. 


Burns Outpatients 

In the Burn Outpatient Clinic you will be seen by a burns nurse. You may also be treated by a physiotherapist, or an occupational therapist to help with the on-going recovery from a burn injury. Your wound will be checked and a plan will be devised. If your child needs pain control medicine, please give it to your child 30 minutes before the scheduled appointment time. 


Our Team 

We have four Burns Consultants who lead our team of specialist doctors.

We also have a team of anaesthetists who will lead on the care of the children in Burns ITU and will look after your child’s pain control throughout their stay.

The nursing team is comprised of highly skilled nurses, many of them children’s trained, who are used to looking after children with varying degrees of burn injury and skin loss conditions. 


Safeguarding Children 

'Every child and young person has a right to life free from abuse'

All members of staff working in the Children’s Burn Service have a professional responsibility to safeguard and protect children. Safeguarding Children (previously Child Protection) is a highly emotive subject, evoking strong feelings in all of us. In order to provide the most effective support and help for vulnerable children and their families, we have a team of specialist doctors and nurses on site.


Ward Information

Department Name: Burns Adults Ward
Destination Number: E221
Telephone Number: 01245 513914

Department Name: Burns ITU
Destination Number: E220
Telephone Number: 01245 513914

Department Name: Stock Ward
Destination Number: E320
Telephone Number: 01245 513922 

Department Name: Billericay Ward
Destination Number: E321
Telephone Number: 01245 513923 

Department Name: Mayflower Ward
Destination Number: E322
Telephone Number: 01245 513924


Hand Trauma and Assessment Unit (B340)

How to find us

We are located in Zone B on the third floor. The location code for Hand Trauma and Assessment Unit is B340. 

Hand Trauma patients - Phone number: 01245 516561

If you have been referred from A&E you have been asked to attend the clinic for review of your injury

The Clinic is run similar to Accident and Emergency and each patient is seen in clinical priority order

Please bring any prescriptions for medication you are currently taking

Following assessment with a Plastic Surgeon a plan for your treatment will be discussed with you

This may include management with dressings, hand therapy or an operation

You may be asked to return on another day for your surgery

Your position on that list will depend on the severity of your injury, the type of anaesthetic needed and your medical history  

However, we can experience high numbers of referrals and due to the emergency nature of the service your operation may be rescheduled for a different day.

Pre-Assessment patients - Phone Number: 01245 516013

Please bring any prescriptions for medication you are currently taking

You will see the nurse who will take a full medical history

You may need to have tests while at the hospital. E.g; Blood tests or ECG

Some patients may need to see an anesthetist

We do advise that in some cases you may be at the hospital for up to 3 hours.


Laser Service

St Andrew's Centre is able to offer laser treatments for the following conditions: 

Pulsed dye laser

Port Wine Stain
Rosacea
Haemangioma/ Angioma
Vascular Malformation
Psoriasis
Vascular scars
Facial/ Nasal Telangiectasia
Solar/Age spots (face and hands)

Long pulse / Q switched ruby laser

Facial hirsutism
Pigmented lesions
Tattoo removal

CO2 laser

Rhinophyma
Skin resurfacng
Other skin ablative surgery 

Most treatments are NHS funded but some private packages are available. 

For more Information : 
Email : Laser.Service@meht.nhs.uk
Telephone : 01245 515027


Therapy Services
 
St Andrew’s Burns and Plastics Department has its own designated Therapy Department, which prides itself on giving a highly specialist and best practice service to the following specialities: Burns, Plastic Surgery, Head and Neck Cancer, Breast Reconstruction. Hand Trauma, Elective Hand Surgery and ENT.

The team consists of both Physiotherapists and Occupational Therapists and is led by a Lead Therapist with over 30 years of experience in the area specialising in the treatment of hand surgical and non- surgical conditions.  A Physiotherapy Consultant, who has attained a PhD in the field of Burns Intensive Care, published many research papers and has over 20 years of experience working with patients with Burns and those following Plastic Surgery and Head and Neck Cancer Surgery.

Burns, Plastic Surgery, ENT Surgery

We work with adults and children who have suffered burns to all areas of the body. The role of the physiotherapist is varied, and involves advising on ways to assist a patient’s breathing, improving a patient’s comfort, and restoring mobility. Additionally, the physiotherapist may be asked to give advice on the extent of a patients potential after rehabilitation.

Key roles of the Physiotherapist

Optimising a patient’s breathing is especially important and particularly whilst a patient requires mechanical ventilation in the intensive care unit. Normally patients in the ICU will be assessed and receive physiotherapy treatment twice per day, however, burn patients often require chest physiotherapy many times throughout the day and night and for as long as required, until a more normal breathing function is restored.

Patients who have had head and neck cancer or ENT surgery will require physiotherapy to maintain a clear chest afterwards, to manage and remove the tracheostomy tube at the right time, and to restore general mobility. 

Patients who are very unwell following burns, surgery and other illness may be confined to bed over a protracted period. This results in a rapid loss of muscle tissue and strength whilst prolonged limited movement leads to restricted and sometimes painful movement of important joints. It is vital therefore that physiotherapy is available to provide a range of rehabilitation exercises designed to support the patient’s limbs and optimise movement and comfort. Additionally, the physiotherapist is available to help to restore the patient’s baseline mobility.

As a burn patient’s wounds heal, physiotherapy and occupational therapy will be required to ensure scars are kept as soft and supple as possible using massage techniques and pressure therapy.

Key roles of the Occupational Therapist

The occupational therapists focus is to preserve the patient’s functional movement throughout the rehabilitation process, providing assistance and practise of the activities of daily living e.g. feeding, washing and returning to normal routines.

Occupational therapists tend to concentrate on rehabilitation of the upper limbs, as daily functions depend a great deal on a range of good hand and arm movements. Occupational Therapists make special splints, specifically designed for each patient to maintain functional positions of joints and discourage the formation of deformities after burns and long periods of immobility.

Hand Therapy Service

We provide specialist care for both adults and children with both non-surgical or surgical conditions of the hand and forearm,

Care is carried out by a Specialist hand therapist who are state registered Occupational Therapists and Physiotherapists.

Patients receive individual assessments and treatment sessions.  We work closely with plastic and orthopaedic surgeons.  Your Therapist will have detailed knowledge and understanding of your surgery or condition and will plan with you a treatment programme.  This may include various evidence based assessments.  Treatments may include splinting, paraffin wax, electrotherapy, exercises, joint mobilisation and rehabilitation to support your return to work and leisure activities. 

Location

The Department is located within Zone E121, which is within the St Andrew’s Outpatients, to give patients the opportunity to have multi-disciplinary team discussions during their Outpatient appointment when required.

Contacts

Main Therapy Reception – 01245 516009


Facial Palsy Services

Overview of service

The service is run by a consultant Plastic Surgeon, and a dedicated, highly specialised team including Facial Physiotherapists, Oculoplastic Surgeons, Nurses, with support from Neurophysiology Consultants. 

We offer treatments for the following conditions:

Newly diagnosed facial palsy in newborns, children and adults.
Recurrent facial palsy.
Longstanding facial palsy with synkinesis, asymmetry and other problematic symptoms.
Facial dystonia.

We treat patients from throughout our local catchment area, as well as from other regions of the UK through GP referrals, and referrals from other specialist centres. We are currently in process of organizing regular patient information days.

For information regarding patient referrals please contact:

Secretary
St Andrews Centre 
Broomfield Hospital
Chelmsford
Essex
CM1 7ET 

Tel no: 01245 516119
Email:  suki.wheal@nhs.net or kallirroi.tzafetta@nhs.net

Useful external links for further information

Facial Palsy UK:

www.facialpalsy.org.uk/

NHS Choices Bell’s Palsy:

http://www.nhs.uk/Conditions/Bells-palsy/Pages/Introduction.aspx


North Thames Cleft Lip and Palate Service 

This is a joint service run by Great Ormond Street Hospital, London and the St Andrew’s Centre, Broomfield Hospital, Chelmsford, treating children and adults with clefts of the lip and palate from all over the North Thames region.  This includes patients from North London, Essex and South and West Hertfordshire.

Contact Details

North Thames Cleft Centre
St Andrew’s Centre
Broomfield Hospital
Court Road
Broomfield
Chelmsford
Essex
CM1 7ET

Clinic appointments: 01245 516201
Cleft Team Secretary: 01245 516120
Clinical Nurse Specialists: 01245 516029
Speech & Language Therapists: 01245 516020
Dental Nurse: 01245 516012
Inpatient Admission Officer: 01245 513635 option 2
Email: Mie-tr.midessexcleftservice@nhs.net


How to refer a patient

New babies with cleft

1. Please contact our Clinical Nurse Specialists immediately after birth on: 01245 516029.

Please leave a voicemail if no answer at any time of the day.

See referral document, cleft protocol, RCPCH leaflet and feeding guides below. 

Referral document

Cleft protocol

RCPCH leaflet

Feeding guides

Pierre Robin Sequence Pathway

2. Please complete the referral form and email it to:

Mie-tr.midessexcleftservice@nhs.net or fax to: 01245 516134

Our standard is that the Clinical Nurse Specialists will aim to see new babies within 24 hours of referral.  A delay in referral will prevent babies being seen and assessed (please see cleft protocol).

Referral of mothers diagnosed antenatally

1. Please contact our Clinical Nurse Specialists immediately on 01245 516029.

Please leave a voicemail if no answer at any time of the day.

2. Please email referral to: Mie-tr.midessexcleftservice@nhs.net

or fax to: 01245 516134

We aim to contact mothers following antenatal diagnosis of a baby with a cleft within 24 hours.

Other referrals

Please send referral letters to: Mie-tr.midessexcleftservice@nhs.net


Children's Burns Club

DREAM. BELIEVE. ACHIEVE.

The club offers support to young burn survivors and their families to help them come to terms with burn trauma and altered body image.

We organise fun activities including residential camps, days out, workshops, parties and encourage the benefits of peer support amongst members.

This support helps rebuild self-esteem, confidence and expectations after a burn injury and along the way lasting friendships are made by the children and their families whilst giving mutual support to one another.

The club is open to any child or young person under the age of 18 years old that has a been treated by a burns consultant; any young person aged 18-24 is able to join the Young Adult CBC group

The Children’s Burn Club is a registered charity under the umbrella of the Mid Essex Hospital Trust; the hospital  fund all staffing costs.

This means any income raised or donated to the club goes directly to supporting the children, young people and families that need it to increase the support offered to them.

Contact us!

Tel: 01245 515988 | Mob: 07473374592
Facebook: Children's Burns Club
Email: Childrensburnsclub@meht.nhs.uk

St Andrew's Facial Palsy Services

Overview of Service

We offer treatments for the following conditions:

  • Newly diagnosed facial palsy in newborns, children and adults.
  • Recurrent facial palsy.
  • Longstanding facial palsy with synkinesis, asymmetry and other problematic symptoms.
  • Facial dystonia.

We treat patients from throughout our local catchment area, as well as from other regions of the UK through GP referrals, and referrals from other specialist centres.


Signposting

Facial Palsy UK:

https://www.facialpalsy.org.uk/

Useful Information 

https://www.facialpalsy.org.uk/support/useful-info

Patient Guides 

https://www.facialpalsy.org.uk/support/patient-guides/

Self Help Videos 

https://www.facialpalsy.org.uk/support/self-help-videos/


What are the treatment options for Facial Palsy?

  • Physiotherapy
  • Botox
  • Surgery 


Physiotherapy  

Physiotherapy is an important treatment for Facial Palsy. Your physiotherapist will complete a thorough assessment of your condition and individual presentation and work with you to produce a personalised treatment plan. They will monitor your progress using photographs and certified outcome measures which will include you completing some questionnaires. 

Physiotherapists work with you to improve facial symmetry, reduce muscle tightness and pain, improve function, and discuss management strategies. Treatment normally includes massage, stretching, exercises, education and synkinesis management. 

The team here at St. Andrews comprises of Marie Matanle and Christopher Keast, who see patients every Monday.


Botox

Botox is a drug which weakens and/or paralyses muscles. Used alongside physiotherapy as an adjunct; it can be injected into muscles which have become tight or overactive. Sometimes we inject the unaffected side to improve symmetry – for example if you are unable to raise the eyebrow on one side, we may inject the contralateral side to reduce the effect of this and improve symmetry. Botox takes about up to 2 weeks to see an effect. 


Surgery 

There are a range of reconstructive surgical operations for the correction of Facial Palsy. As all cases of the condition vary, each surgical intervention is tailored very specifically to a patient’s needs. For example, surgery can help with eyelid closure by inserting a small gold weight or correcting the position of the eyelid, or can help with mouth movements by transferring muscle from elsewhere in the body to the face, to improve function. Surgery will be discussed in outpatient clinic initially, and if required can take place at Broomfield Hospital.  

For information regarding patient referrals please contact:

Ms Suki Wheal, secretary to Ms K Tzafetta 
St Andrews Centre 
Broomfield Hospital
Chelmsford
Essex
CM1 7ET 
Tel no: 01245 516119
Email:  suki.wheal@nhs.net

Physiotherapy Department 
Marie Matanle, Christopher Keast - 01245 516009

Going to Burns Theatre

This video shows the preparation for patients going to burns theatre.

Children’s Burns Ward

This video shows children - who will be attending the ward - what the unit is like and what to expect. It is also be beneficial for school friends to see where their friend has been treated and care for.