Purpose 

Our League of Friends coffee shop is run by a wonderful team of volunteers who like to give a few hours every week to serving customers with a smile.

Some volunteers do several shifts a week whilst others do just one, but they all play a key role in the friendly service that we aim to give our customers. In turn this encourages more people to visit the coffee shop, to buy refreshments and so to raise more money for Southmead Hospital.

Every day the coffee shop needs volunteers to run effectively. Could you become a League of Friends volunteer?

Commitment level

3-4 hours a shift

Shifts available 10am – 2pm or 1:45 – 5:15, Monday to Friday

Summary of duties

• Serve refreshments and light snacks.
• Operate the till.
• Provide a vital customer service for patients, visitors and NHS staff – greeting and serving customers.
• Be part of a friendly team of dedicated, public-spirited people
• Help raise funds for essential hospital equipment and services.

Skills, experience, attitudes, and qualities needed

Essential

• Excellent listening skills and a non-judgmental attitude 
• A friendly and open manner
• To feel comfortable in an acute hospital environment
• To adhere to the Trust values of treating others with respect at all times
• Understand the importance to stay within the boundaries of the role description.
• Positive attitude to working in a clinical environment.
• Reliable and trustworthy

Desirable

Experience working with people with cognitive impairments 

Training and information provided

• League of Friends Volunteer mandatory training programme (please find further information on our FAQs page)
• Department orientation and induction
• Specialist training if required, such as Dementia Level 2
• Shadowing induction sessions with an existing volunteer or staff member demonstrating the role.
• Ongoing supervision and support 
• Ongoing updates and information

Challenges of the position

•    Coming into hospital can be an anxious time for patients and their relatives. Sometimes this may make people less tolerant than they might usually be and they may come across as impolite. It is important that the volunteer remains calm and listens politely and seeks staff support immediately if required.
•    Potentially supporting patients with cognitive impairments or dementia (around 25% of inpatients at NBT have dementia), additional training and support will be provided. 

Boundaries of the position

Volunteering within the NHS has clear boundaries to ensure that we are keeping our patients and volunteers safe. Please download the detailed role description below for further details. 

Reimbursement of expenses

•    Travel expenses to and from the hospital can be reimbursed
•    Meal vouchers for use in the staff Vu restaurant are offered if volunteering for over 4 consecutive hours in one day

Benefits of volunteering

• Gain practical volunteer experience and learn about the healthcare environment. 
• Enjoy ‘putting something back’ into the NHS
• Provide a smile and comfort to patients and their visitors in trying times
• Give support and friendly service to our NHS staff customers
• Keep mentally and physically active, if retired
• Develop skills and experience that may be transferable to paid employment, such as working as a part of a team!
• Opportunity to help/support patients during a difficult time.
• References can be provided on completion of three months volunteering, if required 
• Ongoing support and supervision sessions
• Making friends with other volunteers and meeting new people
• Awards in recognition of volunteering contribution
• Light refreshments when on duty
• Free parking

Recruitment information

You will be asked to provide two independent references from people who have known you for more than three years (this cannot be a family member).

You will also need to have a basic Disclosure and Barring Service (DBS) check for this role, which will be paid for by the Trust.

How to apply

If you would like to apply for this volunteer opportunity, please click the link below to be taken to the application portal, where you will be able to apply online: 

Current Vacancies | North Bristol NHS Trust (nbt.nhs.uk)

If you would like an alternative method to apply, such as a paper application form, please get in touch with us directly on: 

Telephone Number: 0117 414 0110

Email: Volunteer.services@nbt.nhs.uk

Postal Address: Volunteer Services, North Bristol NHS Trust, Brunel building, Level 1, Gate 18, Southmead Hospital, Bristol, BS10 5NB

This information is for patients who have been referred to to be seen in the Same Day Emergency Care (SDEC) department.

This is in the Brunel building of Southmead hospital, Gate 36, Level 1. This is for investigations to rule out acute Cauda Equina Syndrome (CES), which may be one of the causes for your symptoms.

What is CES?

CES is caused by compression of the nerves travelling down the central spinal column of your lumbar spine (lower back), which control your legs, bladder, bowel, and sexual function. Disc prolapse or degenerative changes can put pressure on these nerves and may require urgent surgical intervention if you have new (acute):

• Numbness/altered sensation in the buttocks, inner thighs, genital/saddle (bottom) area which is new or not normal for you. 
• Pain in the lower back and legs, with or without leg weakness and numbness, which is severe or getting worse.
• Sudden difficulty with bladder or bowel function, including loss of feeling and control (incontinence), not being able to pass, or have the urge to pass urine (retention) which is not normal for you.
• Loss of sexual function/feeling, which is not normal for you, including (for men) an inability to achieve erections or ejaculation.

CES is a relatively rare but serious condition, affecting between 1-3 in 100,000 people. This is just 2–6% of all lumbar disc problems which require surgery. 

Urgent diagnosis is extremely important so we can treat it as soon as possible. We know that earlier surgery is associated with better outcomes, particularly when symptoms are recent onset and progressive (new and getting worse).

Most surgeons prefer to carry out surgery as soon as it is safe. 

What happens when I come to the SDEC? 

• Before you have arrive to SDEC you will have already been assessed by a clinician. This may be your GP, the physiotherapist, or emergency department clinician. 
• Your assessment will have met the criteria to rule out CES and you will have been referred to the emergency Neurosurgery service for an MRI of your lumbo-sacral spine (lower back). The MRI scanning unit is located at Gate 19 on Level 2. Once you have had your MRI, you will be asked to return to SDEC Gate 36, Level 1.
• After your MRI, the SDEC team managed by nurses will contact the on-call neurosurgery registrar to review your referral and MRI scan with the report.
• Whilst awaiting the MRI report, we may ask for a pre- and post-void bladder scan which will require you to tell the SDEC nurses before and after you pass urine.
• If there is no evidence of cauda equina compression following assessment of your case the Neurosurgery registrar will tell the SDEC nurses by phone after discussing with the on-call consultant. You will be discharged with relevant advice.
• If there are any concerns identified, the Neurosurgery registrar will see you in person to discuss options. You may be asked to only drink clear fluids until then in case you need urgent surgery.

Reason for urgent surgical intervention may include: 

• True cauda equina compression.
• Nerve root compression which may be causing foot drop. 

What is an MRI scan? 

An MRI scan is a way of assessing the space around your nerves of your lower back. It requires lying flat for approximately 30 minutes in a scanning unit. 

Please tell the MRI radiographer and the SDEC team if you have any of the following: 

• A permanent pacemaker. 
• Any surgical clip inserted in a previous operation or procedure. 
• Ever had a metallic foreign body in your eye. 
• Severe claustrophobia or inability to lie flat. 

Will I need any other tests? 

As part of this assessment, and depending on your symptoms, you may require a scan of your bladder.  This is an ultrasound scan where gel is applied to your lower abdomen to assess your bladder. 

Measurements need to be taken both before and after you go to the toilet to empty your bladder (pee). Therefore, please try not to pass urine until you have your assessment. If you need to use the toilet before your assessment, please speak to one of the nursing staff.

If I don’t need an operation, why do I still have pain and what do I do next? 

Pain can be caused by degenerative changes to the spine that are not always seen on the MRI scan. This may cause you to experience abnormal sensory changes, low back spasm, foot weakness and even bladder, bowel problems and erectile dysfunction in men. Without nerve compression shown on the MRI, surgery will not be required. 

In these cases, we will advise you see your GP for a pain review and consider stronger pain killers and referral to MATS (Musculoskeletal Assessment and Treatment Services) for further treatments. 

Stronger pain killers such as amitriptyline, gabapentin, pregabalin that work specifically on nerves, should be started by a clinician who can monitor your progress and side-effects. SDEC will be able to provide simple pain killers and laxatives to prevent constipation. 

The SDEC is only able to diagnose or rule out CES which is a neurosurgical emergency.  If this is ruled out, you will be asked to see the GP to consider other diagnoses that may cause referred back/leg pain (e.g. abdominal/pelvic pathology).

What happens if I get worse when I go home? 

If you develop any new symptoms when you go home, please seek urgent medical advice as the assessment done in the SDEC does not exclude future problems. It is important you seek advice urgently (within 24 hours of onset) if you develop: 

• New leg/foot weakness. 
• Bowel/bladder problems not related to severe levels of pain (new incontinence, inability to start or stop void, new urinary retention, or constipation unrelated to medications)lower back pain with buttock or leg pain that is getting worse. 
• New sensory changes affecting your buttock (bottom), for example you cannot feel when wiping.  
• New loss of sexual function or feeling during sex. 

Whilst you are in severe pain, please avoid strenuous levels of exercise, heavy weightlifting, long distance running that may make your pain worse and make you prone to injuries. Gentle exercises and physical activity are encouraged as reduced mobility may make your symptoms worse.

Is there anything else I should be aware of? 

Whilst attending SDEC please do not have anything to eat and only have clear fluids until the neurosurgery registrar and the SDEC nursing team have discussed your case. This is in case you require any form of anaesthetic for an operation to relieve any pressure on your nerves. 

Please consider any additional arrangements that may need to make such as childcare, contacting your work or family whilst you await your assessment, investigations and results.

© North Bristol NHS Trust. This edition published April 2024. Review due April 2027. NBT003620. 

Haematology advice

For non-urgent advice. Haematology aim to respond to Careflow referrals within 24 hours, Monday to Friday. If TTP or acute leukaemia is suspected please bleep 9441 in addition to sending the written referral, as these are Haematological emergencies. Provide your bleep/contact telephone number in case further discussion is required. For all other queries, please ensure you have reviewed Haematology Trust guidelines on LINK (Home Page - LINK (nbt.nhs.uk) and have discussed with your senior team member first. Answers to common Haematology questions can also be found via Guidelines for Primary Care (Remedy BNSSG ICB) and the Buku Medicine app (free to access via Apple Store or Google Play)

Haematology referral - new low level paraprotein detected

If the patient has a normal full blood count, renal function, calcium, negative BJP and normal SFLC ratio, and Monoclonal paraprotein of IgG less than 15g/L, IgA or IgM less than 10g/L and no bone pain then this is likely to be Monoclonal gammopathy of undetermined significance (MGUS). These patients do not need to be seen by a Haematologist and simply need GP monitoring. Please ask the Haematology secretaries for the MGUS GP information document, ask the GP to monitor according to this guideline. If you wish to speak to a Haem registrar, avoid bleeping before 2pm - unless urgent - as they will be in clinic or on a ward round

Haematology referral - new unexplained lymphadenopathy

If the patient has unexplained palpable or radiological lymphadenopathy please request a lymph node biopsy (not FNA) & request CT NCAP to look for other sites of Lymphadenopathy. Please also check FBC, renal and liver function, calcium, serum electrophoresis and LDH. We will be happy to advise on patient management if biopsy shows a haematological malignancy. Feel free to send patient details to us and then update us with biopsy results once available . It remains YOUR responsibility to chase up the biopsy results. If you wish to speak to a Haematology registrar, please avoid bleeping them unless it is urgent before 2pm as they will be in clinic or on a ward round

Haematology referral - suspected new myeloma

If patient has monoclonal paraprotein of IgG more than 15g/L, IgA or IgM more than 10 or IgD/E of any level, then please request FBC, renal function, liver function, Urine for BJP, SFLC, B2M, PV and request CT NCAP and head, and put CT whole body for myeloma in clinical details. We are happy to see/advise on management of these patients. If you wish to speak to a Haem registrar, please avoid bleeping before 2pm - unless urgent - as they will be in clinic or on a ward round

We hope that you never have reason to feel concerned about any of our services. However, if you do have an issue, the best thing to do is speak with a senior member of the relevant department. If you do this as soon as possible we can hopefully resolve the matter immediately. 

You can also contact the Trust's Patient Experience Team.

Trust Links

How to Raise a Concern or a Complaint | North Bristol NHS Trust (nbt.nhs.uk)

How to say thank you and offer a compliment | North Bristol NHS Trust (nbt.nhs.uk)

How to make a suggestion | North Bristol NHS Trust (nbt.nhs.uk)

Pathology Concerns and Complaints

These are best directed to the relevant department and either the service lead or laboratory manager. Contact details for each department are available in the following areas of our website:

• Antimicrobial Reference Laboratory: Antimicrobial Reference Laboratory | North Bristol NHS Trust (nbt.nhs.uk)
• Blood Transfusion: Blood Transfusion | North Bristol NHS Trust (nbt.nhs.uk)
• Bristol Genetics Laboratory: South West Genomic Laboratory Hub | North Bristol NHS Trust (nbt.nhs.uk)
• Cellular Pathology: Cellular Pathology Key Contacts | North Bristol NHS Trust (nbt.nhs.uk)
• Clinical Biochemistry: Clinical Biochemistry Contacts | North Bristol NHS Trust (nbt.nhs.uk)
• Haematology: Contact Haematology | North Bristol NHS Trust (nbt.nhs.uk)
• Immunology: Immunology & Immunogenetics Laboratory Contact Details | North Bristol NHS Trust (nbt.nhs.uk)
• Infection Sciences: Infection Sciences (Microbiology & Virology) | North Bristol NHS Trust (nbt.nhs.uk)
• Point of Care Testing: Point of Care | North Bristol NHS Trust (nbt.nhs.uk)

GMC number: 7077649

Year & location of first qualification: 2010, University of Aberdeen

Specialty: Obstetrics and Gynaecology

Clinical interests: Ambulatory Gynaecology, Gynaecology two week wait Lead

Secretary: Cherilyn Griffiths

Secretary phone number: 0117 414 6757
 

Member of the Royal College of Obstetricians and Gynaecologists
British Society of Gynaecological Endocopy

My Medical Record is a free and secure website where you can access information about your post cancer treatment follow-up. It is currently available to a limited number of cancer specialties at North Bristol NHS Trust.
The website enables you to self-manage your follow-up care from home, and allow your cancer support team to remotely monitor your test results and provide support. In many cases this will reduce the number of outpatient appointments you need to attend at the hospital. You will be invited by a member of your cancer support team to access My Medical Record at an appropriate point in your pathway. 

How to sign up

When appropriate, your Consultant or Clinical Nurse Specialist will refer you to have your follow-up remotely monitored by the cancer support team. You will then be introduced to the My Medical Record website and offered access.

To register for My Medical Record you will need to provide an email address and telephone number.

If you are already registered on My Medical Record, please visit My medical record (uhs.nhs.uk).

My Medical Record offers:

• Information and support to help you to self-manage during your follow up.
• A plan for the ongoing tests you need.
• The ability for you and your cancer support team to monitor your test results remotely.
• Secure online access to letters associated with your follow-up plan.
• A way to securely message your cancer support team.
• Access from any web-enabled device, at any time.
• Access to reliable information about your condition, such as websites, apps, videos, leaflets and support groups.

What if I do not have access to the internet?

If you do not have internet access or an email address, you may decide to allow a family member or friend to help you access the system or log in on your behalf. You must get their consent to do this as we will store their email address and telephone number with your details.

Looking after your password

The information in My Medical Record is confidential and personal to you. You should protect your access details and password in the same way you would for other online services.

My Medical Record is owned and operated by University Hospital Southampton NHS Foundation Trust and is licensed for use by NBT.

© North Bristol NHS Trust. This edition published February 2024. Review due February 2027. NBT003332. 

Consent

It is the responsibility of the responsible clinician to obtain consent for testing and storage. Our laboratories assume this has been done upon receipt of the sample and do not routinely check consent has been obtained.

Receipt of the sample and request form establishes an agreement to perform testing.

The following must be clearly stated on the referral form:-

Test required
Clinical details
Relevant family history
Mother’s details for prenatal testing requests

Where specific, informed consent is required for testing, this will be prompted on the request form. This is particularly appropriate for testing under the Human Tissue Act.

Further information on consent can be found in the following webpages:

• Consent for post-mortem examination and tissue retention under the Human Tissue Act 2004 | Human Tissue Authority (hta.gov.uk)
• Joint Committee on Medical Genetics
• Patient Consent & Information | North Bristol NHS Trust (nbt.nhs.uk)

Use of information

Pathology complies with the North Bristol NHS Trust policies to safeguard patient infomation Information Governance | North Bristol NHS Trust (nbt.nhs.uk).

Where there is a requirement to share information with a third party (e.g. regulatory or compliance body, or for monitoring of quality standards) information, comprising minimum data sets, will be only be shared once it has been fully anonymised. 

Gastroenterology research taking place at North Bristol NHS Trust

Please speak to the person treating you to see if there is a research study that may be able to help you.

Current Studies:

UK-PSC (A UK Collaborative Study to Determine the Genetic Basis of Primary Sclerosing Cholangitis)

PBC Genetics Study (Investigation of the Genetic and Molecular Pathogenesis of Primary Biliary Cirrhosis)

Promise

Reduce-2

Boppp

Static

Introduction

This information is for you if you are starting, or have already started taking a medicine called ciclosporin. This page contains important information on how to take this medication safely.

For most medicines, information is provided by the manufacturer in the medicine package. However, this medicine does not have a license to be used for ulcerative colitis in the UK. This means that the information provided by the manufacturer does not tell you everything you need to know. This leaflet has been designed to provide you with some extra information.

Unlicensed use

Some medicines have been licensed for a certain condition and then later, experience or research shows that it works well for a different condition. The manufacturer can choose whether to apply to the Government to have more recent information added to the license. This is expensive and in some situations it is not economically viable to extend the license.

Ciclosporin is an immunosuppressant made by the manufacturer to prevent organ rejection after transplant and for the treatment of rheumatoid arthritis and psoriasis. However, it is also useful in the treatment of ulcerative colitis.

What is ciclosporin and how does it work?

Ciclosporin works by suppressing the immune system, which is overactive in ulcerative colitis. When used in a severe flare of ulcerative colitis that has not responded to standard treatment for inflammatory bowel disease, including steroids, it has been demonstrated to reduce the need for surgical operations to remove the large bowel (known as a colectomy). 

Before starting treatment

Before starting treatment with ciclosporin your doctor should check if you have any allergies, if you are (or could be) pregnant, or breast feeding. Receiving treatment with ciclosporin while you are pregnant could harm your unborn baby. If you are of child-bearing potential you should ensure that you use an effective form of birth control to prevent pregnancy. If you think you have become pregnant while using the medicine, tell your doctor right away. 

Your doctor should check if you have any pre-existing medical conditions that could be complicated by treatment or if you take any medicines that may interact. 

Conditions which you should ensure your doctor is aware of include:

• Renal (kidney) or hepatic (liver) problems.
• Poorly controlled high blood pressure.
• Cancer.

What dose do I take?

The dose of ciclosporin is initially based on weight and may be adjusted according to the response and blood levels of the drug. Ciclosporin capsules are available as 10, 25, 50, or 100 mg strengths and you need to pay careful attention to the capsule strengths to achieve the correct dose. Ciclosporin is available in a liquid form if you have difficulty swallowing capsules. You should stay on the same brand of ciclosporin unless directed otherwise by your doctor.

How long will I take ciclosporin for?

Ciclosporin is usually a short-term (3-6 months) option as the risk of side effects increases with longer-term use. Most patients will be started on a medicine called a thiopurine (azathioprine or mercaptopurine) around the time of starting ciclosporin when there is evidence that symptoms are responding to ciclosporin treatment. The hope is that the thiopurine will take over from the ciclosporin and then keep the colitis in remission. You will receive information on this medicine if your consultant decides you need it. 

How should I take ciclosporin?

Some patients start ciclosporin intravenously (into the vein) when they are in hospital. If you respond well to the treatment, this is then changed to oral form (capsules or liquid) to take twice a day. Ideally the dose should be taken 12 hours apart. Capsules should be taken with water and swallowed whole. 

Grapefruit and grapefruit juice should be avoided as it can increase the ciclosporin levels in your blood.

How will I be monitored?

Regular blood tests will check the level of ciclosporin in the blood and also check that the kidneys and liver are working properly. These will be weekly initially, decreasing to fortnightly and then monthly once stable.

To measure the concentration of ciclosporin in the blood, the timing of the blood test is very important. We want to know the lowest drug level (drug trough level), which is 12 hours after your last dose, just before taking your next dose. Your ciclosporin drug level blood test should be planned for this trough level as best as possible. Your gastroenterology team at North Bristol NHS Trust will contact you if we need you to change your dose. 

Your blood pressure will be monitored regularly as ciclosporin may cause it to rise. These blood tests and blood pressure checks can be arranged with your GP surgery, and your GP will be informed of the monitoring you will need when you are on this medicine. The gastroenterology specialist pharmacists will be reviewing your blood results and will communicate any issues to you and your GP.

How will I get more prescriptions?

Ciclosporin can only be prescribed by a gastroenterology consultant or specialist registrar at North Bristol NHS Trust. 

The prescriber will ensure they provide you with enough medicine to last you until your next outpatient appointment. If you are running out of medications, or your dose changes and you require different strength capsules, contact the secretary for your consultant. Your GP will be informed that you are on this medication.

What are the common side effects?

The leaflet provided by the manufacturer for ciclosporin contains a list of all the effects reported for this medicine. It is very unlikely you will experience all the listed effects, but some of the most common side effects (occurring in more than 1 in 10 patients) are listed below:

• Headache.
• Increased hair growth.
• Slightly enlarged or sore gums.
• Shakiness of hands.
• Feeling sick.
• Reduced appetite.
• Metallic taste in the mouth.
• Cramps and painful periods – some women notice their periods cease whilst taking ciclosporin.

As ciclosporin suppresses the immune system, you are potentially at more risk of infections. If you develop a sore throat, any infections or begin to feel generally unwell contact your doctor, IBD nurse or pharmacist immediately.

What happens if I forget to take a dose? 

If you forget to take a dose, take another as soon as you remember, unless it is almost time for your next dose. Do not double dose. If you take too much tell your doctor immediately. 

Does ciclosporin interfere with other medication?

Ciclosporin can interact with other medications. Always tell your doctor that you are taking an immunosuppressant when any changes are made to your medication. You should also inform your dentist when you see them. Always check with your pharmacist before buying any over-the-counter medicines, alternative medicines or herbal remedies. Do not take aspirin or anti-inflammatory pain killers e.g. ibuprofen, unless prescribed by your doctor. 

Can I have vaccinations whilst I am taking ciclosporin?

You may not be able to have certain vaccinations whilst you are taking ciclosporin. All vaccinations may be less effective but live vaccines may also increase the risk of you developing the infection it’s protecting you from therefore should be avoided. Example of live vaccines are rotavirus, shingles, varicella, MMR (or any of the separate measles, mumps or rubella vaccines), yellow fever, oral typhoid and BCG. Discuss 
with your GP or IBD nurse before having any vaccinations.

For prescription queries please contact your consultants’ secretary or the gastro pharmacists/IBD nurses.

IBD advice line: 0117 4146354

Appointments helpline: 0300 5550103

© North Bristol NHS Trust. This edition published January 2024. Review due January 2027. NBT003124.

What is hepatitis B?

Hepatitis B is a serious inflammation of the liver that is caused by a viral infection.

It is spread by contact with blood and body fluids.

If you have long-term hepatitis B infection you can infect other people with the disease, even if you are well.

Around 1 in 5 people living with long-term hepatitis B will develop scarring of the liver. This happens over 10-20 years and is known as cirrhosis.

Why are people with chronic kidney disease at more risk of hepatitis B?

People with CKD are at an increased risk of hepatitis B infection because they are exposed to blood and body fluids during haemodialysis.

Some countries outside the UK have a higher rate of hepatitis B infection, so it is particularly important to be immunised if you plan to have haemodialysis abroad.

Procedures are in place to reduce the risk of hepatitis B infection across all sites supported by the Richard Bright Renal Unit, however the risk cannot be removed completely.

The Department of Health recommend that people with CKD are immunised against the hepatitis B virus. You won't have to pay for the vaccinations.

People who will need dialysis or may have a kidney transplant in the future are all offered immunisation.

People who have had a kidney transplant need to take medicines which dampen their immune system (immunosuppressive drugs). This makes it more difficult for their body to fight infection and can increase the risk of them developing a more severe hepatitis B infection.

The vaccine is safe for people on the kidney transplant waiting list.

Vaccination also prevents the disease spreading and causing harm to other people.

How is the vaccination Given?

The treatment involves a course of injections – which will be given in your upper arm, over a number of months. A nurse at your kidney unit clinic or haemodialysis unit will give you the injections.

The vaccination that will likely be given and the doses are described below, however there are other brands of vaccination available, so this may change. They will be given over a time period of six months.

Vaccination: HB VAX PRO 40®

• Dose: 40mcg/ml
• Total number of clinic visits: 3

Vaccination: ENERGIX B®

• Dose: 40mcg/ml = 2 X 20mcg/ml per dose
• Total number of clinic visits: 4

The doses of the vaccine used for people with chronic kidney disease are slightly higher than those used for people without kidney disease.

What happens when I have the vaccine?

The vaccination will encourage your body to produce antibodies to fight the hepatitis B virus – in case it  enters your blood stream. 

Your kidney doctor, pre-dialysis or dialysis nurse will arrange for you to have a blood test to measure your antibody level once you have completed the course of injections (2 months after you receive the 3rd dose).

For your protection, it is recommended that your antibody level is greater than 100mlU/ml. 

A level between 10 & 100 mlU/ml – will still give you some protection, but your doctor/nurse may recommend a further injection of the hepatitis B vaccine (a booster).

If you are on haemodialysis your hepatitis B antibody levels will be measured every year. If you level drops below 10mlU/ml you may be advised to have a booster injection.

For the immunisation to be most effective – it is very important that you have the injections at the recommended time and complete the course. Your doctor/nurse will remind you when your injections are due. We can provide you with a hepatitis B vaccination card if you wish.

Does the vaccine have any side-effects?

As with any vaccine, you may have a reaction or experience side-effects. These may include the following:

Common (about 1 in 10 people): 

• Redness, tenderness, pain, and swelling at the injection site (this usually only lasts a few days).
• Headache. 

Uncommon (about 1 in 100 people): 

• Fever or flu-like symptoms.
• Skin rash.

Very rare (less than 1 in 10,000 people):

• Severe reaction: swelling of your face with difficulty breathing (anaphylactic reaction). 

Whoever gives you your vaccine will discuss possible side-effects with you. 

Who should not have the vaccine?

Before you have the first dose of the hepatitis B vaccine, please tell your doctor/nurse if you have had a severe reaction to any vaccine in the past.

If you have had a previous severe reaction to the hepatitis B vaccine you should not have another Hepatitis B vaccination.

If you have a high fever or severe infection when your vaccination is due, the vaccine should be given after you have recovered. If you have a minor infection e.g. cold – this should not be a problem with having the vaccination. You can discuss this with the nurse/doctor before you receive the jab.

There is no evidence of any risk from vaccinating pregnant or breastfeeding women against hepatitis B.

NHS Website: Hepatitis B - NHS (www.nhs.uk)

Please speak to your kidney doctor or renal nurse if you are unsure of anything or if you have any further questions or website: Renal (Kidney) | North Bristol NHS Trust (nbt.nhs.uk)

© North Bristol NHS Trust. This edition published February 2024. Review due February 2027. NBT002096.