Young Person’s Diabetes Group

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  • Feeling stressed or worried about diabetes?
  • Feeling frustrated, angry or burnt out?
  • Is diabetes impacting work, studies or relationships?
  • Are you struggling with moving to adult services?
  • Do you feel alone with diabetes or as if no-one gets it?

The Young People’s Diabetes Group at Southmead Hospital offers a great opportunity for young individuals who attend the young person’s diabetes clinic to learn more about managing diabetes and, to connect with others who share similar experiences.

The six-sessions are 90 minutes each and are led by a clinical psychologist where participants can gain valuable support in a safe and understanding environment. Plus, the convenience of joining via computer or mobile phone makes it accessible to everyone.

To join, speak to your diabetes nurse or consultant, or email the psychology team with your name and hospital number at psychologymedicine@nbt.nhs.uk.

Clinical Neuropsychology

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Information for patients referred to Clinical Neuropsychology at North Bristol NHS Trust. 

Why have I been sent this appointment?

You might be referred to see a neuropsychologist for a number of reasons including:

  • To help you and/or your healthcare providers understand more about how your thinking skills are working, to assist with making a medical diagnosis, or assess the impact of a neurological condition/illness on your thinking skills, mood, and coping.
  • To help evaluate your suitability for surgery or to monitor the effects of surgery or medical treatment.
  • To try and identify what might help with any changes to thinking, emotions, or behaviour you are experiencing.
  • To help you cope with the effects of a neurological illness or injury and/or provide advice on cognitive strategies or psychological treatments that may be useful to you.

You have been sent this appointment for an assessment:

  • To see how your brain is working and/or how you are coping with a neurological injury/condition.
  • To try to identify what would help you cope better with your difficulties.

The primary purpose of your assessment will be explained to you at your appointment. 

What is a neuropsychologist?

Neuropsychologists are psychologists who specialise in understanding the link between the brain and behaviour. 

Neuropsychological assessments are a way of describing and measuring the effects that changes in the brain can have on thinking skills, behaviour, and emotion.

Changes in thinking skills and behaviour may be caused by aging, brain damage or disease, and sometimes by stress or low mood.  

Neuropsychologists also commonly provide rehabilitation and treatment to help people manage and work around any difficulties they might have. 

What happens when I see a neuropsychologist?

Your appointment will be with one or more members of the neuropsychology team. Usually, you will discuss your difficulties with the neuropsychologist, who will take notes of what you say. These notes will become part of your healthcare record. You will be able to ask questions. 

You can have someone with you, such as a friend or family member, if that is helpful, for example for support or because they can offer helpful information about your difficulties. This discussion will happen either over the phone, video-call, or face to face.

When you attend the appointment(s):

  • You will be asked to discuss your difficulties with a neuropsychologist.
  • You will be asked to do some tests of your thinking skills, like memory.
  • You may be asked to complete some questionnaires about your emotions, for example stress and worry, or feelings of unhappiness. 

If appropriate, you will have an assessment of your thinking skills, such as your memory ability, and of how you are feeling emotionally. This will be done either face to face or by video-call, through questionnaires and cognitive tests. The assessment requires concentration and effort and some people may feel tired afterwards.

Details of your appointment will be in your letter.

Once you have completed the assessment the neuropsychologist will write a report of the findings and may contact you to discuss the results and possible ways forward. The report will be shared with your referring doctor and other members of your healthcare team as appropriate.  

A copy may be sent to you routinely, or if not, is available upon request. 

A neuropsychology report typically includes an explanation of the tasks given and the scores that were achieved. It may include an opinion about the likely cause of any difficulties observed as well as some recommendations for how to help with any problems identified. 

Sometimes the report might be difficult to understand or you might have further questions, in which case you should contact us so that we can assist you. 

Depending on the service pathway, and what was agreed with the neuropsychologist, you may have further appointments with members of the neuropsychology team to help you with your cognitive and/or emotional difficulties.

After you have attended: 

  • A report will be written by the neuropsychologist which will go to the referrer or other appropriate members of your healthcare team.
  • In some services the report is also sent to you.
  • Depending on the service pathway, you may also be invited to attend further appointments for rehabilitation or therapy.
  • If you have any questions about the report or what happens next please contact us. 

What do I need for the appointment?

On the day:

  • Please have your glasses and hearing aids with you if you need them.
  • Please take any medication as you normally would.
  • You may find it helpful to write down any questions ahead of the appointment.

Consent

You will be asked by the neuropsychologist if you agree (consent) to the assessment and, if appropriate, any relevant treatment. The neuropsychologist will explain the assessment and/or treatment to you and you can ask any questions that you may have.  

You are free to decide whether or not you want to have the assessment or treatment offered. 

By consenting you agree that:

  • The neuropsychologist can take notes of what is said and done during your work with them.  
  • These notes will form part of your healthcare record.
  • You agree to undertake the tasks of the assessment and/or treatment as appropriate.
  • You agree a report summarising appropriate details of your discussion with the neuropsychologist, the results of your assessment, and any treatment can be shared with your GP and treating healthcare team as required. 

Personal data

We will process personal data to enable us to provide neuropsychological services to you. This information may include personal details, family details, lifestyle and social circumstances, employment and education details, and physical and mental health details. 

In order to carry out our work we need to process personal information about our patients, their relatives/guardians and sometimes other professionals. 

We sometimes need to share the personal information we process with the individual, and also with other organisations. Where this is necessary we are required to comply with all aspects of relevant law. 

Confidentiality

Information discussed and shared with the neuropsychologist or staff under their supervision, along with the results of any assessment or treatment undertaken and reports or letters written, will remain confidential within your healthcare record. 

We will share this information with members of your healthcare team as part of your care. We will not share this information with people outside of your healthcare team without your permission. 

There are, however, circumstances in which we are legally required to breach confidentiality. Under these circumstances we will make all reasonable efforts to inform you of the need to share information. We will breach confidentiality if we believe failure to do so will result in harm to you or others. Specifically, we will breach confidentiality if we believe a child is at serious risk of harm, we believe there is serious risk of harm to you or someone else, or if we believe you have not disclosed relevant information that you are required by law to disclose, such as a condition that will likely affect your ability to safely work or drive.

Supervision of staff, students, and trainees

Supervision of staff

Staff within the Department of Neuropsychology receive supervision of their work from a senior clinician to maintain and improve their skills. Within this they may discuss details of their treatment with you. The supervisor is bound by the same rules of confidentiality as outlined above.

Students and trainees

North Bristol NHS Trust is a teaching trust and we often have students and trainees working within the Department of Neuropsychology. If you do not wish for them to be present during your assessment or treatment please let us know. Your decision will not affect the treatment you receive. 

Concerns or complaints

You may not wish to raise a complaint, but would like us to be aware of an issue and try and make it right. If you need advice or have a concern at North Bristol NHS Trust the Patient Advice and Liaison Service (PALS) can be contacted at:

Email: pals@nbt.nhs.uk
Phone: 0117 414 4569

If you wish to make a formal complaint you can:

Complete our online form: www.nbt.nhs.uk/patients-carers/feedback/advice-complaints/raise-a-conce…

Email: complaint@nbt.nhs.uk

Phone: 0117 414 4567

Write to: 

Complaints Team,
Beaufort House,
Southmead Hospital
Bristol
BS10 5NB

© North Bristol NHS Trust. This edition published February 2024. Review due February 2027. NBT002933

Contact Neuropsychology

Department of Neuropsychology
Rosa Burden Centre
Donal Early Way
Southmead Hospital
Bristol
BS10 5NB

Phone: 0117 414 0454
Email: neuropsychology@nbt.nhs.uk

Support your local hospital charity

Southmead Hospital Charity logo

Find out about what we do and how you can support us. 

Genomic testing in inherited Breast Cancer (Test Code R208)

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Why have I been offered an inherited breast cancer genetic test (R208)?

You are being offered this test because of your breast cancer diagnosis and because you meet the current national criteria for genetic testing. 
The test may give us information about why you developed breast cancer and about your risks of developing new cancers in the future. As this test looks for inherited (germline) variants, it may have implications for your future health and for your family. If we find that you have an increased risk of future cancers’ we will discuss screening and risk reducing methods with you. 
Please take time to ask all the questions that you need to. If you don’t feel ready to have a test right now, your team can store a DNA sample and revisit this with you at a later date. If you decide not to have a genomic test you will still get the best possible health care, based on what we know about your cancer.
 

Is breast cancer inherited?

Most breast cancer is not inherited. Breast cancer is a common condition, it affects around one in seven women in the UK. Only a minority of breast, around 5-10%, are influenced by a genetic variant. Genes which influence breast cancer risk generally fall into one of two categories: 
 

High risk breast cancer genes. These genes can cause a high lifetime risk of breast cancer. High risk is defined as a lifetime breast cancer risk of 30-80%. Examples of high risk genes include BRCA1, BRCA2 and PALB2. These genes also influence the risk of ovarian cancer. There may be some increased risk of other cancers, depending on family history. 
 

Moderate risk breast cancer genes. These genes increase breast cancer risk, but not as strongly as the high risk genes. Moderate risk genes typically cause a lifetime breast cancer risk of 20-30%, depending on family history. Examples of moderate risk genes include CHEK2 and RAD51C. Some of these genes also influence ovarian cancer risk. Moderate risk genes were discovered more recently, so we are still learning about their effect on cancer risk. 
 

Inheritance: If a parent has a gene variant, there is a 50% chance of passing it on each time they have a child. This is not influenced by sex; we all have these genes and either parent can pass them on to any child.
 

What happens in a Genetic Test?

Genomic testing in inherited Breast Cancer (Test Code R208) is carried out on a blood sample. 


If you decide to have the R208 genetic test, your healthcare professional will discuss this with you and there is a form to complete which records your choices. Your blood sample will be sent to our regional Genomics Laboratory Hub for testing. Testing usually takes between 2 to 3 months. This test is about your cancer and inherited breast cancer risk, it does not look for changes in DNA that may cause other health conditions.


The R208 gene panel includes a number of genes and the laboratory will add to it as we learn more about cancer genetics. Only genes with a proven influence on breast cancer risk will be added. If you have specific questions about the genes currently included in the R208 test, please discuss these with your healthcare professional. If required, you have the option to speak to a genetic specialist before making your decision about testing. Everyone who tests positive, or has a significant family history, will be offered a referral to a genetic specialist.
 

Your Genomic Test results

Once your sample has been taken the results are returned to your healthcare professional who will share them with you. There are three outcomes to this genetic test: 
Positive: A variant is found in a breast cancer gene. 
Negative (normal): No variants were found in the genes tested. 
Inconclusive: A gene variant was found but its significance is unclear.
 

1. What does it mean if a gene variant is found on my genetic test?
This is likely to explain why you developed breast cancer. Your breast cancer team will inform you of the result and consider this information when planning your treatment.

You will be referred to Clinical Genetics so that you can discuss your result in more detail. Clinical Genetics will explain what the test result means for your future risk of cancer, your options for cancer screening and measures to reduce these risks.

A test will be available for your relatives to assess their genetic cancer risk. Clinical Genetics will support you in sharing the information with family members, so that everyone gets the care they need.

2. What does it mean if no gene variants are found on my genetic test?
This is the most common result. This result means it is unlikely that your breast cancer was caused by an inherited gene variant. The risk of future cancers (in you or your relatives) is unlikely to be raised unless you have a significant family history of cancer.

If you have a significant family history of cancer you will be referred to Clinical Genetics for further discussion.

3.    What does an inconclusive result mean?
People are diverse and there is a lot of variation within our genes. Some gene variants have no effect on how a gene functions. If a new or rare variant is picked up, it can hard to predict whether it affects cancer risk, or whether it is just harmless variation.

If the scientists cannot be sure of a variant’s effect, they will report it as an uncertain finding. (In technical terms this is called a “variant of uncertain significance”, or “VUS”). If an uncertain variant is found, you may be referred to Clinical Genetics so that they can assess this for you and your family.
 

Further information about Cancer Genomic Testing

Cancer Genomics 

Cancer occurs when damage inside of a cell results in that cell growing and dividing in an uncontrolled manner. Some cancers are triggered by specific environmental factors, such as smoking, UV light or radiation. Most cancers involve a number of different factors and are essentially a chance event, one that becomes more common as we age. In a small number of cases cancer can be caused by an inherited gene “variant”, one that can be passed on between generations. 


Genomic testing is increasingly being used in cancer treatment pathways. This kind of testing may help us to understand: 


•    Why you developed a cancer 
•    Which treatments may be most effective for your cancer 
•    If you are at risk of developing a further cancer in the future and potential screening and risk reducing options 
•    Whether your relatives are at increased risk of cancer
 

What is a Genomic test? 

A gene is a specific sequence of DNA. Each gene performs a particular role in the body, some genes help to prevent cancer. A “variant” is a different code to the standard gene sequence. Changes to the gene sequence can affect how the gene functions. 


The exact effect depends on the gene involved. There are different types of genetic tests: inherited (germline) and cancer-specific (somatic).


Testing for inherited variants (germline) testing

This test, called R208, is an inherited variant test. This test can pick up gene variants that are present in all of your cells and have been present since you were born. Your DNA is a combination of both of your parents, so this type of gene variant is usually inherited. Inherited (germline) variants may tell us why a cancer occurred. These variants may also predict the risk of future cancers, in you and your relatives.


Testing for cancer-specific (somatic) variants 

This is separate to the R208 test but might be mentioned by your cancer treatment team. A somatic test looks at the DNA in your tumour, rather than the DNA in the rest of your body. These variants are not inherited and cannot be passed on. Somatic variants may give us information about your cancer type, or what treatment is most suitable for you.


Are other cancers associated with these genes? 

The R208 genes primarily influence breast and ovarian cancer risk. Some R208 genes also influence the risk of other cancers, although this risk is smaller than the risk of breast cancer. Associated cancers can include; ovarian cancer for women. Pancreatic and skin cancer for men and women. As well as prostate and male breast cancer for men.


Important information about your data 

Your genomic data and samples will be stored as part of your health record. DNA samples may be used anonymously for quality control. All data is kept securely and confidentially in line with UK law and NHS policy. More information can be found at www.england.nhs.uk/contact-us/privacy-notice Information in this guide should be used to supplement professional advice specific to your circumstances. If you have any questions, it is important to ask your medical team 
 

'BReast CAncer genes and me'

‘BReast CAncer Genes and Me’ is a digital patient empowerment project that’s set to transform the experience of people with a diagnosis of breast cancer that might have implications on other family members.

The project introduces the concept of genetic testing for breast cancer in an accessible format, presented as a six-part series of colourful animations. Each video features digestible information accompanied by gentle music and a clear voiceover that takes the participant through the process and implications of genetic testing.

This project has been developed as part of a Collaborative Working initiative between the South West Genomic Medicine Service Alliance and AstraZeneca UK, and has been co-designed by clinicians and patients alike, providing an overview of the genetic testing pathway from start to finish. We have been working with Magentus Global Health Tech for our digital solution.

BReast CAncer Genes and Me aims to streamline the consent process for breast cancer genetic testing through a digital consent pathway, supporting patients and their families through every stage and guiding them to become confident decision-makers.

View the videos on our YouTube channel.

Acute Oncology Nurse Specialist and Support Team

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The Clinical Nurse Specialist (CNS) Team

The Acute Oncology Clinical Nurse Specialists are experts in acute cancer care; we work as part of the Cancer Support Team. We can answer your questions and give you information about your diagnosis, treatment, and support available during and after your care.

Cancer Support Worker (CSW)

The Cancer Support Team also has support workers. They are trained to provide support and information about physical, emotional, and practical concerns to help you self-manage your recovery, and return to a healthy lifestyle as soon as possible.

Personalised Care and Support Planning (PCSP) 

Personalised Care and Support Planning is a conversation and assessment you will be offered with your Clinical Nurse Specialist and/or Cancer Support Worker, to help you discuss your health and wellbeing in relation to your cancer. It will assess your individual needs and concerns, to understand what matters to you. 

Personalised Care and Support Planning includes sharing information with you about diet, physical activity, fatigue, and other practical information relevant to you. This may include anything from emotional support, to signposting you to local support services such as benefits advice.

Making decisions about your healthcare

At NBT we encourage you to be a partner in your healthcare.

When patients work with healthcare professionals to make decisions about their healthcare, this is called shared decision making. Shared decision making ensures that you are supported to make decisions that are right for you. It means supporting you to choose tests and treatments based on medical evidence, as well as your individual preferences, beliefs, and values. 

It can be helpful to write down questions you have for your healthcare team. You should bring these, and a pen and paper to make any notes when you have appointments. 

Some questions that may be helpful to ask:

  • What are my options?
  • What are the possible benefits and risks of those options? 
  • What support and information is available to help me make my decisions? 

Shared decision making matters to us. Tell us what matters to you.

NGS Macmillan Wellbeing Centre 

We offer help and information about different kinds of cancers and treatments. We also talk about money, benefits you might get, what to eat, and exercises to do. If you have concerns or just want to talk with one of the team, we have time to listen and help you.

The centre offers ‘drop-ins’ for coffee and a chat or appointments for specific needs. 

Opening times: Monday to Friday 08:30 - 16:15

Phone number: 0117 414 7051

Cancer Information Session

As part of your routine care you may be invited to a group education and support session at or soon after the time of a cancer diagnosis. 

The session provides:

  • Information about cancer and related topics that help you participate in your care and recovery. 
  • The opportunity to meet other people with similar experiences. 
  • Help to enable you to make choices best suited to you.

Venue: NGS Macmillan Wellbeing Centre, Southmead Hospital 

Days and times: Monday 13:30 - 14:30, Thursday 10:00 - 11:00. 

How to contact us

Acute Oncology Clinical Nurse Specialists 
Gate 10, Brunel building 
Southmead Hospital 
Bristol 
BS10 5NB 

Acute Oncology Number 07860 783116 

Macmillan Wellbeing Centre 0117 414 7051

© North Bristol NHS Trust. This edition published June 2024. Review due June 2027. NBT002801.

Pain Management FAQs

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Frequently asked questions about the Pain Management Service: 

I would like a review of my medication, can you help?

If you have a goal to review your medication, this will need to be with your GP or pharmacist. We do not prescribe medications in pain management, however we can help advise you how to make a plan towards achieving your medication goals. 

Why should (would) I see a psychologist?

We know pain impacts on many areas of life and often people must adapt to changes in their circumstances. Living with pain has many challenges and pain psychology supports people to re-build their lives and adapt to change, develop coping strategies, and support their emotional wellbeing. 

Can you help me get more investigations for my pain?

Pain management focusses on the strategies you can put in place to minimise the impact pain has on daily life. We do not offer medical investigations and for most people medical investigations have been completed. If you are concerned in relation to medical problems, it would be advisable to discuss this with your GP.

Have I been referred to your service because the pain is ‘just in my head’?

Chronic / persistent pain is a very common problem. Pain is complicated and often there are many automatic systems involved in long term pain. It is recognised as a long-term condition and is very real. 

I have had physiotherapy before, and it did not help. How would pain management physiotherapy help me?

Physiotherapists in pain management look at all the factors impacting on function and pain levels. It is important to develop functional abilities and activity, whilst improving the control of pain. The physiotherapist will work with you to find a successful level of activity that can then improve over time. This may be a different approach to previous experiences.

What will happen after pain management?

We will tailor the support that you receive in the pain management service to you, so everyone’s route through will be slightly different. It might be that when you come to the end of the work that you do with us you might be signposted elsewhere. Or it might be that you take some time to put the strategies that you have learned into practice for yourself.

© North Bristol NHS Trust. This edition published January 2025. Review due January 2028. NBT003762


 

Support your local hospital charity

Southmead Hospital Charity logo

Find out about what we do and how you can support us. 

Contact Pain Management Service

For all appointment enquiries, please contact:

Pain Management
Gloucester House
Southmead Hospital
Telephone: 0117 414 7357
email: painmanagementcentre@nbt.nhs.uk

Please note that we are not a crisis service and we may not be able to answer your call but you are more than welcome to leave us a voice message and we will get back to you within 2-3 working days. 

If you need urgent medical support or advice you will need to contact your GP, or phone 111 or 999

If you feel you need emotional support urgently, please contact your GP, or phone 111.

If you wish to speak to to the Pain Clinic, please visit the Pain Clinic page

Infection Sciences (Microbiology & Virology)

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The Department of Infection Sciences is a collaboration between the North Bristol NHS trust and UK Health Security Agency to provide a hospital-based service for the laboratory diagnosis and clinical management of microbial diseases for patients both in hospital and the community, together with advice on the control of infection.

Laboratories participate and perform well in national quality assurance schemes and is fully accreditied. They are accredited for training with the Institute of Biomedical Science and registration with the Health Care Professions Council and the Royal College of Pathologists.

Medical microbiologists are available, both during the day and out-of-hours, to give advice concerning the diagnosis, treatment, and monitoring of infectious diseases. Where appropriate, preliminary reports and results are phoned to the clinician concerned. Ward rounds are conducted daily to review and offer advice on the management of inpatients with serious infections.

An active Infection Control Team is available at all times to help with matters relating to the control and prevention of infection.

Contact Microbiology

General Enquiries/Results/Clinical Advice
Southmead Hospital telephone: 0117 4146222

Email: microbiology@nbt.nhs.uk
 

Laboratory Hours
Monday to Friday 9am - 5.15pm
Saturday 9am 12 noon
A 24-hour on-call service operates outside normal laboratory hours - please contact via switchboard.

Infection Sciences (Microbiology & Virology)

Badger Notes - A guide for patients

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This page contains information about how to use different features of the Badger Notes app to access your maternity care record. 

Get the Badger Notes app or visit the website: 

Badger Notes - Access your healthcare records

Creating a new account

If you have used Badger Notes at a different trust or in a previous pregnancy, please see "Adding your pregnancy to an existing account" section below. 

You will need:

  • The passphrase given to you by your midwife or booking clerk.
  • Your mobile phone to receive your verification text. 

To create your account: 

  1. Open Bader Notes app and tap "Crease account."
  2. Agree to the terms and conditions if you are happy to.
  3. Enter the email address you gave to the midwife or booking clerk and use the activation phrase given to you.
  4. You will be asked how you would like to register. Please register with Badger Notes. We do not recommend registering with NHS login.
  5. Enter the verification code you received via text. 
  6. Create your password.
  7. Create your PIN. 
Screenshot of Badger Notes app showing Create account page and Create your password page

Changing language

You can change you Badger Notes language through the tab with your current chosen language:

  1. Tap/click on the three lines at the top left of the screen.
  2. Tap on English (this is selected as the default).
  3. Select the language you require.
  4. Tap continue. 
Screenshot of Badger Notes app with English on main menu circled
Screenshot of Badger Notes with language selection of English circled
Screenshot of languages menu on Badger Notes app
Badger Notes app language selected as Romanian, with continue option circled

Adding your pregnancy to an existing account

You will need:

  • A new activation phrase from your midwife or booking clerk

To add your pregnancy: 

  1. Log in with the same details used in your previous Badger Notes account.
  2. Tap on the three lines on the top left of the screen.
  3. Select Add a care record.
  4. Add new activation phrase provided by your midwife.
  5. Your current pregnancy is now added to your old record.
Badger Notes app with main menu three lines circled at top left
Badger Notes app main menu with Add care record circled
Badger Notes app screenshot adding care record option screenshot

Pre-booking questionnaire

You will have the opportunity to complete your pre-booking questionnaire before your booking appointment with your community midwife. You can return to the questionnaire and update up to the day of your booking appointment. 

Screenshot of Badger Notes app showing Pre-booking questionnaire menu

Edit profile

You can change your phone number or email address associated with your Badger Notes log in through the Edit Profile tab.

(This does not update the phone number or email address that the hospital has on record for you, to do this you will need to speak to your community midwife). 

Screenshot of Badger Notes app Edit Profile section

Key Details

Your care provider may ask you for key details such as your hospital number, if you contact them over the phone. 

The key details are:

  • Your key information, e.g. NHS number, hospital number, due date etc.
  • Your circle of care, for example GP and Named Midwife. 
  • General health history.
  • Medical history.
  • Plan of care for your pregnancy.
  • Current management plan(s).

To find these details:

  1. Tap on the Maternity Record tab at the bottom of the app.
  2. Select My Key Details.
Screenshots of Badger Notes app with Key Details section circled

Notifications

We recommend you have push notifications switched on to allow appointment reminders and important updates from our maternity unit.

To change notification settings:

  1. Tap on the three lines on the top left of the screen.
  2. Select Settings.
  3. Enable or disable the options and save.
  4. Notifications can be found in the bell icon on the top right corner of the Care Plan page.
Screenshot of Badger Notes app with menu and settings circled
Screenshot of Badger Notes app with care plan and notifications icon circled

Care Plan

In the Care Plan tab, you can see a weekly summary of your pregnancy.

For example at 28 weeks, you will be offered routine screening blood tests and recommended to read the information leaflet on screening.

You will be able to:

  • Write some thoughts (only visible to you) into the diary by selecting Add photo or diary entry.
  • Upload an image for your own purposes (this is not visible to your maternity staff).
Screenshot of Badger Notes app with Care Plan circled
Screenshot of Badger Notes app with Add photo or diary entry circled

Conversations

In the conversations tab, you can:

  • Write antenatal, postnatal and birth plan thoughts and notes to speak with your midwife or doctor about at your next appointment.

Your midwife or doctor will be able to see these notes however they will not be notified of an entry therefore it is very important not to put any urgent messages in this area.

Screenshot of Badger Notes app with conversations page displayed

 

Maternity Record

A summary of your maternity notes can be found within the Maternity Record tab. 

To view your antenatal care summary:

  1. Tap on the maternity record tab and scroll down to the summary
  2. Scroll to the row you would like to view.
  3. Click to open and scroll to view the details. 

You may need to turn your phone landscape to make viewing easier.

Screenshot of Badger Notes app with Maternity record option circled
Screenshot of Badger Notes Maternity record pages

Leaflets

Our hospital maternity leaflets are available in the Badger Notes Library tab

These can be viewed throughout your pregnancy and after birth.

You can also access the Glossary to help you understand any new medical terms you may see in your notes.

Leaflets which have been specifically recommended to you by your midwife or doctor can be found by:

  1. Tapping on the Care Plan tab.
  2. Tap on recommended reading at the top of the page.
Screenshot of Badger Notes app with Library circled
Screenshot of Badger Notes app with Glossary and Recommended Reading circled

Hospital Contacts

To view your hospital contacts, including emergency phone numbers:

  1. Tap on the three lines on the top left of the screen.
  2. Select the Hospital Contacts tab.
Screenshot of Badger Notes app with menu and Hospital Contacts circled

Badger Notes Helpline

If you have any problems accessing your Badger Notes, please use the Badger Notes Helpline where someone will be able to help you.

Please note this is a non-urgent helpline for Badger Notes access queries only.

Phone 0117 342 9301

Email badgernotessupport@uhbw.nhs.uk

Open hours: 

  • Monday to Friday, 10:00 to 16:00
  • Saturday and Sunday, 11:00 to 15:00 

© North Bristol NHS Trust. This edition published December 2024. Review due December 2027. NBT002914.

Vascular Research Team

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Vascular Surgery Research Team

Our Surgery Research team is a dedicated group of nurses, administrators, and surgeons, conducting studies across specialities including Colorectal, Upper Gastrointestinal (UGI) and Vascular.

Our research is supported by the Department of Health with our research projects encompassing a wide breadth of both laboratory-based and clinical work, to improve patient health, wellbeing and care.

We work on a range of commercial and non-commercial, qualitative and quantitative projects and collaborate with colleagues locally, nationally and internationally in order to improve outcomes for patients suffering from various conditions. 

Our work benefits patients not only here in the NHS, but also increases care standards globally.

The team has a wealth of experience conducting research studies and trials, and improving training, guidelines, and patient outcomes.

Our staff work in close collaboration with a number of partners, primarily linked with the University of Bristol and University of the West of England (UWE) as well as a number of other NHS Trusts.

Team Members:

Samantha Loud

Lead Research Nurse

Sam currently works as the Lead Research Nurse for the Surgery Research team overseeing Colorectal, UGI and Vascular Research at Southmead Hospital, managing a team of 6 competent research practitioners. Having qualified in 2000 as a Children’s Nurse, she began her career working in the Paediatric Intensive Care Unit at Bristol Children’s Hospital where she worked for 7 years. She then moved and worked for 4 years on a busy Surgical and Trauma ward.  

After seeing an advert for the opportunity of a research nurse post at led jointly with NBT (North Bristol Trust) and UoB (University of Bristol) working with Children and their families researching into the risk of developing Type 1 diabetes she jumped at the chance for a new challenge. She spent 9 years in this post working her way up, initially as a junior nurse band 5 to a senior nurse band 7 role where she then led the team and managed the research project. This came to an end in 2020 when the study funding finished.

Sam was then offered the opportunity of a completely new role and challenge within NBT as the Senior Research Nurse for Surgery. This involved putting together smaller teams within different areas of Surgery research bringing them together as one team. This has been a success; the team has grown and consists of dedicated research nurses and administrators and is still growing! We have opened and reopened many studies across all the areas which are recruiting well.

Sam has lots of plans to extend this over time and build a bigger team to be able to cover more areas of surgery in the future.

Dr Marcus Brooks

Consultant Vascular Surgeon

Dr Marcus Brooks is a Consultant Vascular Surgeon at North Bristol NHS Trust, Honorary Secretary elect for the Vascular Society of Great Britain and Ireland, and clinical member of NHSE Specialised Services Vascular Clinical Reference Group. His main clinical interest is in the management of aortic disease, including complex endovascular repair of aortic aneurysms and aortic dissection. 

He is also the Principal Investigator for the EXcel Registry (Gore Conformable aortic stent graft) in the UK and also recruits to the COMPASS trial (Observational study of patients with juxta-renal abdominal aortic aneurysms).

Chris Twine

Vascular Surgeon

Chris is a vascular surgeon in Bristol and is clinical lead for vascular research. He has a research interest in amputation, chronic limb threatening ischaemia and antithrombotic therapy for peripheral arterial disease. He is an associate editor of CVIR endovascular and is on the editorial board of the European Journal of Vascular and Endovascular Surgery. He is a council member of the British Society for Endovascular Therapy where he is research lead, the Vascular Society special interest research group for peripheral arterial disease where he is intervention lead, and the European Society of Vascular Surgery guidelines steering committee where he is chair of the upcoming antithrombotic guideline. He has published over 100 original papers and his scientific work has received several prizes.

More information about Chris and his work can be found on the University of Bristol website.

Helen Cheshire

Vascular Research Nurse

Helen is a senior research nurse specialising in vascular. She has worked for North Bristol NHS Trust since 2015. Prior to this Helen was a key member of the intensive care team at the Bristol Royal Infirmary, where she worked as a senior nurse for sixteen years.

Helen has extensive experience, spanning multiple studies and specialties, delivering ground-breaking research. She ran gastro-hepatology research for two years, before moving to lead the vascular portfolio in 2017. Under Helen’s leadership, the vascular portfolio has grown exponentially.

Helen welcomes the challenges research presents as a continuously growing field. It can enable patients to participate in adjustments that result in a longer, better quality of life.  She enjoys working at the forefront of new developments in treatments for our patients.

Seeve Suppiah

Vascular Research Nurse

Seeve is a surgical research nurse specializing in Vascular research and two colorectal research as well as helping with the AHEAD study - Preclinical Alzheimer's Disease with Elevated Amyloid. Prior to this, Seeve was an ITU nurse, a Renal dialysis nurse, a Research nurse for AVONCAP-COVID-19, pneumococcus, and respiratory syncytial virus (RSV), and a Haematology Research Nurse.

Gosia Slowinska

Surgery Research Nurse

Gosia is a research nurse in vascular surgery team. She has worked for North Bristol Trust since 2020 in Intensive Care Unit and in HIV and Immunology Research team.

Prior to this Gosia worked as a nurse in Intensive Care Units in Royal Papworth Hospital, Yeovil District Hospital and Specialised District Hospital in Wroclaw, Poland.

Alice Smith

Research Administrator - Colorectal & Vascular

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Cardioversion

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This page is for patients and their families when preparing for a cardioversion.

What is a cardioversion and how is it done?

Cardioversion is done in hospital under a short general anaesthetic (you will be asleep) to treat an abnormal heart rhythm. 

The doctor will place electrode ‘sticky pads’ on the front and back of your chest and send electrical energy through the chest to the heart. This energy is synchronised (works at the same time) with your own heartbeat and should return your heart to the normal regular rhythm. 

Cardioversion is usually done as a day case, so that you come to hospital and go home the same day. Occasionally it is necessary to stay overnight.

Why do I need to have a cardioversion?

You may have been having palpitations or an irregular heart beat for some time. Your doctor may have prescribed a course of tablets such as amiodarone, digoxin, bisoprolol, or diltiazem to control your heart rhythm. These are not always successful and if you are troubled by palpitations, breathlessness, chest discomfort, or reduced activity then cardioversion may help. By restoring your heart’s normal regular rhythm (sinus rhythm) your symptoms can improve.

Will it be successful?

The cardioversion is more likely to be successful if your heart has been in an abnormal rhythm for only a short while, like a few months. The effectiveness varies, but in 9 out of 10 people the cardioversion will restore the normal regular rhythm.

However, some of these people will go back to how it was in the next few days or weeks. In a few cases the procedure will not be successful at all.

For 5-6 people out of 10 who have cardioversion, their heart will likely still be in the normal regular sinus rhythm 12 months later.

The best results are seen in patients with normal heart structures seen on an echo scan. Patients with structural heart impairment, for example leaky valves or enlarged heart chambers, have a lower chance of long-term success.

Before you come into hospital

Your doctor will prescribe a blood thinning medication called oral anticoagulant, for example apixaban or dabigatran. These are taken twice a day for 4-6 weeks before the cardioversion and you will continue taking them afterwards. It is important that you don’t miss doses of the anticoagulant as this can increase the slight chance of having a stroke following the cardioversion.

You will be seen by a cardiology pre-op assessment nurse, before your procedure date. Usually, the procedure is done as a day case procedure (home on the same day).

The nurse will talk to you, take a blood sample, do an ECG recording, and check that that you can get to the hospital, and someone can take you home. You will not be able to drive yourself home.

Important information

  • You must not eat or drink for at least six hours before your admission to prepare for the general anaesthetic.
  • Take your regular medications as usual, early on the morning of your cardioversion with a small sip of water.
  • If you are taking digoxin, you should stop taking it 48 hours before you come to hospital.
  • If you are diabetic, the pre-assessment nurse will explain what you need to do before you come into hospital.

When you arrive at hospital

You will be seen by a nurse and a doctor who will talk about the procedure and answer any questions you have. You will then be asked to sign a consent form to show that you are happy to have the treatment.

The anaesthetist will talk to you about what will happen and ask you about your health and any allergies you may have.

You will be attached to a cardiac monitor to record your heart rate. Staff will take your blood pressure and record your breathing rate.

The anaesthetic will be given through a small needle in the back of your hand and as you drift off to sleep the electrical cardioversion will be done. The procedure takes about 5 minutes. You will then be taken to the recovery area.

What happens next?

You will sleep off the effects of the anaesthetic and wake up in your own time. When you wake up you will probably be lying on your side and wearing an oxygen mask. The nursing staff will monitor your blood pressure, heart rate, and breathing rate.

When you are fully awake you will be told how the procedure went and staff will be happy to answer any questions. Some people feel slightly sick after anaesthetic, but you will be given a drink and something to eat when you feel able to.

When you have recovered, you will have another ECG done to see if the procedure has been successful.

As long as you feel well enough, you will be able to be collected and go home 2-4 hours after your treatment.

Even if the treatment has been successful, the doctor may tell you to continue taking some or all of your tablets for a while longer.

An outpatient appointment will be arranged for you to see your hospital doctor who recommended the cardioversion and you can ask about your medicines then.

Please remember it takes a while to recover from a general anaesthetic.

For 24 hours after cardioversion:

  • You must not drive.
  • You must not operate any potentially dangerous devices as your reflexes may be reduced.
  • You must not make any important decisions or sign any legal documents.
  • Do not drink alcohol.
  • Do not boil a kettle or use anything that involves heat.
  • When rising up to sitting or standing, do it slowly as you may feel dizzy if you get up too quickly
  • We advise you to rest for the remainder of the day after your treatment and to take the next day off work.

What risks are there?

Cardioversion is a safe procedure which has been done in most hospitals in the UK for many years.

Complications are rare, but there are risks that you need to think about before you sign the consent form.

These risks are higher in patients who are very unwell or have certain medical conditions. You need to weigh up the risks of having the procedure or leaving the condition untreated, against the potential benefit of the procedure.

Below are approximate complication rates for patients having cardioversion. However, you need to remember that these numbers include all patients, regardless of how ill they were to start with.

  • Risk of an anaesthetic problem or death is one in every 100,000 patients.
  • Risk of having a stroke or another type of blood clot problem is approximately one in every 1000 patients.
  • There is a minor risk of slight burns to the chest from the paddles or adhesive pads used during the procedure.
  • Rarely, some patients may require a temporary pacing wire to be inserted if the heart beats too slowly.
  • Rarely the procedure causes a more serious, life threatening abnormal heartbeat. This is so uncommon that there are no available statistics.

References and further information

Cardioversion - BHF

© North Bristol NHS Trust. This edition published December 2024. Review due December 2027. NBT002341

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Surgery Research Team

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Surgery Research Team

Our Surgery Research team is a dedicated group of nurses, administrators, and surgeons, conducting studies across specialities including Colorectal, Upper Gastrointestinal (UGI) and Vascular.

Our research is supported by the Department of Health with our research projects encompassing a wide breadth of both laboratory-based and clinical work, to improve patient health, wellbeing and care.

We work on a range of commercial and non-commercial, qualitative and quantitative projects and collaborate with colleagues locally, nationally and internationally in order to improve outcomes for patients suffering from various conditions. 

Our work benefits patients not only here in the NHS, but also increases care standards globally.

The team has a wealth of experience conducting research studies and trials, and improving training, guidelines, and patient outcomes.

Our staff work in close collaboration with a number of partners, primarily linked with the University of Bristol and University of the West of England (UWE) as well as a number of other NHS Trusts.

As part of our Colorectal & Upper Gastrointestinal portfolio, we also work closely with Bristol’s Haematology and Oncology Centre (BHOC) and operate a shared care research pathway between us so patients can receive the highest standard of care whilst taking part in a research study.

Colorectal & Upper Gastrointestinal (UGI) Research Team:

Dr Anne Pullyblank

Consultant Colorectal Surgeon

Anne was appointed consultant colorectal surgeon at North Bristol NHS Trust in 2003 and has held many leadership positions within the trust including chair of the clinical risk committee, Clinical Director for Surgery and lead for colorectal and emergency surgery. Anne performs open and laparoscopic bowel (keyhole) surgery and has an interest in bowel cancer, surgical infections, vacuum dressing for the open abdomen and emergency surgery.  She was awarded an MD for laboratory-based research from University of London examining the role of monoclonal antibodies in colorectal cancer. She was principal investigator for CREST, PPAC2, Bluebelle, Selfi and DISCOVER. She is currently PI for VODECA, CREST2 and CONSIDER-19 and sits on the trial management group for CREST2.

Kathryn McCarthy

Consultant Colorectal Surgeon

Miss Kathryn McCarthy studied at UCL (1993-1998), attained her MD with the University of London (2005), following which she completed her FRCS at Royal College of Surgeons of England (2007), and her Gynaecological Fellowship (2009) and Laparoscopic Subspecialty Fellowship in Glasgow (2011-12).

Her clinical interests include laparoscopic colorectal surgery, endometriosis and pelvic surgery. Her academic interests include the IGF pathway in colorectal cancer and surgical outcomes in older people (OPSOC.eu). Her subspecialty interests include minimally invasive trans anal surgery, early rectal cancer and pelvic floor surgery.

She is clinical lead for Endoscopy and GI physiology. Nationally, she is the NIHR lead for surgical research (West of England).

She is also a member of The Royal College of Surgeons of England, National Pelvic Floor Society and European Society of Coloproctology.

Ann Lyons

Consultant Colorectal Surgeon

Miss Ann Lyons was appointed as a consultant colorectal surgeon at North Bristol Trust in 2005. Prior to joining North Bristol NHS Trust, Ann was a fellow at international centres of St Marks Hospital, London and Mount Sinai Hospital, Toronto expanding her management of complex pelvic conditions. Graduated with Hons, Surg and Antomy Medal Ann completed by Higher Surgical Training in the South West Deanery, centred on Bristol. During her Higher Surgical Training, she had valuable out of training experience, educated with Professor Hohenberger in colon and rectum cancer surgery and Prof Matzel in pelvic floor disorders, in the University of Erlangen. She has actively engaged programmes for cancer patient communication,  including in the NCAT cancer care programme 2013.

Within this experience Ann has developed a holistic approach to cancer care, and a specialty interest in delivering safe careful pelvic surgery for regional patients; and surgery for early and advanced cancer. I have extensive experience in minimally invasive surgery.

Ann has clinical, educational and research experience. Awarded MD for her bench to bed side T cell immune response to major stresses, Harvard Medical School and since appointment has been PI for several clinical research trials at North Bristol NHS Trust. Ann has presented both nationally and internationally.  Ann is the lead surgeon for Colon and Rectum Cancer at North Bristol. She has a position on the SWAG CAG Colorectal Cancer Alliance.

Miss Ann Lyon is a member of RCSE, ACPGBI, ESCP, ASCRS and RSM.

Andy Smith

Colorectal Surgeon 

Angus McNair

Colorectal Surgeon 

Jodie Rawlings

Colorectal Research Nurse

James Hopkins

Upper Gastrointestinal Surgeon

Suzie Royle

Colorectal Research Nurse

Suzanna is a research nurse specialising in colorectal research, and has worked for North Bristol Trust since 2023. Prior to this, Suzanna worked at Surrey and Sussex Healthcare NHS Trust (SASH) across both elective and emergency surgical wards, for upper and lower gastrointestinal surgery. She is passionate about improving patient outcomes and patient experience, and therefore finds her role in colorectal research highly rewarding.

Vascular Surgery Research Team:

Dr Marcus Brooks

Consultant Vascular Surgeon

Dr Marcus Brooks is a Consultant Vascular Surgeon at North Bristol NHS Trust, Honorary Secretary elect for the Vascular Society of Great Britain and Ireland, and clinical member of NHSE Specialised Services Vascular Clinical Reference Group. His main clinical interest is in the management of aortic disease, including complex endovascular repair of aortic aneurysms and aortic dissection. 

He is also the Principal Investigator for the EXcel Registry (Gore Conformable aortic stent graft) in the UK and also recruits to the COMPASS trial (Observational study of patients with juxta-renal abdominal aortic aneurysms).

Chris Twine

Vascular Surgeon

Chris is a vascular surgeon in Bristol and is clinical lead for vascular research. He has a research interest in amputation, chronic limb threatening ischaemia and antithrombotic therapy for peripheral arterial disease. He is an associate editor of CVIR endovascular and is on the editorial board of the European Journal of Vascular and Endovascular Surgery. He is a council member of the British Society for Endovascular Therapy where he is research lead, the Vascular Society special interest research group for peripheral arterial disease where he is intervention lead, and the European Society of Vascular Surgery guidelines steering committee where he is chair of the upcoming antithrombotic guideline. He has published over 100 original papers and his scientific work has received several prizes.

More information about Chris and his work can be found on the University of Bristol website.

Helen Cheshire

Vascular Research Nurse

Helen is a senior research nurse specialising in vascular. She has worked for North Bristol NHS Trust since 2015. Prior to this Helen was a key member of the intensive care team at the Bristol Royal Infirmary, where she worked as a senior nurse for sixteen years.

Helen has extensive experience, spanning multiple studies and specialties, delivering ground-breaking research. She ran gastro-hepatology research for two years, before moving to lead the vascular portfolio in 2017. Under Helen’s leadership, the vascular portfolio has grown exponentially.

Helen welcomes the challenges research presents as a continuously growing field. It can enable patients to participate in adjustments that result in a longer, better quality of life.  She enjoys working at the forefront of new developments in treatments for our patients.

Seeve Suppiah

Vascular Research Nurse

Seeve is a surgical research nurse specializing in Vascular research and two colorectal research as well as helping with the AHEAD study - Preclinical Alzheimer's Disease with Elevated Amyloid. Prior to this, Seeve was an ITU nurse, a Renal dialysis nurse, a Research nurse for AVONCAP-COVID-19, pneumococcus, and respiratory syncytial virus (RSV), and a Haematology Research Nurse.

Cross-Portfolio Team:

Samantha Loud

Lead Research Nurse

Sam currently works as the Lead Research Nurse for the Surgery Research team overseeing Colorectal, UGI and Vascular Research at Southmead Hospital, managing a team of 6 competent research practitioners. Having qualified in 2000 as a Children’s Nurse, she began her career working in the Paediatric Intensive Care Unit at Bristol Children’s Hospital where she worked for 7 years. She then moved and worked for 4 years on a busy Surgical and Trauma ward.  

After seeing an advert for the opportunity of a research nurse post at led jointly with NBT (North Bristol Trust) and UoB (University of Bristol) working with Children and their families researching into the risk of developing Type 1 diabetes she jumped at the chance for a new challenge. She spent 9 years in this post working her way up, initially as a junior nurse band 5 to a senior nurse band 7 role where she then led the team and managed the research project. This came to an end in 2020 when the study funding finished.

Sam was then offered the opportunity of a completely new role and challenge within NBT as the Senior Research Nurse for Surgery. This involved putting together smaller teams within different areas of Surgery research bringing them together as one team. This has been a success; the team has grown and consists of dedicated research nurses and administrators and is still growing! We have opened and reopened many studies across all the areas which are recruiting well.

Sam has lots of plans to extend this over time and build a bigger team to be able to cover more areas of surgery in the future.

Gosia Slowinska

Surgery Research Nurse

Gosia is a research nurse in vascular surgery team. She has worked for North Bristol Trust since 2020 in Intensive Care Unit and in HIV and Immunology Research team.

Prior to this Gosia worked as a nurse in Intensive Care Units in Royal Papworth Hospital, Yeovil District Hospital and Specialised District Hospital in Wroclaw, Poland.

Alice Smith

Research Administrator - Colorectal & Vascular

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