Support with AAC devices

Here is some information about what to do for some common issues with AAC devices.  

Please only contact AAC WEST about devices that we are responsible for. 

Our contact details are at the bottom of this page.  

Supplier contact details 

Check your device for the company name. Suppliers can support with a range of issues. If you give them consent they can have remote access to your device to provide support. 

• Smartbox (Grid)
  • info@thinksmartbox.com
  • 01684 578 868                   
  • www.thinksmartbox.com
• Jabbla UK (previously called Techess)
  • info@jabbla.co.uk
  • 01476 561 991
  • www.jabbla.co.uk
• Tobii Dynavox
  • support.uk@tobiidynavox.com
  • 0114 481 0011
  • www.uk.tobiidynavox.com
• Liberator
  • info@liberator.co.uk
  • 01733 370 470
  • www.liberator.co.uk 

AAC WEST contact details 

Please contact us if the above do not resolve your device issue. 

Admin

• For admin, appointments, and referral queries.
  • aacwestadmin@nbt.nhs.uk
  • 0117 414 5850

Tech Team

• For hardware issues like faulty batteries, broken screens, missing equipment, and frozen iPads.
• aacwesttech@nbt.nhs.uk                                     
• 0117 414 5850

Support

• Support for software issues like missing grid sets/cells, Dropbox/account issues, and connectivity.
• aacwestsupport@nbt.nhs.uk
• 0117 414 5850

© North Bristol NHS Trust. This edition published October 2025. Review due October 2028. NBT003817.

Leukaemia and Non-Hodgkin Lymphoma Diagnosis and Monitoring

The laboratory provides a comprehensive service in the investigation of Leukaemia and Non-Hodgkin Lymphoma. Immunophenotyping provides additional information to morphology and cytogenetics in the diagnosis, classification and monitoring of these disorders.

HIV Monitoring
Immunophenotyping is used serially to monitor CD4 levels.

Investigation of Cellular Immunodeficiency Disease
Wrong choice of tests, especially in the paediatric setting, can mean rare cases of immunodeficiency are missed. Vital information includes type and site of infections, family history, other pathology results, X-rays and clinical features. Please refer to the Clinical Immunologists: ward or clinic referral is the ideal.

• Immunophenotyping identifies numerical defects in lymphocyte subsets, inherited or acquired, and are indicated in cases with recurrent viral, fungal or mycobacterial infection.
• PNH Testing performed on peripheral blood samples looking for the absence of GPI-linked proteins on neutrophils, monocytes and red blood cells.
• Functional Leucocyte Assays

These assays are technically complex and require prior discussion with the laboratory. Abnormalities are rare, most commonly due to poor sample quality, testing during drug therapy or intercurrent infection.  Abnormal findings should always be confirmed on a second sample.  True abnormalities may need further, more specialised tests to specify the disorder.

• Lymphocyte function studies are indicated in cases of recurrent viral, fungal and mycobacterial infections in whom no numerical lymphocyte defect has been defined. The investigation provides a measure of lymphocyte activation. Lymphocytes are cultured for 5 days with mitogens which mimic antigen activation.
• Neutrophil function studies screen for defects in the metabolic burst and adhesion molecules and are indicated in cases with recurrent fungal or bacterial infection with a normal neutrophil count (>1x109/1).A normal result excludes major defects in neutrophil function.

Quantiferon Assay

The QuantiFERON-TB test is an interferon gamma release assay (IGRA) used for the diagnosis of latent Tuberculosis (TB). The assay requires special blood tubes and has specific sample handling requirements. The laboratory can issue guidance and sample tubes to requestors. Interpretation of the result needs to be in the context of clinical history and other laboratory and clinical investigations.  The antigens used in the test are absent from all BCG vaccine strains of TB and from most known non-tuberculoid mycobacteria, it is possible to have a reactions to M. kansasii, M. szulgai and M. marinarum.  If such infections are suspected, alternative testing should be sought.

The QuantiFERON-TB test (and other TB IGRAs) may give false negative results in immunosuppressed patients. The laboratory provides a positive control tube for all tests to ensure the validity of results. Where the positive control fails (indeterminate result) the laboratory may suggest alternative testing. Please see guide below for interpreting indeterminate results.

Guide to interpretation

•    Negative: A negative result indicates that latent infection with M. tuberculosis is NOT likely. This result does NOT exclude active TB infection. The investigation of suspected active TB requires clinical, radiological and microbiological assessment.
•    Positive: A positive result is consistent with latent or active TB. This result may be due to exposure to M.tuberculosis complex (except M. bovis BCG), M. kansasii, M. szulgai or M. marinarum.  IGRA should not be used for the investigation of suspected active TB. The investigation of suspected active TB requires clinical, radiological, and microbiological assessment.
•    Indeterminate: The likelihood of the patient having M. tuberculosis infection cannot be determined from the blood sample provided. Please see the guide to interpreting indeterminate results below.

Quick guide to interpreting INDETERMINATE and EQUIVOCAL QuantifFERON-TB results

INDETERMINATE RESULTS

An indeterminate result from the QuantiFERON-TB assay means that the likelihood of the patient having M. tuberculosis infection cannot be determined from the blood sample provided.

The majority of indeterminate results are caused by a low T lymphocyte response to mitogen stimulation (reported as mitogen tube failure).  
This can be caused by:

•    An insufficient number of T lymphocytes in the blood sample. Is the patient immunosuppressed?
•    A functional inability of the patient’s lymphocytes to generate Interferon-gamma (IFN-γ) in response to mitogenic stimulation, for example if they are taking drugs that supress their immune system.
•    Reduced lymphocyte function due to improper sample handling.

Ideally repeat the QuantiFERON-TB test once with a fresh blood sample. If a mitogen tube failure is reported a second time, there is no value in repeating the QuantiFERON-TB test again until the underlying cause has been identified and resolved. 

Rarely a high background in the negative control (Nil) tube generates an indeterminate result. 
This can be caused by:

•    Excessive levels of circulating IFN-γ or the presence of heterophile antibodies in the sample. Stimulating the cells further as part of the QuantiFERON-TB test does not produce a further IFN-γ response.

Ideally repeat the QuantiFERON-TB test once with a fresh blood sample. If a high background is reported a second time, there is no value in repeating the QuantiFERON-TB test again until the underlying cause has been identified and resolved.

Other causes of indeterminate results can include:

•    Incorrect filling/mixing of the Lithium Heparin or QuantiFERON-TB tubes.
•    If the time between venepuncture and sample incubation in the laboratory is greater than 16 hours.

These indeterminate samples should be repeated using the correct sampling and handling procedures.

For further information please see:

https://www.qiagen.com/gb/tb-testing/what-is-quantiferon/how-does-qft-work/quantiferon-tb-test-result-interpretation

EQUIVOCAL RESULTS

An equivocal reference range of 0.2 – 0.7 IU/mL is now applied to the Q-TB results generated when subtracting the negative control tube value (NIL) from the TB1 and TB2 tube results: TB1-NIL and TB2-NIL.

Where both TB1-NIL and TB2-NIL results are within the equivocal range (0.2 – 0.7), or where one result is equivocal (0.2 – 0.7) and one is true negative (<0.2) the Q-TB results will be reported as EQUIVOCAL with the following interpretation applied:

The significance of this result is uncertain. The risk of progression to active TB disease is likely to be different when compared to patients with clear positive (>0.7) or clear negative (<0.2) results. Suggest repeat testing if clinically indicated; approximately one third of patients with equivocal results will revert to either a clear positive or clear negative result when a fresh blood sample is analysed within six months. We would recommend repeat testing again in 4-8 weeks where practical. Where this is not practical, we would recommend a repeat test in weeks rather than days.

Why have we implemented an equivocal reference range?

Reversion and conversion of low positive (TB-NIL: 0.35 – 0.7) and high negative (TB-NIL: 0.2 – 0.34) Q-TB results on repeat testing is a well-recognised phenomenon. To address this issue, multiple European centres have proposed an equivocal range of 0.2 – 0.7 IU/mL [1-7]; conversion to true positive results have been shown to occur most frequently when the first Q-TB result is between 0.2 – 0.35 IU/mL, and reversions to a true negative result have been shown to occur more frequently when the initial result is between 0.35 – 0.7 IU/mL [5].

The Royal Free hospital in London has implemented this equivocal range in line with other low-incidence TB European settings [6].  Data from the Royal Free lends support to the use of the equivocal range for the reporting of Q-TB results; ~1/5th of their results that fell just below the 0.35 cut-off were positive when repeated on a fresh blood sample, and half of those just above the 0.35 threshold were negative when repeated on a fresh blood sample. This data strongly implies that relying on results within the equivocal range could result in either over-treatment or under-treatment of patients.

1. Torres Costa J, Silva R, Sa R, et al. Serial testing with the interferon-gamma release assay in Portuguese healthcare workers. Int Arch Occup Environ Health 2011; 84: 461–469.
2. Schablon A, Harling M, Diel R, et al. Serial testing with an interferon-gamma release assay in German healthcare workers. GMS Krankenhhyg Interdiszip 2010; 5: Doc05.
3. Schablon A, Diel R, Diner G, et al. Specificity of a whole blood IGRA in German nursing students. BMC Infect Dis 2011; 11: 245.
4. Ringshausen FC, Schablon A, Nienhaus A. Interferon-gamma release assays for the tuberculosis serial testing of health care workers: a systematic review. J Occup Med Toxicol 2012; 7: 6
5. Nienhaus A, Ringshausen FC, Costa JT, et al. IFN-gamma release assay versus tuberculin skin test for monitoring TB infection in healthcare workers. Expert Rev Anti Infect Ther 2013; 11: 37–48.
6. Brown J, Kumar K, Reading J, et al. Frequency and significance of indeterminate and borderline Quantiferon Gold TB IGRA results. Eur Respir J 2017; 50: 1701267
7. Hermansen TS, Lillebaek T, Langholz Kristensen K, et al. Prognostic value of interferon-gamma release assays, a population-based study from a TB low-incidence country. Thorax 2016; 71: 652–658.

Introducing supported self-management

North Bristol NHS Trust (NBT) has introduced supported self-management and remote monitoring. This is done using a website called My Medical Record (MMR). This can be used to manage your follow-up care securely.

Regular follow-up appointments can involve organising travel and time off work, which can be costly and inconvenient. Although some people find these appointments useful and reassuring, some find them unnecessary unless they have something specific to discuss.

If individuals report symptoms and concerns as they occur, rather than waiting for a routine appointment, this can help address concerns more quickly.

Following breast cancer treatment, you will be followed up for a period of time (usually 5 years) when you can contact your Breast Care Team directly if you have any queries or concerns.

What does supported self-management and remote monitoring mean?

• Supported self-management: This enables you to take a leading role in your follow-up with support as needed.
• Remote monitored: The Breast Care team can monitor your health and plan of care even when you are not in a face-to-face appointment.

The main aim is to enable you to develop the skills and knowledge to:

• Make positive choices about your health.
• Manage the physical and emotional impact of breast cancer and its treatment.
• Make healthy lifestyle changes.

Follow-up after breast cancer treatment

Depending on the type of treatment you have had, you may have a plan of regular mammograms or other imaging.

At NBT we use MMR to provide you with your monitoring plan, test results, and useful resources.

You can use it to message your cancer support team securely with non-urgent queries.

After finishing treatment, a Breast Clinical Nurse Specialist will discuss your monitoring plan and how self-supported management works.

Once introduced to MMR, you will be offered access to the website. You can access the website from your smart phone, tablet, or computer at any time.

Here is a short film about MMR: 

After watching this video, if you would like to use MMR, you will be provided with login details. You can also choose not to use MMR, your monitoring will continue with routine telephone appointments.

What tests will I have?

• Yearly mammogram or MRI depending on your follow-up plan. We call this surveillance. Usually this is for 5 years.
• Depending on your treatment pathway, you may be prescribed anti-hormone tablets. We call this endocrine therapy.
• At the end of your monitoring period, you may continue to have imaging tests under the National Breast Screening Programme, depending on your age.

Imaging appointments will be arranged by the Radiology Administrative Team.

You will receive an appointment to attend the hospital typically 1 year from when you had your surgery, and yearly afterwards for the monitoring period.

Your mammograms will be carried out by the Radiology department at the Breast Care Centre during your period of follow-up.

MMR will show when future tests are due.

• If your test results are normal, a digital letter confirming this will be available on MMR, as well as the date of your next test.
• If your test results are abnormal, the Breast Cancer Team will contact you. You will likely be asked to come to an appointment at the Breast Care Centre.

Picture of the MMR homepage

Useful resources available on MMR

Information resources including websites, leaflets and videos are available on MMR. These cover topics such as:

• Managing the side effects of treatment.
• Self-examination.
• Healthy lifestyle.
• Support groups.

Contact information

© North Bristol NHS Trust. This edition published February 2026. Review due February 2029. NBT003691

If you have been offered an appointment with us, it is because your local speech and language therapist has referred you. 

What to expect  

Appointments 

Your appointment may take place at your home, your school/college, your day centre/hospice/care setting or at one of our outpatient service buildings. 

Your appointments will usually last around 2 hours but may take longer. We will offer you regular breaks and can split the assessment over two appointments if needed.  

Who will be there? 

• Your local speech and language therapist. 
• An AAC WEST speech and language therapist. 
• An AAC WEST occupational therapist.  
• An AAC WEST assistant practitioner. 
• Your school, college or day centre staff. 
• Your family, carers or support staff. 

There may be lots of people at your appointment, please let us know if there is any way we can make it more comfortable for you.  

Appointment pathway 

1. Referral – your referral is made by your local speech and language therapist.  
2. Initial assessment – we will assess your communication access needs (how you select what you want to say). 
3. Equipment provision – an AAC device is loaned to you and we will set your goals together.  
4. Review/final review – your AAC and goals will be reviewed. At the final review we hand your care back over to the local team.  

What will happen in my initial assessment?

What will happen in my equipment provision appointment?

What will happen in my review?

What will happen in my final review?

What is an Emergency Appointment?

What is a mounting appointment?

© North Bristol NHS Trust. This edition published December 2026. Review due December 2029. NBT003829.

Introduction

This page will tell you about Exclusive Enteral Nutrition (EEN). It will answer some questions you may have about it.

What is Crohn’s disease?

Crohn’s disease can affect any part of your gut. It causes inflammation, ulcers, swelling and soreness on the lining of your gut.

When symptoms are under control, it is known as remission. When symptoms are more active, it’s called a flare-up.

Crohn's disease is a lifelong illness. It currently has no known cure. However, medications, surgery, or a mix of the two can help you stay well.

Symptoms of Crohn’s disease can include:

• Feeling tired. 
• Diarrhoea.  
• Blood in your poo.  
• Constipation.  
• Bloating and wind. 
• Tummy pain.  
• Joint problems and/or weaker bones.  

What is EEN?

It is a liquid only diet. The aim is to put your Crohn’s into remission or to reduce your symptoms. The diet is followed for a short time of 6-8 weeks.

It replaces all food and most drinks with prescribed drinks. These drinks will provide all you need to stay healthy. These drinks come in a range of flavours. Your dietitian will tell you how many drinks you need.

We don’t fully know how it works. One idea is that it helps the gut ‘rest’. Some studies have shown it works for 45-75% of patients.

Sometimes you will need to follow it if you have a narrowing in your gut called a stricture. Your doctor will tell you if you have this.

How long will I need to follow EEN?

• It should usually be followed strictly for 6-8 weeks. This depends on your response. 
• Once you start to eat food again, you may need to continue some of the drinks. Your dietitian will advise on this.  

My target for EEN

• Extra fluid you need: 
• Provides:
  • kcal:
  • g of protein:
  • ml fluid:

Following this diet can be hard! Here are some tips to make it easier:

• Freeze your drinks into ice lollies.
• Try lots of flavours. Your dietitian can discuss this with you.
• Spread your drinks throughout the day.
• Sip on the drinks slowly to make them last longer.

Contact your dietitian if you can’t finish all your drinks.

How do I know if EEN is working?

The treatment goal includes:

• Remission.
• Normal bloods.
• Healing of your gut.
• Better quality of life.

We can use The Harvey-Bradshaw Index to see if the diet is working. 

This table is at the back of the sheet for you to fill out. Please fill it out before, during, and after your diet. 

If you have an appointment with a dietitian, please take this completed with you.  

What happens after your EEN diet?

After following EEN for a minimum of 6 weeks, you can slowly reintroduce food over 5 days. This is an example based on a total based on total 2400kcal.

• Day 1 - breakfast, 7 nutritional drinks.
• Day 2 - breakfast, lunch, 5 nutritional drinks.
• Day 3 - breakfast, lunch, dinner, 3 nutritional drinks.
• Day 4 - breakfast, mid-morning snack, lunch, afternoon snack, dinner, 1 nutritional drink.
• Day 5 after EEN - follow your normal diet. You may need to continue the nutritional drinks for weight gain or support. You can discuss this with your dietitian.

Going forward

There is no specific diet you need to follow when your Crohn’s is in remission. No diet has been proven to help keep you in remission. Also, no foods can cause flare-ups. Some foods may trigger symptoms, but they can’t cause a flare-up. If that happens, use the food and symptom diary at the back of this booklet. It may help you spot trigger foods when you are in remission.

Key points for diet in remission

• Aim for a healthy, balanced diet that gives you all the nutrients you need to stay healthy.
• Avoid cutting out foods or food groups, as you would miss out on important nutrients.
• Try to eat a variety of fruits, vegetables, nuts, seeds, proteins, and whole grains.
• Limit high-fat, high-sugar, and high-salt foods, especially animal fats and processed meats.
• You don't need to cut back on fibre unless you have a narrowing in your gut (called a stricture).

Always talk to your GP, IBD team, or dietitian before making major changes to your diet.

Harvey-Bradshaw Index for Crohn’s

Food and symptom diary

© North Bristol NHS Trust. This edition published February 2026. Review due February 2029. NBT003821

AAC WEST process for working with people who have a privately funded AAC device 

If an individual has an AAC device funded through private, medicolegal, or charity routes, they may still be referred to AAC WEST by a health, education or social care SLT if they meet NHS specialist services criteria. (See How AAC WEST work with independent professionals, suppliers and charities)

Please note the following important points: 

• AAC WEST will carry out an impartial assessment of the individual’s AAC needs before making decisions about next steps.  As part of this assessment we will review all privately purchased elements and make a decision about whether this best meets the person’s needs. This would include reviewing the device, software, access method, accessories, and mounting solutions.  
• Decisions are made at the conclusion of the assessment process. This may be a single assessment appointment, but will usually (though not always) include a trial/review period. 
• AAC WEST’s assessment may include consideration of other assistive technology needs, but the primary focus will be on the individual’s communication needs. 
• Our recommendations may differ from previous advice. 
• We do not reimburse any costs associated with purchasing or hiring devices privately. 

Potential outcomes following AAC WEST assessment 

Where the AAC user/family accept the above points, we would proceed with an AAC WEST assessment. The following outlines the typical potential outcomes of an AAC WEST assessment for people who have a privately funded AAC device. 

A. Current AAC setup is appropriate and NHS criteria is met. 

If the AAC WEST assessment indicates that the current AAC setup (device, access method, vocabulary, mounting) is appropriate and NHS Specialised Services criteria has been met, AAC WEST will: 

• Offer to take on responsibility for the device. 
  See section below: What does it mean for AAC WEST to take on responsibility for a device?
• Recommend and provide mounting solutions. 
• See section below: What if the AAC user/family does not wish for AAC WEST to take on responsibility? 

B. Current AAC device is appropriate, but setup needs adjusting.

If the AAC WEST assessment indicates the device is suitable, but changes are needed to optimise the set up, AAC WEST may recommend a trial period to explore some of the following: different access method, vocabulary package, or software settings.

If the trial is successful and NHS criteria is met: 

• AAC WEST will offer to take on responsibility for the device. 
• Provide mounting solutions. 
• See section below: What if the AAC user/family does not wish for AAC WEST to take on responsibility? 

C. A different AAC solution is recommended and NHS criteria is met.

If the AAC WEST assessment indicates a different AAC solution is needed, AAC WEST may recommend a trial of an alternative AAC solution. This trial will follow our standard pathway.

See section below: What if the AAC user/family does not wish to follow AAC WEST's recommendation.  

D. NHS criteria is not met 

AAC WEST assessment indicates the individual does not meet NHS Specialised Services criteria, and therefore their AAC needs should be met locally. 

• AAC WEST will provide recommendations in a written report.
• Responsibility for the AAC device and support remains with the family and/or local team. 
• Mounting solutions will not be provided. 

Important notes 

• AAC WEST will only be responsible for one AAC device per person. If a device has previously been provided by AAC WEST, it must be returned before we take on a new privately funded device. 

What does it mean for AAC WEST to take on responsibility for a device?

What if the AAC user/family does not wish for AAC WEST to take on responsibility of the device?

What if the AAC user/family does not wish to follow AAC WEST’s recommendations?

Independent Professionals  

Definitions: 

• A statutory professional is employed or commissioned by health, education or social care.  
• An independent professional (also referred to as ‘private’) is not directly employed or commissioned by these services. They may be funded by individuals, families, charities or by medicolegal settlement.  We will use ‘independent professional’ to include Speech Therapists, Occupational Therapists, Physiotherapists, AAC Consultants, AAC Teachers, and home school tutors. 

At AAC WEST, we value collaborative working to achieve the best possible outcomes for our AAC users.  We encourage input from independent professionals, however only statutory Speech Therapists can refer to AAC WEST due to the way that NHS AAC Specialised Services are funded.  

Working with independent professionals can work well when: 

• The statutory SLT and the independent professionals work together. They can both contribute to the AAC assessment and the AAC WEST referral form. 
• Everyone knows their role from the start and respects each other’s work. You can use tools such as ‘Choosing Roles in AAC Decision Making’ to help (can be found on the I-ASC Resources website). 
• The team shares the same goals, with the AAC user at the centre. 
• There is clear and open communication. Everyone is kept up to date. 
• Everyone supporting the AAC user follows the plan made by AAC WEST. 
• The AAC user, family, and professionals understand: 
  • The AAC WEST assessment process 
  • The criteria for NHS AAC specialised services 
  • How funding works 
  • That AAC WEST will: 
    • Carry out impartial assessments. 
    • Aim to find the best AAC option for the user, whether it’s low tech (paper based) or high tech (powered). 
    • Make recommendations that may differ from previous advice, even if devices were already tried or bought. (See also Privately funded devices).

If the AAC user or team want to try something different to AAC WEST’s recommendations, they can choose a private AAC pathway instead of the NHS one. 

AAC Suppliers and Assistive Technology Charities  

(visits, trials, loans for people not seen by AAC WEST)  

Some families or clinicians arrange visits from AAC suppliers. This can help the team to explore potential AAC options, but it may also make things more confusing, as the AAC user and their family will receive advice from multiple people. 

We recommend: 

• The clinician (statutory and/or independent) maintains responsibility on these visits, and makes the clinical decisions. 
• Everyone knows their role: 
  • AAC suppliers bring technical knowledge of their company’s devices. 
  • Clinicians bring knowledge about the AAC user.  
• The clinician considers arranging visits from multiple suppliers to explore different options. 

If the AAC user is referred to AAC WEST, we will: 

• Carry out an impartial assessment 
• Aim to find the best AAC option for the user, whether it’s low-tech (paper-based) or high-tech (powered). 
• Make recommendations that may differ from previous advice, even if devices were already tried or bought. We do not refund money spent on privately bought or hired devices. (See also Privately funded devices).

This page has information for people who have been referred by your GP or specialist to the Bristol M.E. Service for an assessment.

What happens now?

Your first appointment normally takes about an hour. We can offer face to face, video, and telephone assessments. We hope to offer a time that works for you. If you need to take a break part way through your assessment, please let us know.

The assessment appointment will give us more information about your health problem and the effect this has on your everyday life. It does not involve any kind of physical tests.

We will also send you a link to some questionnaires which include the questions we ask in the assessment so you have time to think about your answers. This is so that we can build up a clearer picture of your difficulties, and answer any questions you may have. We can then work out with you the best way to take things forward.

We offer a variety of approaches depending on your needs. Our main focus is to help you develop a range of coping strategies to improve your quality of life. You may be offered one or more of the following:

• Individual contact based on your needs. 
• Group self-management programme using video conferencing/calls. 
• Us giving advice to existing services or organisations involved in your care. Face to face, video, or telephone appointments.
• Face to face, video, or telephone appointments.

Who is involved in running the service?

This service includes:

• Occupational therapists
• Physiotherapists
• Psychologists
• Specialist dietitians

All these professionals are specialists in helping people to manage ME/CFS and post viral fatigue syndromes such as long COVID. We are all committed to understanding your individual difficulties. Fatigue and other symptoms can affect your life in many ways and this varies between people. Because of this we tailor our approach to meet your needs.

Where can you find out more about ME/CFS, post viral fatigue syndrome and long COVID?

You might find these web pages from our website to be helpful:

• Foundation Phase Online Course
• Long Covid Information 
• Employment with Fatigue and Pain Online Course 
• ME/CFS Useful Resources

Please note that not everyone that we assess will have (or be given) a diagnosis of ME/CFS, post viral fatigue syndrome, or long COVID. So, please be aware that this information might not be appropriate to everyone referred to the Service.

© North Bristol NHS Trust. This edition published February 2026. Review due February 2029. NBT003856

Don’t

Do not move around existing vocabulary cells – there is a lot of research behind where cells are placed. Moving cells also impacts on the motor patterns the AAC user has learnt.

Do not give out the guided access code (if the device has one) to a young AAC user or others who may not understand these guidelines around editing.

Do not delete words or phrases – your AAC user or someone who models on the device may still need access to these.

Do not duplicate words or phrases to another part of the vocabulary without a good reason – check this with your local SLT.

Do not have lots of different people editing the device – this can quickly make the vocabulary disorganised and confusing.

Do

Get your AAC user involved in suggestions of what words and phrases they would like on their device.

Ask for vocabulary suggestions from other places your AAC user spends time – family members, friends, day centres, clubs etc.

Have a system in place for reviewing your AAC user’s vocabulary and do this regularly – at least every term.

Ask for support from AAC WEST (if the AAC user is still being seen by them) or your local SLT.

Agree on a main device editor – others can still be involved in contributing, via email, a shared notebook, whatever works for you.

Understand the colour coding system for different word types on your vocabulary. Ask AAC WEST or your local SLT for more information. It’s important to stick with this system for new words you are adding to help your AAC user learn them.

Attend AAC WEST Software Training to help you learn/refresh your editing skills.

Attend AAC WEST Keeping Vocabulary Updated training for further resources and information about how to ensure your AAC user has access to words they need.

What is hypersensitivity pneumonitis? 

Hypersensitivity pneumonitis is a condition in which your lungs develop an immune response (hypersensitivity) to something you breathe in and results in inflammation of the lung tissue (pneumonitis).

What are the causes of hypersensitivity pneumonitis?

What are the symptoms of hypersensitivity pneumonitis?

What tests will I have?

What happens to patients with hypersensitivity pneumonitis?

How is hypersensitivity pneumonitis treated?

How can I help myself?

Resources

© North Bristol NHS Trust. This edition published June 2023. Review due June 2026. NBT002702