Emergency care at The Royal London Hospital

After being registered, everyone who comes to the emergency department is assessed on arrival, so patients can be seen in order of priority. 

We understand that long waits can be frustrating, however, it means that the patients going ahead of you are more unwell or are expected by a different team of specialists, even if that isn’t always visible. 

Some of the sickest patients come directly through another entrance and you may not be aware of their arrival in the department. 

After you have had your initial assessment, you may be directed to another service, such as the co-located Urgent Treatment Centre, a community service or one of a number of co-located Same Day Emergency Care (SDEC) services within the hospital.  

If you remain in the emergency department you will either be seen in the adult or paediatric (children’s) area. 

Our adult emergency department is open 24 hours a day, 365 days per year.

We look after all patients over the age of 18 years, and co-ordinate the admission of those over 16 years to an adult bed space where appropriate.

We provide the following emergency services at The Royal London Hospital:

• Major trauma centre for north east London 
• Hyper-acute stroke unit for innter north east London
• Medical, surgical, orthopaedic, gynaeological for those who are generally unwell 
• Emergency access for patients who require our specialist services including: kidney disease, gastroenterology, ear nose and throat, maxillo-facial (facial surgeons), plastics (reconstructive), urological (kidney, bladder and male genitalia surgeons), vascular (blood vessel surgeons), neurological (brain doctors) and neurosurgical (brain surgeons).  

We work closely with our colleagues from East London Foundation Trust who have a mental health liaison team working in our emergency department to assess patient unwell from mental health disorders.

We have access to X-ray and CT scan services via the emergency radiology area of the emergency department which has 3 x-ray rooms and 2 CT scanners, staffed by highly experienced radiographers.

Facilities

We have toilets with disabled facilities in all areas of our adult emergency department, except in our main waiting room, where the toilets in Zone D can be accessed as an alternative.

There is a vending machine in the main waiting room and there are 24-hour shops with daytime places to eat 200m away on Whitechapel Road. A small coffee shop in the main hospital entrance is open from 8am to 3pm daily, and a hospital canteen on the 5^th floor (accessible via lift core 5). 

We supply hot and cold drinks to our patients in all clinical areas of the emergency department, and for those staying in the department for longer than 4 hours, there are sandwiches and snack bags. For those waiting more than 8 hours for a ward bed space then hot meals are served at meal times (as they are on the wards).

On our small observation ward (Clinical Decision Unit) hot meals and snacks are available in line with all our ward areas in the hospital.

Our children's (paediatric) emergency department cares for children from new-born to 17 years old. Anyone attending after their 18th birthday will be directed to the adult area. 

Children aged 16 and above who require admission to The Royal London Hospital as in inpatient will usually be admitted to an adult ward under the care of the appropriate adult team. 

Children over 16 years old who are under ongoing care of specialist teams at our children's hopsital and yet to transition to adult services will continue to be admitted to one of our children’s wards.

Patients who come to the department are cared for by a dedicated team of nurses and doctors who are also supported by our health play specialists.

Patients needing to be seen by one of our specialty teams will usually be seen in the department. Patients needing a longer period of assessment may be admitted to our paediatric clinical decision unit (PCDU) located next to emergency department, or transferred to the paediatric assessment unit (PAU) located within the children’s hospital.

Facilities 

There is a breastfeeding room in our waiting room and two rooms with baby changing facilities. We keep a small number of nappies in the department but wherever possible please bring a supply with you. 

There is a vending machine in the main adult waiting room, and there are shops on Whitechapel Road just a few minutes walk away.

If you are asked to stay for observation, then staff can arrange a snack box or a hot meal. If your child has specific food and drink requirements, then please try wherever possible to bring these with you. 

There are toys to help distract children while they are waiting to be seen. Our play specialists will help support children needing distraction when they are available. If you know your child would benefit from a specific distraction toy/device, then please try wherever possible to bring it with you.

Adult emergency department

Where possible we ask that each patient only has one family member or friend with them. Our department is very busy and it is important we keep everyone safe and avoid overcrowding.

There are some exceptions where patients can attend with more than one visitor:

• Critically unwell patients, including those who are dying
• Patients with cognitive impairment or chronic confusion who may need extra support
• Patients with learning difficulties or additional needs who may need extra support

If you wish to contact a patient in the department please call 0203 377 7000 and ask for the main emergency department. You will need a name and date of birth. 

Children's emergency department 

Wherever possible we ask that only one parent/ guardian and no other sibilings attend the children's emergency department with a child that needs to be assessed. 

There are some exceptions where patients can attend with more than one visitor:

• Critically unwell patients 
• Those under 28 days 
• Those with significant learning disability or complex needs requiring two people to look after them
• Children who are being admitted and are resident in a PED cubicle awaiting admission can have two parents sit with them inside the cubicle

If you wish to contact a parent of a child in the department please call their personal phone. If for any reason you are unable to reach them, then please call the main hospital switchboard on 020 3377 7000 and ask to be transferred to the children's emergency department. 

We are the first in London to be accredited by the National Autistic Society

Adults 

As a department we welcome all adults with additional needs whether that is learning disabilities or neurodivergent adults, such as those with autism.

We know that many adults with additional needs will attend our emergency department and we know that area is a busy, noisy, bright, unpredictable and highly stimulating environment with plenty of strangers amongst our large team of staff as well as other patients and their loved ones. 

Our staff are keen to support and champion additional needs and know that particularly autistic patients will find the emergency department a very challenging environment. When you arrive at our hospital please ensure you inform reception, initial assessment nurses, area nurses and treating clinicians of any additional needs. If you or your loved one has a hospital passport please bring it for review by staff, this will help us determine how best we try to accommodate specific requests or reasonable adjustments.  

We will do our best to place patients with additional needs in spaces where light and noise can be more controlled where this is available, although sometimes there will be a delay in identifying and making available this space when we are very busy. 

Please also inform staff of any special dietary requirements for patients who need to stay longer than 4 hours.

Children 

We know that for children and young people with additional needs, the children's emergency department environment can be overwhelming due to the light, sound and activity. Please let the nurse who sees you at your initial assessment know if your child has additional needs and may require some additional accommodation. 

Whenever possible, we will try to accommodate any child or young person with additional needs in a quieter area and we can provide sensory play equipment on request.  

If your child or young person has any specific food or distraction device requirements or if they require any sensory protection equipment, please try wherever possible to bring this with you as we cannot guarantee we can provide specific equipment that meets every individual's needs. 

Further information 

Our AccessAble tool helps visitors with a diasibility to navigate around the hospital and there is more information about the support we offer to patients with learning disabilities on our website.