Trail Point 5
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Visibility
Watch the below message from NBT staff member Gwyneth Brain (She/Her), Associate Practitioner in Severn Pathology, about the importance of visibility.
Trail Point 4
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This Pride Month, when we think about how we can best support LGBTQIA+ people as patients and colleagues, we should consider the overlapping identities that people may hold and how those may impact them.
Read the following article from NHS Employers to learn more about intersectionality: www.nhsemployers.org/articles/understanding-intersectionality-diverse-engagement
Trail Point 3
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Listening to our LGBTQIA+ patients and visitors
The voices of our patients, parents, carers and visitors matter to us. We want to learn from your feedback and strive to ensure NBT is an inclusive place for all.
We have asked some patients, as members of the LGBTQIA+ community, what would improve their experience at NBT. Have a read through to see if there are things you can do to improve inclusion.
"It’s the small and simple things that can have the biggest impact on my confidence in accessing healthcare without fear of judgement and discrimination. Whether that is wearing a progress pride pin badge, a rainbow lanyard or the clinician introducing themselves including their pronouns. If I am to fully engage in my health, attend my regular clinic appointments and adhere to taking my medication I need to feel seen and valid when I attend those appointments. This will allow me to have full conversations with my clinicians so they can provide the best care for me.”
Aled Osborne (He/Him), Community Engagement Manager for Brigstowe
“It seems inconsequential, but asking, 'So, is this your partner?' instead of 'So, is this your boyfriend?' has been enough that I can fully engage in an appointment. A clinician at Southmead asked me whether I had a partner recently. I instantly felt like safer and could talk more honestly, and I know it doesn't make much sense to some people, but it's just a tiny thing that has a massive impact on my ability to be comfortable in an environment that can often be quite scary.”
Anonymous Patient
“It's really encouraging when a clinician doesn't make assumptions about me based on gender or being straight. This goes beyond avoiding an awkward situation, and it shows me that they're ready to see me as a person rather than a set of assumptions, which is how I want to feel in a healthcare context.”
Anonymous Patient
As a patient or carer you can also feedback to us in many ways. You can send a Thank You, make a suggestion or raise a concern. If you want to get more involved and regularly input into making NBT a better place you could join us as a Patient and Carer Partner. Our Patient and Carer Partners are a group of volunteers who work closely with the Trust as critical friends. Our Partners use their experience as patients or carers to represent the views of patients, their families, carers, the public and our local communities. They help us ensure the patient’s best interests are at the centre of all our work.
Trail Point 2
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The Importance of LGBTQIA+ Allies
Listen to an audio clip from Liz Jordan (She/Her), Library and Knowledge Service Manager, sharing different insights on how to be an LGBTQIA+ Ally and why it's important.
Trail Point 1
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Celebrating Pride at NBT
Watch the below message from our Chief Nursing Officer, Professor Steve Hams (He/Him) about celebrating Pride month at North Bristol NHS Trust.
SWGLH Inherited Cancer Testing Services
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SWGLH Contact us
Educational resources
SWGLH Inherited Cancer Testing Services
This page provides information and toolkits to support clinicians who are requesting germline genetic tests for inherited cancer syndromes. The toolkits provide a step by step guide for selecting and arranging these tests, including key forms for consent and arranging samples.
The following drop-down boxes contain information for some of the inherited cancer testing services we support. For a full list of genetic tests available via our service, please visit the National Test Directory.
R207 Inherited Ovarian Cancer
Step 1: Check Patient Eligibility
Eligibility for these tests is determined according to the National NHS England » National genomic test directory - see rare and inherited disease eligibility criteria. If, after accessing the directory and the toolkit, you are unclear about eligibility or sample arrangements, please contact SWGLHcancer@nbt.nhs.uk and we will be glad to support you.
(Note: these toolkits are for germline tests. For somatic tests see SWGLH Requesting a Genomic Test for Solid Tumours)
Step 2: Consent the patient
Germline genetic tests have implications for future and family health. Patients should be informed of the implications and appropriately consented, using a tool such as the Mainstreaming Consent Form to document in the patient record. The below Patient information leaflet can be used with or without local trust logo to support patient information provision.
Patient Information Leaflet – R207 Patient Information Leaflet V1 GLH LOGO:
Patient Information leaflet with the option to add your Trust Logo:
Printing Guidance for Patient Information Sheets
- Print in landscape.
- Print on both sides.
- Flip on short edge.
Step 3: Arranging samples and completing the test request form
Blood samples in EDTA tubes (2 x 4ml for adults, 2-5ml for children and 1-2ml for neonates) are required for these tests. Samples should be kept at room temperature or at 4oC and not be frozen before dispatch.
Please ensure all sample tubes are labelled and accompanied by the test request form
Complete the SWGLH Genomic Test Request form, including:
- The test required.
- Patient diagnosis (confirming eligibility).
- Any relevant family history.
- Who the result should be returned to - a shared results email account for your team is recommended .
Send the completed form with samples:
GMS Test Order Form v2.1.pdf1.73 MB
Step 4: Transportation of samples to the SWGLH
Samples should be transported to the SWGLH through your local pathology systems, unless advised otherwise. These samples should be kept at room temperature or at 4oC and should not be frozen before dispatch. They should ideally arrive within 3 days of sample collection.
Please refer to the SWGLH Sample Requirements and Transport page for further information.
Step 5: Results and turnaround times
Results will be returned to the email account or clinician listed on the form
- The national turnaround time for these tests is 42 working days, from sample receipt. Current turnaround times for some tests are considerably shorter than this.
- When special circumstances require a more urgent result, please flag this on the form and contact the Bristol Genetics laboratory to discuss the best approach.
- Once resultsmailto:ubh-tr.clinicalgeneticsuhb@nhs.net are received, please see your local mainstreaming guidance for information on management and Clinical Genetics involvement. If you need advice, contact your local Clinical Genetics service:
Devon and Cornwall region: rduh.pcgreferrals@nhs.net (or via the Epic system if you are based at the Royal Devon University Healthcare NHS Foundation Trust)
Bristol region: UHBWClinicalGenetics@uhbw.nhs.uk
R208 Inherited breast and ovarian cancer
Step 1: Check Patient Eligibility
Eligible tumours and the available tests are shown in the National Genomic Test Directory for Cancer (NGTD).
Step 2: Consent the patient
Germline genetic tests have implications for future and family health. Patients should be informed of the implications and be appropriately consented, using a tool such as the Mainstreaming Consent Form to document in the patient record. The below patient information leaflet can be used with or without local trust logo to support patient information giving.
R208 Patient Pathway Breast Cancer195.85 KB
Mainstreaming R208 Consent Form:
Patient Information Leaflet – Genomic testing Inherited cancer R208 with SWGLH logo:
Patient Information Leaflet - Genomic testing Inherited cancer R208 with space for Trust logo:
Printing Guidance for Patient Information Sheets
- Print in landscape
- Print on both sides
- Flip on short edge
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.
Step 3: Arranging samples and completing the test request form
Blood samples in EDTA tubes (2 x 4ml for adults, 2-5ml for children and 1-2ml for neonates) are required for these tests. Samples should be kept at room temperature or at 4oC and not be frozen before dispatch.
Please ensure all sample tubes are labelled and accompanied by the test request form
Complete the SWGLH Genomic Test Request form, including:
- The test required.
- Patient diagnosis (confirming eligibility).
- Any relevant family history.
- Who the result should be returned to - a shared results email account for your team is recommended .
Send the completed form with samples:
- GMS Test Order Form v2.1.pdf1.73 MB
Step 4: Transportation of samples and request form to the SWGLH
Samples should be transported to the SWGLH through your local pathology systems, unless advised otherwise. These samples should be kept at room temperature or at 4oC and should not be frozen before dispatch. They should ideally arrive within 3 days of sample collection.
Please refer to the SWGLH Sample Requirements and Transport page for further information.
Step 5: Results and turnaround times
Results will be returned to the email account or clinician listed on the form
The national turnaround time for these tests is 42 working days, from sample receipt. Current turnaround times for some tests are considerably shorter than this.
When special circumstances require a more urgent result, please flag this on the form and contact the Bristol Genetics laboratory to discuss the best approach.
Once results are received, please see your local mainstreaming guidance for information on management and Clinical Genetics involvement. If you need advice, contact your local Clinical Genetics service:
rduh.pcgreferrals@nhs.net (or via the Epic system if you are based at the Royal Devon University Healthcare NHS Foundation Trust)
UHBWClinicalGenetics@uhbw.nhs.uk
Educational resources
Competency frameworks for cancer genomics are available on the Genomics Education programme website.
R444.1 NICE approved PARP Inhibitor treatment (Breast)
Step 1: Check Patient Eligibility
Eligible tumours and the available tests are shown in the National Genomic Test Directory for Cancer (NGTD).
Step 2: Consent the patient
Germline genetic tests have implications for future and family health. Patients should be informed of the implications and be appropriately consented, using a tool such as the Mainstreaming Consent Form to document in the patient record. The below patient information leaflet can be used with or without local trust logo to support patient information giving.
Please use the mainstreaming R208 Consent Form:
- Patient Information Leaflet – Patient Information Leaflet – R444 (Breast Cancer) PIS with SWGLH logo:
- Patient Information Leaflet - Patient Information Leaflet – R444 (Breast Cancer) PIS with space for Trust logo:
Printing Tips for Patient Information Sheets
- Print in landscape.
- Print on both sides.
- Flip on short edge.
Step 3: Arranging samples and completing the test request form
Blood samples in EDTA tubes (2 x 4ml for adults, 2-5ml for children and 1-2ml for neonates) are required for these tests. Samples should be kept at room temperature or at 4oC and not be frozen before dispatch.
Please ensure all sample tubes are labelled and accompanied by the test request form
Complete the SWGLH Genomic Test Request form, including:
- The test required.
- Patient diagnosis (confirming eligibility).
- Any relevant family history.
- Who the result should be returned to - a shared results email account for your team is recommended.
Send the completed form with samples:
GMS Test Order Form v2.1.pdf1.73 MB
Step 4: Transportation of samples and request form to the SWGLH
Samples should be transported to the SWGLH through your local pathology systems, unless advised otherwise. These samples should be kept at room temperature or at 4oC and should not be frozen before dispatch. They should ideally arrive within 3 days of sample collection.
Please refer to the SWGLH Sample Requirements and Transport page for further information.
Step 5: Results and turnaround times
Results will be returned to the email account or clinician listed on the form
- The national turnaround time for these tests is 42 working days, from sample receipt. Current turnaround times for some tests are considerably shorter than this.
- When special circumstances require a more urgent result, please flag this on the form and contact the Bristol Genetics laboratory to discuss the best approach.
- Once results are received, please see your local mainstreaming guidance for information on management and Clinical Genetics involvement. If you need advice, contact your local Clinical Genetics service:
rduh.pcgreferrals@nhs.net (or via the Epic system if you are based at the Royal Devon University Healthcare NHS Foundation Trust)
UHBWClinicalGenetics@uhbw.nhs.uk
Educational resources
Competency frameworks for cancer genomics are available on the Genomics Education programme website.
R430, R444.2 and R240 – Inherited Prostate Cancer and PARP Inhibitor Treatment for Prostate Cancer
There are three different test codes depending on the reason for testing prostate patients. Please see the NGTD for eligibility criteria and select the appropriate test.
• R430 - direct germline testing for patients who are eligible for panel testing based on personal or family history.
• R444 - for patients being assessed for PARP inhibitor eligibility, where somatic testing has failed.
• R240 - for patients whose somatic test showed a gene variant. This test confirms whether the variant is present in the germline.”
Step 1: Check Patient Eligibility
Eligible tumours and the available tests are shown in the National Genomic Test Directory for Cancer (NGTD).
Step 2: Consent the patient
Germline genetic tests have implications for future and family health. Patients should be informed of the implications and be appropriately consented, using a tool such as the Mainstreaming Consent Form to document in the patient record. The below patient information leaflet can be used with or without local trust logo to support patient information giving.
Please use the generic consent form:
- Patient Information Leaflet – Patient Information Leaflet – R444.2 NICE approved PARP Inhibitor treatment (Prostate) PIS with SWGLH logo:
Patient Information Leaflet – Patient Information Leaflet – R444.2 NICE approved PARP Inhibitor treatment (Prostate) PIS with SWGLH logo:
Printing Tips for Patient Information Sheets
- Print in landscape.
- Print on both sides.
- Flip on short edge.
Step 3: Arranging samples and completing the test request form
Blood samples in EDTA tubes (2 x 4ml for adults, 2-5ml for children and 1-2ml for neonates) are required for these tests. Samples should be kept at room temperature or at 4oC and not be frozen before dispatch.
Please ensure all sample tubes are labelled and accompanied by the test request form
Complete the SWGLH Genomic Test Request form, including:
- The test required.
- Patient diagnosis (confirming eligibility).
- Any relevant family history.
- Who the result should be returned to - a shared results email account for your team is recommended .
Send the completed form with samples:
GMS Test Order Form v2.1.pdf1.73 MB
Step 4: Transportation of samples and request form to the SWGLH
Samples should be transported to the SWGLH through your local pathology systems, unless advised otherwise. These samples should be kept at room temperature or at 4oC and should not be frozen before dispatch. They should ideally arrive within 3 days of sample collection.
Please refer to the SWGLH Sample Requirements and Transport page for further information.
Step 5: Results and turnaround times
Results will be returned to the email account or clinician listed on the form
- The national turnaround time for these tests is 42 working days, from sample receipt. Current turnaround times for some tests are considerably shorter than this.
- When special circumstances require a more urgent result, please flag this on the form and contact the Bristol Genetics laboratory to discuss the best approach.
- Once results are received, please see your local mainstreaming guidance for information on management and Clinical Genetics involvement. If you need advice, contact your local Clinical Genetics service:
rduh.pcgreferrals@nhs.net (or via the Epic system if you are based at the Royal Devon University Healthcare NHS Foundation Trust)
R210 Inherited MMR deficiency (Lynch Syndrome)
Step 1: Check Patient Eligibility
Eligible tumours and the available tests are shown in the National Genomic Test Directory for Cancer (NGTD).
Step 2: Consent the patient
Germline genetic tests have implications for future and family health. Patients should be informed of the implications and be appropriately consented, using a tool such as the Mainstreaming Consent Form to document in the patient record. The below patient information leaflet can be used with or without local trust logo to support patient information giving.
- Mainstreaming R210 Consent Form:
- Patient Information Leaflet – Lynch Syndrome (R210) Patient Information Leaflet with SWGLH logo:
- Patient Information Leaflet - Lynch Syndrome (R210) Patient Information Leaflet with space for Trust logo:
Printing Tips for Patient Information Sheets
- Print in landscape.
- Print on both sides.
- Flip on short edge.
Step 3: Arranging samples and completing the test request form
Blood samples in EDTA tubes (2 x 4ml for adults, 2-5ml for children and 1-2ml for neonates) are required for these tests. Samples should be kept at room temperature or at 4oC and not be frozen before dispatch.
Please ensure all sample tubes are labelled and accompanied by the test request form
Complete the SWGLH Genomic Test Request form, including:
- The test required.
- Patient diagnosis (confirming eligibility).
- Any relevant family history.
- Who the result should be returned to - a shared results email account for your team is recommended.
Send the completed form with samples:
GMS Test Order Form v2.1.pdf1.73 MB
Step 4: Transportation of samples and request form to the SWGLH
Samples should be transported to the SWGLH through your local pathology systems, unless advised otherwise. These samples should be kept at room temperature or at 4oC and should not be frozen before dispatch. They should ideally arrive within 3 days of sample collection.
Please refer to the SWGLH Sample Requirements and Transport page for further information.
Step 5: Results and turnaround times
Results will be returned to the email account or clinician listed on the form
- The national turnaround time for these tests is 42 working days, from sample receipt. Current turnaround times for some tests are considerably shorter than this.
- When special circumstances require a more urgent result, please flag this on the form and contact the Bristol Genetics laboratory to discuss the best approach.
- Once results are received, please see your local mainstreaming guidance for information on management and Clinical Genetics involvement. If you need advice, contact your local Clinical Genetics service:
rduh.pcgreferrals@nhs.net (or via the Epic system if you are based at the Royal Devon University Healthcare NHS Foundation Trust)
UHBWClinicalGenetics@uhbw.nhs.uk
Educational Resources
Competency frameworks for cancer genomics are also available on the Genomics Education programme website.
The patient information on the South West Genomic Laboratory Hub webpages are provided by the Genomics Medicine Service. For further information please visit www.england.nhs.uk/genomics/.
Page updated: 25/02/2025
An information guide on what to do after someone has died in hospital
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The staff at North Bristol NHS Trust (NBT) offers their condolences to you at this time.
We understand that you may have important personal and cultural requests about the care of your loved one; please let a member of staff know and we will do our best to help in any way that we are able.
We know that giving all the information in this booklet can look daunting but please do not worry. Take time to share this information with a trusted family member or friend. This booklet will help you when you have the quiet time and space to read through it.
Contents
Overview of steps you will need to take
Next of kin or another person acting for the deceased
What you will need to do first
Medical Certificate of Cause of Death (MCCD)
Role of the Medical Examiner Office
The coroner
Property
How to arrange and view your loved one after death
Tissue donation
Who can register a death?
Registering a death
Documents you will receive
Organisations you need to contact
People you might need to inform
Arranging a funeral
Further information and bereavement support
Overview of steps you will need to take
- NBT (North Bristol NHS Trust) Patient Affairs officers will contact you via telephone the next working day following the death of your loved one.
- Contact funeral director and start to make funeral arrangements.
- Register the death.
- Finalise funeral arrangements with the funeral director.
Next of kin or another person acting for the deceased
The Patient Affairs team will correspond with the person recorded in the hospital records as next of kin concerning
the administration of your loved one’s death. This can be any person designated by the deceased prior to their death and may or may not be a relative of the deceased.
If there is no designated next of kin, then this will usually be the closest relative or other person who will take responsibility for registering the death.
It can be important at this sad and difficult time that the next of kin keeps family members, or those close to the deceased, informed of what is happening.
It is important to read ‘Who can register a death?’ below.
What you will need to do first
Following the death of your loved one, you should receive a telephone call from the patient affairs team between 9am and 4pm on the next working day.
The Patient Affairs team will take some details from you, tell you what to do next and answer any questions you may have.
You are advised not to make a Register Office appointment until you have spoken to the Patient Affairs team.
If you have a query, you can contact the Patient Affairs Office at Southmead Hospital on 0117 414 0184, Monday to Friday, 8am – 4pm.
Please note that the office is not open Saturdays, Sundays or on Bank Holidays.
The Patient Affairs Office is located in the Sanctuary, Level 1, Gate 30 of the Brunel Building, Southmead Hospital.
Medical Certificate of Cause of Death (MCCD)
The Medical Certificate of Cause of Death (MCCD) is an important legal document, showing the cause of death. This must be signed by a doctor who was responsible for the medical care of your loved one while they were in hospital.
Doctors are not always able to complete the paperwork immediately, so it may be several days before the certificate is ready. In some cases, they may need to contact the Coroner’s Office which will delay the paperwork further.
Role of the Medical Examiner Office
North Bristol Trust uses a medical examiner system. This is a role which has been implemented into all NHS hospitals within England. The role of medical examiners (MEs) is to provide support for bereaved families and to improve patient safety.
The Medical Examiner’s Office will be able to share any feedback to the clinical team or request they review the notes to reflect on the care provided and consider if there is any learning to improve the care of patients in the future.
There are two types of medical examiner:
Medical examiners (ME)
Medical Examiners are independent senior medical doctors who are appointed to review all deaths that occur in hospital. They are specially trained in the legal and clinical elements of death certification processes.
They are here to check the information written on the Medical Certificate of Cause of Death (MCCD) is correct, and that any referrals that need to go to the coroner are made in a timely fashion to avoid any delays.
They scrutinise clinical notes and meet with the treating doctor to discuss the deceased’s care and the cause of death.
Medical examiner officers (MEO)
Medical Examiner Officers are a mix of clinical and nonclinical staff who have received special training in the role.
They assist the ME.
You will receive a call from a Medical Examiner or Medical Examiner Officers in the coming days. They will help you understand the wording used on the MCCD. You will have a chance to ask any questions you may have regarding the care of the deceased or their last illness. The Medical Examiner Officers will advise you how you can obtain the Death Certificate and other forms from the Registry Office.
The Medical Examiners Office will make reasonable attempts to contact the deceased’s Next of Kin. If you have any questions and have not been able to speak with the medical examiner, please contact the Patient Affairs team.
Once completed the death certificate will be delivered to the Bristol Registrars from the hospital by email (you do not need to collect the death certificate).
You will need to make a telephone appointment to register the death with the Bristol Registrars (telephone number 0117 922 2800) or complete an online form through the Bristol City Council Website: www.bristol.gov.uk/residents/births-deathsmarriages/deaths/register-a-death
The Medical Certificate of cause of Death will not be issued until the cause of death has been reviewed by the Medical Examiners Office or the Coroner’s Office.
The coroner
In some instances, the hospital doctor is legally required to discuss the death with the coroner. The coroner is
an independent judicial officer and are responsible for investigating deaths in circumstances such as:
- all sudden and unexpected deaths
- deaths where the cause is unknown
- unnatural deaths for example accident or suicide
- deaths that occur during or shortly after an operation
- deaths caused by industrial diseases
- deaths involving a bone fracture
- deaths from acute alcohol poisoning or drug related illnesses
Once information is obtained by the Coroner’s Office from the medical staff, a decision will be made as to whether or not a post mortem is necessary.
In many cases, permission will be given to issue a Medical Certificate of Cause of Death.
However, you should note that the post mortem procedure with the Coroner takes at least 3 working days to complete before the certification can be released and in these circumstances an appointment with the Register Office cannot be made until all documentation has been completed and issued.
The post mortem examination will usually take place within a week of the death at the Coroner’s Mortuary in Flax Bourton.
The Coroner’s Office will take over responsibility from the Patient Affairs Office and will be responsible for keeping you informed of what is happening and guiding you in the next steps that you should take.
The coroner does not require the consent of any other person for this to take place. Funeral directors should be advised about the post mortem and are usually happy to proceed with funeral arrangements.
You will be informed by the Coroner’s Office when they have sent paperwork to the Register Office so that you can make an appointment to register the death.
The Coroner’s Office can be contacted on 01275 461 920. Opening hours: 7.30am - 3.30pm, Monday to Friday.
Coroner’s inquest
In some circumstances the coroner will proceed to open an inquest.
The purpose of an inquest is to find out four facts.
- Who the deceased was?
- When, where, and how they died?
They will also record the medical cause of death.
You may be contacted by one of the coroner’s officers if an inquest has been opened. You may be asked to provide a statement about your loved one. The Trust will also provide the coroner with statements from those who cared for the deceased.
Once the coroner has considered this evidence, there may be a hearing. This is a fact-finding hearing, not to apportion blame, but to answer the above four questions. You will have the opportunity to ask questions.
The coroner will then record a conclusion, such as natural causes or suicide.
Whilst the aim is for this process to conclude within 6 months of the death, it can sometimes take longer. You will be kept up to date by the coroner’s office.
Property
If the deceased has property or clothing in the care of the Patient Affairs team which is not taken by relatives at the time of death, the Patient Affairs team will contact you to discuss arrangements for returning the property to you or the disposal of any unwanted property.
Jewellery (for example wedding rings, earrings) is usually left on the deceased unless family request otherwise and will go to the funeral director where it is removed if requested.
It is important that you agree the arrangements for the return or disposal of property with the Patient Affairs Office.
Any property not collected after 3 months will be disposed of without recourse to the Trust.
How to arrange to view your loved one after death
You may wish to come to the hospital’s viewing room to see your loved one. The viewing room is a separate room within the hospital Mortuary.
If this is something you wish to do, you can make an appointment with the Mortuary Team by telephoning 0117 414 0184 between 8am - 4pm, Monday to Friday, to arrange this. We do not currently offer viewings on evenings or weekends.
Alternatively, you may prefer to wait until the deceased is transferred to the care of the chosen funeral director.
On the rare occasions when the cause of death may be a criminal matter there will be restricted viewing. In these
circumstances, the police will advise.
Tissue donation
After someone has died it may be possible for their tissues to be donated to help others. Your loved one may have carried a donor card, be on the Organ Donor Register or may have discussed donation with you during their lifetime. Even if they did not, you may want to consider tissue donation at this time.
To ensure tissue transplants are as successful as possible, tissues can only be donated in certain circumstances.
- Eyes for Corneal Transplantation can be donated up to 24 hours after death.
- Heart valves can be donated up to 24 hours after death.
If you choose this for your loved one, they will be cared for with dignity and respect and their appearance will be restored. Tissue donation will not delay funeral plans.
You may be contacted by a specialist tissue donation nurse after someone dies to offer information about tissue donation. The nurse will explain the options available for tissue donation and answer any questions.
Please remember, tissue donation is entirely voluntary. If you would like further information, please contact NHS Blood and Transplant National Referral Centre on 0800 432 0559. Please leave your name and contact number and a tissue donation nurse will call you back promptly.
Alternatively, you may ask a doctor, or nurse involved in the care of your loved one to contact the appropriate person on your behalf.
Who can register a death?
You can register the death if you are:
- A relative
- Someone present at the death
- An administrator from the hospital
- The person making arrangements with the funeral directors
Registering a death
Once the Medical Certificate of death has been issued by the doctor and emailed to the registrar, you will need an
appointment to register the death with the Bristol City Council Registrars.
The whole process will be completed in person at the Registrar’s office at Southmead Hospital or at a local Registrar’s office close to you.
You will need to tell the registrar:
- The person’s full name at the time of death
- Any names previously used e.g., maiden name
- The person’s date and place of birth
- Their last address
- Their occupation
- The full name, date of birth and occupation of a surviving or late spouse or civil partner
- Whether they were receiving a state pension or any other benefits
Documents you will receive
When you register the death, you will receive the following:
- A Certificate for Burial or cremation (the ‘green form’), this gives permission for burial or an application for cremation.
- A Certificate for the Department of Work and Pensions Benefit (form BD8) – you may need to fill this out and return it if the person was receiving a state pension of benefits.
- There is an opportunity to purchase death certificates – these will be needed for sorting out the person’s affairs with the bank, insurance companies, private pensions etc.
Once you have registered the death you can inform your chosen funeral director that the death is registered so that arrangements can now proceed.
If the death has been referred to the coroner, you will not be able to register the death until the registrar has received a notification from the coroner’s office.
Organisations you need to contact
Tell Us Once
You will need to report the death to various organisations and government departments. Bristol City Council runs a service called Tell Us Once, which will help you to contact these. In doing so you will not have to pay for extra death certificates for each organisation they contact. There is a cost in providing the certificate to organisations who are not contacted by the council.
If you wish to use this service, inform the registrar when you attend the Register Office, and the options will be explained to you. The registrar will show you what to do and this is a service many people find invaluable. You will be able to access this service by telephone or online once you have registered the death.
If you choose not to use the Tell Us Once service, you will need to report the death to various organisations and
government departments.
The following are organisations which may be appropriate to notify.
Local councils
- Housing Benefit Office
- Council Tax
- Collection of payment for council services
- Libraries
- Electoral Services
- Blue Badges
- Adult Services
- Children’s Services
- Council Housing
Department for Work and Pensions (DWP)
- Pension, Disability and Carers’ Service
- Jobcentre Plus
- Overseas Health Team
Revenue and Customs
- Child Benefit
- Child Tax Credit and Working Tax Credit
- Personal Taxation
Identity and Passport Service
- Driver and Vehicle Licensing Agency
- Ministry of Defence
- Service Personnel and Veterans Agency
- War Pensions Scheme
People you might need to inform
Please ask a member of staff for a printed copy of this patient leaflet if you would like a checklist to complete.
- Family
- Friends
- Healthcare providers, i.e. optician, dentist, GP
- Bank or building society, credit card providers
- Premium bonds, long term savings companies (ISAs)
- Anyone holding money for the deceased
- Social Services such as home help or care
- Previous/current place of work (occupational pension), trade unions
- Executor of the estate (Will)
- Insurance Companies (car, home, life insurance)
- Residential or nursing home
- Landlord or housing agency
- Mortgage company
- Utility companies (water, electric, gas, phone, internet, TV licence, Internet)
- Hire purchase companies
- Post Office (to redirect mail)
- Cancel any upcoming payments
- Transport (to day centres or clubs)
- Deliveries (milk, food boxes, newspapers)
- Return of any borrowed equipment (medical or social)
- Religious organisations (faith leaders)
- Stop any junk mail
Arranging a funeral
Before going ahead with any arrangements, it is advisable to check whether the deceased person left a Will and any instructions for the funeral.
If you are not the next of kin (nearest relative) or executor, you should check with the next of kin or executor that you have the authority to proceed.
Most funeral directors are members of one of 2 trade associations:
- National Association of Funeral Directors (NAFD)
- Society of Allied and Independent Funeral Directors (SAIF)
Member firms must provide you with a price list on request and cannot exceed any written estimate they give you without your permission.
Most people would probably require the funeral director to provide the following services as a minimum:
- Make all necessary arrangements
- Provide appropriate staff
- Provide a suitable coffin
- Transfer the deceased from the place of death to the funeral director
- Care for the deceased prior to the funeral
- Provide a hearse to the nearest cemetery or crematorium
- Arrange for burial or cremation as appropriate
Embalming, viewing of the deceased, or providing a limousine for mourners are optional extras. Discuss these fully with your funeral director and make sure you receive an itemised written quotation.
Funeral costs for the same services may vary considerably from one funeral director to another.
It is advisable to get more than one quote to compare costs and services. Funeral directors should provide detailed price lists for you to take away. Disbursements are fees paid to others, for example doctors (for cremation forms), a minister, newspaper announcements, flowers, and crematorium. Ask the funeral director for a written quotation detailing all these fees.
In addition, it should be remembered:
- When you arrange a funeral, you are responsible for paying the bill.
- Funeral payments are recoverable from the deceased person’s estate and banks are obliged to release money to pay for funeral costs when requested.
- It is recommended that the funeral is held within 3 weeks of death to prevent deterioration of your loved one.
If you receive certain benefits from the Department of Work and Pensions you may be entitled to some assistance towards the funeral expenses of your relative. For further information please contact the nearest Jobcentre Plus Centre.
A bereavement payment or bereavement allowance may be made in certain circumstances if you are the partner or spouse of someone who died whilst employed. These are dependent upon National Insurance contributions and other conditions. Please contact Jobcentre Plus to find out more.
Further information and bereavement support
The time ahead may be a very difficult one for you. If you have any further questions, a member of the chaplaincy team (0117 414 3700) or your GP would be happy to help.
If you would like to discuss any aspect of your loved one’s care, please contact the ward to arrange an appointment with a member of the medical/nursing team.
Useful websites
GOV.UK - What to do when someone dies
www.gov.uk/after-a-death/overview
Age UK - What to do when someone dies
Bristol City Council Bereavement Support
www.bristol.gov.uk/births-deaths-marriages/bereavement-support
GOV.UK - Get help with funeral costs
How to contact us
Patient Affairs Office
If you or the individual you are caring for need support reading this leaflet please ask a member of staff for advice.
If you’re an overseas visitor, you may need to pay for your treatment or you could face fraud or bribery
charges, so please contact the overseas office: Tel: 0117 414 3764 Email: overseas.patients@nbt.nhs.uk
© North Bristol NHS Trust. This edition published April 2023. Review due April 2026. NBT002506
Clinical Biochemistry in Primary Care
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Clinical Guidelines
For guidance on hyperlipidaemia treatment guidelines and monitoring patients on lipid lowering therapy please see advice on Remedy
Hypercalcaemia in primary care.pdf219.99 KB
Hypoglycaemia in primary care.pdf147.42 KB
BNSSG Adult Vitamin D Prescribing Guidance
Blood Tests
Urine and Other Tests
NBT002316 Instructions for urine collection for Cystinuria
NBT002424 Instructions for 24 hour urine collection
Trust Board Meetings 2022/2023
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Now that Infection Prevention & Control guidelines have been relaxed in line with the Government’s “Living with Covid-19” guidance, members of the public and staff are able to attend our Trust Board meetings in public. If you would like to attend, please let us know by emailing trust.secretary@nbt.nhs.uk and we can provide details of the location, and print papers if required. If you wish to ask a question of Trust Board, please submit it in writing follow the process set out here.
The Trust Board meets in public at 10am.
- Thursday 26 May 2022
- Thursday 28 July 2022
- Thursday 29 September 2022
- Thursday 24 November 2022
- Thursday 26 January 2023
- Thursday 30 March 2023
We will continue to record each Trust Board meeting that is held in public, and the recording will be available for viewing for two months following the meeting until the next meeting’s recording is uploaded.
Download Integrated Performance Reports (IPR):
Download Meeting Papers:
Respiratory Current Research
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Respiratory
With over 15 years of commercial and non-commercial research, the Respiratory Research team led by Professor Maskell is one of the largest and most successful clinical and academic pleural research teams in the UK.
For nearly a decade they have been designing and delivering practice-changing clinic trials, improving the lives of patients with mesothelioma, pleural infection, and pneumothorax.
They have tested new devices designed to manage recurrent pleural effusions and pneumothorax, including a first in human trial which led to an international multi-centre randomised controlled trial (SEAL-MPE trial).
The multidisciplinary team includes highly skilled and motivated research nurses, managers, clinical research fellows and clinical academics. The team has also successfully been awarded research grants of more than £5million.
Please speak to the person treating you to find out if there is a research study that may be able to help you.
Current Studies:
ASPECT (Aspirin after hospitalisation with Pneumonia to prevent cardiovascular Events randomised Controlled Trial)
The ASPECT (Aspirin after hospitalisation with Pneumonia to prevent cardiovascular Events randomised Controlled Trial) is the largest ever pneumonia trial.
It will investigate whether aspirin can reduce the risk of a heart attack or stroke in patients who are admitted to hospital with pneumonia. Led by the University of Bristol, sponsored by North Bristol NHS Trust (NBT) and supported by the Bristol Trials Centre, the trial has been awarded funding of over £2.3 million by the National Institute for Health and Care Research (NIHR).
The randomised controlled trial will recruit 22,600 patients from over 60 hospitals across England. Findings from the four-year study will support future treatment guidelines, if appropriate, for patients with pneumonia. If aspirin is shown to be effective it could prevent up to 3,000 heart attacks and strokes a year in England alone.
Adults over 50 years of age admitted to hospital with pneumonia will be invited to take part in the trial. Those who agree will be split into two groups. Every person joining the study will have an equal chance of being in either group, so both groups will be made up of similar people.
One group will be prescribed a three-month course of low-dose aspirin, the other group will not. In all other respects, both groups will receive the standard pneumonia treatment. Participants will be followed up after three months.
The researchers will assess the participants recovery, specifically whether they have had a heart attack or stroke, or any serious side effects from the aspirin. This will be done by reviewing the 'usual care' health records of participants held by NHS hospitals.
Following up participants like this has been shown to be robust, reduces the burden on participants and makes the research much less expensive. To ensure participants are not getting side effects that would not be picked up in their health records, the research team will contact the first 2,000 participants, this follow up will include questions about whether they took the medication prescribed.
Dr David Arnold, NIHR Academic Clinical Lecturer in Respiratory Medicine in Bristol Medical School: Translational Health Sciences (THS) and Respiratory Registrar at NBT, who is joint lead of the trial, said: "Pneumonia is the commonest cause of unplanned hospital admissions worldwide. It has been shown that patients recovering from pneumonia have an increased risk of a heart attack or stroke due to the stress of infection on the body.
"Aspirin has been used for decades to reduce the chance of having a heart attack or stroke in patients at high risk of either event. We hope our trial will show it reduces the risk to patients with pneumonia and that it can save lives too."
Pneumonia is an inflammation of one or both lungs, usually caused by infection. Pneumonia is very common with 270,000 patients admitted as an emergency to hospital in England every year. Most people recover completely but some have complications. Two of the most significant complications are heart attack or stroke. Around 1 in 13 patients (8%) who are admitted to hospital with pneumonia have a heart attack or stroke within three months.
'Aspirin after hospitalisation with Pneumonia to prevent cardiovascular Events randomised Controlled Trial' (ASPECT) is a four-year trial.
Project Details
Principal Investigator: Dr Nick Maskell
Planned End Date: 31/08/2025
Local Ref: 5019
CONTENTed study: Characterisation Of Neuroimaging and wellbeing over Time in severe EosiNophilic asthma Treated with mepolizumab.
There is a high prevalence of anxiety, depression and neurocognitive dysfunction which impacts on the wellbeing of patients with severe asthma. These factors may be the result of poorly controlled asthma, the effects of asthma treatments, but also themselves impact on asthma severity. The relationship between these factors is not well understood.
Magnetic resonance imaging (MRI) of the brain demonstrates structural and functional differences between the brains of people with asthma and those without. Though not extensively studied, a small number group of trials have shown a 'normalisation' of brain activity after cognitive behavioural therapy in patients with asthma and depression. The effect of asthma treatments on brain structure and activity requires further investigation.
Mepolizumab is amongst a group of injectable treatments that have revolutionised the treatment of poorly controlled severe eosinophilic asthma. Randomised controlled trial and real-world data shows reduced exacerbations and oral corticosteroid use in patients taking mepolizumab. Trials also show improved asthma-specific quality of life, though there have not been studies that have assessed anxiety, depression, well-being and cognition in detail.
In this observational study we propose to examine the MRI structure and function of the brains of people with severe eosinophilic asthma before and six months after starting mepolizumab as part of routine clinical practice. We will collect detailed health and neurocognitive information to evaluate changes in psychological health and cognition with mepolizumab. We will compare these data, to results in patients with well-controlled asthma. We will assess whether changes seen on MRI brain imaging relate to the direct effect of the mepolizumab on the brain, or of the secondary effects of improved asthma control that is known to be achieved by mepolizumab.
To become participate in this study, find out more information here.
Project Details
Principal Investigator: James Dodd
Planned End Date: TBC
Local Ref: 5409
UK Lung Volume Reduction: Multi-centre Observational Study
Many people with chronic obstructive pulmonary disease (COPD) remain very breathless and limited. In some patients, with the appropriate pattern of emphysema, an operation called lung volume reduction surgery is effective at removing the worst affected area of lung. New techniques have been developed where emphysema can be treated using a fibre-optic camera called a bronchoscope. Trials have shown that using a bronchoscope to place endobronchial valves into the airways can be very effective in carefully selected patients and the technique is now being adopted in hospitals across the UK.
This study will collect data from people undergoing these procedures at hospitals across the UK to evaluate how well they work in practice and what factors at baseline influence response. Baseline, three month and 12 month follow up data will be collected. This will include lung function data, measures of exercise capacity, questionnaires about health status and CT scan results. Questions addressed will include:
- What lung function improvement is seen in clinical practice?
- What factors determine who is most likely to respond?
- How safe are the procedures and what is the rate of complications?
- What proportion of people undergoing bronchoscopic procedures require repeat procedures or surgery subsequently?
- Does long term survival differ between people undergoing the different treatments?
The study is supported by The British Lung Foundation and sponsored by Imperial College, London. By building collaboration, the establishment of the network will also produce a structure that will make evaluation of future bronchoscopic techniques easier bringing innovative treatments into play more quickly.
Project Details
Principal Investigator: Dr James Dodd
Planned End Date: 30/06/2026
Local Ref: 4076
Pleural Antibiotic Concentrations Informing Treatment (PACT) Study
When people get chest infections, fluid can sometimes build up around the lung. This is called a parapneumonic pleural effusion. In about 1 in 10 cases, the fluid itself becomes infected, this is called pleural infection. Pleural infection is usually treated by removing the infected fluid and using antibiotics to mop up the left-over infection.
Patients with pleural infection often receive long courses of intravenous antibiotics because doctors are uncertain of how well antibiotics reach the infected pleural fluid and whether bacteria are becoming resistant to them.
The Pleural Antibiotic Concentrations informing Treatment (PACT) study is observational and aims to see how well antibiotics are reaching the infected fluid, and how quickly the bacteria are being killed. To answer this, we will collect samples of pleural fluid from participants who are being treated for pleural infection with pleural drainage. This fluid will be tested to measure how much antibiotic has managed to get into it. We can then tell if the antibiotics are reaching high enough concentrations to kill bacteria. We will also be testing this fluid to see if the bacteria are being killed by the antibiotic or not. In the future, this information may shorten the time patients are treated with intravenous antibiotics and therefore how long they need to stay in hospital.
Project Details
Local Ref: 4581
TARGET: Reducing repeat pleural biopsies in suspected cancer
Background and study aims
Pleural mesothelioma is a cancer that affects the lung lining, caused by asbestos. Despite recent treatment advances, the prognosis is often poor. Prompt diagnosis is vital. A biopsy can diagnose mesothelioma, guide treatment and support compensation claims. However, some people need multiple biopsies, increasing the risk of biopsy-related complications and prolonging the time to diagnosis. Doing additional tests on initial biopsies may increase the chance of diagnosing mesothelioma and avoid repeat biopsies. This would allow anti-cancer treatment to be started sooner and improve survival. The extra tests are not genetic but look for genetic changes in the cancer that allow it to grow and spread. The genetic markers in mesothelioma are called BAP1, p16 and MTAP. If they have disappeared on biopsy mesothelioma is diagnosed. Another study was previously conducted on people with suspected mesothelioma who required further biopsies as their first biopsy did not give a diagnosis It took place in eight UK centres and recruited 59 patients. This study aims to perform these additional tests on their biopsy samples to see whether this would have made the diagnosis sooner and removed the need for further biopsies. It will investigate how many biopsies could have been avoided, how much time would have been saved, how this may have impacted survival and what cost-savings this would have offered the NHS.
Who can participate?
This study includes the 59 participants in the original TARGET study who were recruited between September 2015 and September 2018. No additional participants will be recruited. Should any participants of the original TARGET trial wish to opt-out, they can contact the main contact below.
What does the study involve?
Biopsy samples taken as part of the participants’ routine clinical care will be tested for the markers of genetic change in mesothelioma (BAP1, MTAP and p16). The ability to make a diagnosis using these tests will be compared with the original diagnostic pathway, which was before the use of these tests.
What are the possible benefits and risks of participating?
The benefits of enrolling are to future patients, whose diagnostic process could be improved, with no additional requirements of TARGET participants. As there are no additional interventions required of participants and this will not impact management, there are no risks identified.
Project Details
Principal Investigator: Prof Nick A Maskell
Duration: October 2022 - July 2025
Funded by the Southmead Hospital Charity
Main contact : Geraldine.lynch@nbt.nhs.uk
The effectiveness and risks of Treating people with Idiopathic Pulmonary fibrosis with the Addition of Lansoprazole (TIPAL)
IPF is a progressive scarring lung condition causing coughing and breathlessness. IPF patients often have reflux disease meaning stomach acid may be breathed into the lungs, potentially damaging them. Medicines which stop stomach acid production, proton pump inhibitors (PPIs), can be used to reduce reflux symptoms including heartburn. Some researchers suggest PPIs also reduce IPF progression.
This research aims to see if IPF progresses slower if treated with PPIs. Based on the results, we will be able to recommend whether or not IPF patients should take PPIs.
This trial will involve 298 IPF patients from approximately 37 UK hospitals. At the beginning of the study, we will ask patients to perform breathing tests, and ask those with a cough to use a device to count the number of times they cough in 24hours. We will ask them to answer two questions rating their coughing and breathlessness, and complete questionnaires on their coughing, IPF, sleep habits and general condition. People will be given a PPI, called lansoprazole, or dummy tablets, twice per day for 12 months. They will be given a leaflet telling them what to do about reflux symptoms. At the end of the study, we will repeat these tests and analyse the results. We will record any side effects people may get. If people suffer side effects, they can reduce the dose.
People taking medicines that interact with PPIs or have other serious medical conditions won’t be able to participate. People receiving PPIs will only be able to participate if they can stop taking their medication without their heartburn returning.
The study will be undertaken by doctors and researchers with experience of IPF, reflux disease, PPIs and coughing. We will publicise our results by writing reports for medical publications, media articles and social media.
Project Details
Local Ref: 4672
Take Part in Research
Become one of the thousands of people taking part in research every day within the NHS.
About Research & Development
Find out more about our research and how we're working to improve patient care.
Contact Research
Research & Development
North Bristol NHS Trust
Level 3, Learning & Research building
Southmead Hospital
Westbury-on-Trym
Bristol, BS10 5NB
Telephone: 0117 4149330
Email: research@nbt.nhs.uk