North Bristol NHS Trust is committed to making reasonable adjustments to support patients and carers whilst they are in hospital and to work in partnership with them.

Carer contributions are greatly valued. To help you to give ongoing support and care to your loved one whilst they are in hospital we have a Carers Support Scheme. The Scheme provides complimentary parking, an access card to the staff restaurant and referral to our Carers Liaison Service.

Complimentary parking and restaurant access card

Eligibility

The carer spends a minimum of three hours per day or the equivalent of 20 hours or more over a seven day period on the ward providing support to the patient.

This support could include:

• Personal care - providing assistance with washing/dressing.
• Oral hygiene/mouthcare - teeth brushing/cleaning dentures.
• Assisting with eating and drinking.
• Providing support at the end of life.
• Helping to reduce patient anxiety or behaviour which indicates that the patient is anxious or distressed.
• Providing reassurance to the patient when difficult or painful procedures need to be performed, including accompanying the patient to the theatre and being present in recovery after the operation.
• Providing assistance if the patient is uncooperative, for example if physiotherapy is considered to be necessary to aid the patient’s recovery.
• Helping to prevent the patient falling.
• Providing other forms of support as agreed between the carer/parents/ward staff or registered practitioner.

Carers who are eligible can receive:

• Complimentary car parking for up to two weeks (this can be renewed when requested by staff).
• Access to the staff restaurant for meals.
• Support to stay overnight which, depending on availability, may be a reclining chair or bed.
• Referral to the Carers Liaison Support Service.

Senior members of staff should be consulted when applying for a carer to access a car parking permit or restaurant access card, but any member of staff can support a carer to complete the form.

Carers will be given an information leaflet about the Carers Support Scheme to read to make them aware of the terms and their accountability under the agreement.

Complimentary parking

• A complimentary car parking permit is valid for all public car parks on the Southmead Hospital Site.
• Carers must visit the Security and Parking office to collect their permit where their car registration will be added to the system. Car park barriers will open and a parking ticket will be issued for use in the pay and display car parks.
• The car parking permit is valid for up to two weeks. Permits can be renewed multiple times up to the end of a hospital stay. Ward staff will need to complete a new form each time it is renewed.

Please note that two carers’ registration numbers will be allocated to one permit/per patient.

If you wish to exchange a registration number for another please take the slip issued by the Security and Parking Office who will then update your details. If circumstances change you will not automatically be guaranteed a new permit.

Important information for Blue Badge holders

This badge can only be used by the named badge holder, or by a person who has dropped off or is collecting the badge holder from the place where the vehicle is parked. It is a criminal offence for anyone else to use this badge in any other circumstances.

Access to the staff restaurant

Carers Cards

• Carers can obtain a Carers Card from the Security and Parking office. A £5 deposit is required and will be fully refunded when the card is returned.
• The Carers Card will allow access to the staff restaurant (you will be given a separate map when you pick up the card) to purchase a hot meal and drink at advertised prices. Meals and drinks are not discounted or free; cards only provide access to the Vu restaurant.
• To use the card, hold it up near the grey boxes at the side of the door. There should be a beep and the light will change to green. You can now open the door. Try again if you get multiple beeps or a red light.
• Carers Cards are valid for up to two weeks and can be renewed multiple times up to the end of the hospital stay. The ward will need to complete a new form each time it is renewed.
• All Carers Cards must be returned to the Security and Parking Office upon discharge where the £5 deposit will be fully refunded.
• All Carers Cards will be cancelled after seven days if not being used.

Please note the Security and Parking Office is open 7am – 6.30pm, Monday to Friday. If a patient’s expected discharge date is outside of office hours please return the card before the office closes at 6.30pm explaining the situation.

Card usage rules

• Cards do not provide access to any wards.
• Access to the staff restaurant from the Atrium is through one specified door (see map).
• Only one card will be issued per patient (cards can be shared if more than one person is providing care that fits the eligibility above).
• Only two carers are permitted per restaurant visit (if sharing cards as above).
• Patients are not permitted in the staff restaurant.
• Cards must not be passed to other hospital visitors; it is only valid for the carer it is issued to and must not be kept on the wards.
• Meals are not discounted or free - cards only allow access to the restaurant.
• If you are found to have abused any of the above, cards will be withdrawn.
• Cards must be returned to the Security and Parking Office at the end of hospital stay when the £5 deposit will be refunded.

Cards can be withdrawn should the criteria not be fully adhered to.

If you have any questions or concerns regarding the Carers Support Scheme, please speak to staff on the ward or at the Security and Parking Office.

Carer Support Services

There are a number of different carer support organisations across the country who can provide information, support and signposting for unpaid carers. These organisations can make sure you are linked into services providing financial, practical and emotional support for your role.

To find your local carers support service contact your county council or go to the Carers Trust website at https://carers.org/ and use the search feature to find your local centre.

Support for Carers in Bristol and South Gloucestershire

Carer liaison workers are based at Southmead hospital. We work with carers supporting someone living in Bristol and South Gloucestershire.

We can:

• Provide help, information, and advice to carers through their hospital journey as a carer and/or patient, working directly on wards and signposting to other services for support.
• Refer carers for ongoing community support upon discharge.
• Provide information on services available to carers within the hospital and the wider community.
• Liaise between the discharge team, ward staff and carers and their family, to help with any concerns or worries.

How to contact us 

Telephone: 07557 418692

Email: carersliaison@nbt.nhs.uk

© North Bristol NHS Trust. This edition published February 2023. Review due February 2026. NBT003195

Appetite and health

Having a good appetite is important to make sure your body gets all the nutrients it needs to stay healthy.

As you get older or become unwell, your appetite can disappear.

This page offers tips to help you eat better.

Some of the information may be different to typical ‘healthy eating’. However, when you are ill healthy eating may be harmful for your health.

Once you are well or a healthy weight you can return to healthy eating.

Possible side effects of having a small appetite

• Higher risk of infection
• Higher risk of falls
• Lower mood
• Lower energy levels
• Loss of muscle and reduced strength
• Nutrient deficiencies
• Hospital treatment may be less effective
• More hospital admissions and longer hospital stays

Tips for eating better with a small appetite

• Eat ‘little and often’.
• Have 2-3 small snacks or milky drinks in between meals.
• Try not to skip meals. Skipping meals often can cause low appetite.
• Choose full fat/full sugar versions of food/drink rather than the ‘diet’ alternatives.
• Try to eat more on the days and times you feel well.
• Aim to have 1 pint of milk a day. This can be in tea, coffee or milkshakes.
• If following a plant based diet, try and include alternative milky drinks and puddings (e.g soya, oat milks etc).
• Have a pudding after meals.
• Eat in a peaceful environment. You may find turning on the TV or eating with friends and family helpful.
• If cooking/shopping is too much, consider meals on wheels e.g. Wiltshire Farm Foods, Oakhouse or Cook.
• If you have access to the internet you may also find home delivery helpful. Age UK and Red Cross can help with shopping.

Which foods should I snack on?

Foods with lots of energy and protein are a good source of fuel. They also help fight infection.

High protein foods include:

• Meat, fish, poultry
• Cheese, milk, eggs
• Tofu, beans, lentils
• Yoghurt, cream and milky puddings
• Nuts and seeds
• Milky drinks e.g. hot chocolate, ovaltine
• Fortified drinks and food
• If on a plant based diet - dairy free milks and puddings

High energy foods include:

• Biscuits
• Crisps
• Cakes
• Chocolate
• Puddings
• Cream
• Butter
• Fruit juice and smoothies

Choose full-fat versions of these foods whilst you are unwell.

Snack ideas

Aim for 2-3 snacks every day.

Savoury

• “Cream of” soups - have 1 x tin or 1/2 tin with croutons
• Handful of Bombay mix or nuts
• Matchbox size portion of cheese and crackers
• 1x bag of crisps
• Slice of quiche
• 3 x cocktail sausages
• 2 x mini sausage rolls
• 1 x small pork pie
• 1 x slice of toast with butter
• 1 x crumpet or bagel with butter

Sweet

• 1 x slice toast with butter and jam/marmite/peanut butter/chocolate spread
• Scone with jam and cream
• Rice pudding
• Cereal bar
• 1 x tea cake
• 1 x slice malt loaf
• Individual puddings e.g. trifle, custard, cheesecake, mousse
• 1 x bar of chocolate
• Full fat yoghurt
• 1 x handful of dried fruit
• 1-2 x scoop of ice cream

Nourishing drinks

If you struggle to have extra snacks try to have 1-2 nourishing drinks instead.

Aim to have 1 pint of milk a day. Use in cereal, tea, coffee and other nourishing drinks listed below.

• Full cream milk (aim for 1 pint per day)
• Milkshakes
• Hot chocolate
• Malted drinks
• Milky coffee and tea
• Smoothies
• Sugary fizzy drinks e.g. lucozade, cola
• Fruit juice
• Soya drinks e.g. Provamel, Alpro Soya

Fortifying foods

This can be helpful to make food more nourishing, without having to eat a larger portion.

Fortified milk

• Whisk 4 heaped tablespoons of milk powder (e.g. Marvel or supermarket own brand) into 1 pint full fat milk.
• Use this fortified milk in cereal, porridge, milky drinks, tea/coffee, puddings, soups and sauces.

Fortified mashed potato

• Add 1 x heaped tablespoon of butter and 1 x tablespoon of cheese to a scoop of mashed potato.
• Use fortified milk.

Fortified yoghurt/custard/milk pudding

• Add 1 x heaped tablespoon of milk powder to one serving of yoghurt/custard/milk pudding.
• Add toppings such as jam, syrup, honey, seeds or fruit.

Fortified sandwiches

• Use spreads (e.g butter/margarine) generously.
• Use lots of mayonnaise or salad cream.
• Choose nutritious fillings such as peanut butter, egg mayonnaise, ham, tuna or cheese.

Fortified soups

• Add cream, fortified milk, evaporated milk, creme fraiche, cheese or cooked meat.
• Have croutons or bread.
• Choose creamy varieties e.g. cream of tomato.
• If using cuppa soups, make with fortified milk.

Fortified sauces

• Use enriched milk to make white, cheese or packet sauces.
• Add meat juice to gravy.
• Add grated cheese, oil or 1 x teaspoon milk powder to one serving of tomato based sauces.

Fortified vegetables and salads

• Try frying or roasting vegetables instead of boiling/steaming.
• Add butter or grated cheese to vegetables.
• Have cheesy or creamy sauces with vegetables.
• Add cheese, nuts, eggs, beans, tofu or lentils to salads.
• Use generous helpings of oil/creamy dressing and croutons/potatoes.

What about diabetes?

If you have diabetes and a poor appetite it may not be helpful to follow the usual ‘low fat, low sugar’ healthy eating advice.

However, once your appetite has returned to normal, you can return to healthy eating.

Meal ideas

Breakfast

• Creamy scrambled egg with buttered toast
• Porridge/cereals with honey/sugar
• Crumpets with butter and jam
• Muesli with whole cream milk and natural yoghurt

Lunch/lighter meals

• Beans on buttered toast with grated cheese topping
• A buttered jacket potato with tuna mayonnaise filling.
• Ham or cheese omelette, chips and salad with mayonnaise
• A creamy soup with added grated cheese and croutons

Main meals

• Shepherd’s pie with grated cheese topping and vegetables with added margarine or butter
• Chicken curry or dahl with rice or chapatti spread with oil, butter or margarine
• Cauliflower cheese made with fortified milk with grated cheese topping
• Fish in cheese sauce with creamed potatoes and vegetables with added margarine or butter

Puddings

• Milk pudding e.g. rice/tapioca/semolina
• Baked egg custard
• Crumble with ice cream
• Trifle with cream
• Jelly made with fortified milk

Nutritional supplements

Some people may be prescribed nutritional supplements from their doctor or dietitian.

Supplements are drinks that are high in energy and protein and can be helpful for some people whilst unwell. They are available on prescription. Your doctor or dietitian will discuss these with you if they think you may need them.

You can buy other supplements such as Complan or Meritene from local chemists. You may find these helpful if you cannot make nourishing drinks at home.

Where now?

For further information you may find the following resources useful.

Brotherton et.al (2010). ‘Malnutrition Matters: Meeting Quality Standards in nutritional Care.’ A report on behalf of the BAPEN Quality Group

Diabetes UK

www.diabetes.org.uk

Cook Food - freezer meals with delivery service

www.cookfood.net

Parsleybox - cupboard meals with delivery service

www.parsleybox.com

Wiltshire Farm Foods

www.wiltshirefarmfoods.com

Oakhouse Foods

www.oakhousefoods.co.uk

Eating well in later life - Malnutrition Task Force

www.malnutritiontaskforce.org.uk/eating-well

Food enrichment - BAPEN

www.bapen.org.uk/nutrition-support/nutrition-by-mouth/food-first-food-enrichment

Malnutrition fact sheet - British Dietetic Association

www.bda.uk.com/resourceDetail/printPdf/?resource=malnutrition

The Red Cross - offering help with shopping

www.redcross.org.uk

AgeUK - offering help with shopping

www.ageuk.org.uk

How to contact us 

Dietetic Department: 0117 414 5248

© North Bristol NHS Trust. This edition published April 2023. Review due April 2026. NBT002833

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

Information for GP's

The implementation of the Faecal Immunochemical Test (qFIT) testing for occult blood for the detection of colorectal cancer in patients in the SWAG cancer alliance area

Individual CCGs (Gloucester, BNSSG, BSW and Somerset) within the SWAG Cancer Alliance have funded FIT testing for the early detection of colorectal cancer.  Originally this was for low risk patients but indications have been expanded and updated. 

For further information on the requesting indications, process and reporting guidelines please refer to the relevant page on the REMEDY website: https://remedy.bnssg.icb.nhs.uk/adults/gastroenterology-and-colorectal-surgery/fit-test/

Information about qFIT testing is presented in this video made when the service was first introduced. Although some of the indications have been expanded the essence of the video is still applicable https://youtu.be/zb1o8ykvS6U

The team comprises clinical scientists and trainees who work closely with urology, gynaecology, consultants, physiotherapists and dietitians, enabling a holistic service.

As well as performing diagnostic tests the team also attends MDTs, conducts research and provides teaching to other healthcare professionals.

Rachel Tindle
Clinical Scientist/Lead Clinical Scientist for NBT

Amie Sutton
Trainee Clinical Scientist

Sarah Massa
Clinic Co-ordinator

Alex Bacon
Clinical Scientist

Laura Thomas
Department manager/Clinical Scientist

We are pleased to be able to offer this free online training course via Microsoft Teams.  

The course is a full day and consists of both theory and practical exercises outlining models, tools and access considerations for AAC Assessment and implementation for people with Adult neurological conditions.

We will ask those attending to bring a case study with them to share and relate their learning to. A template for case studies will be sent out to attendees a week before the course date. There will be opportunities to ask any specific questions you have and learn more about the service AAC WEST offer.

Available dates:
Tuesday 13th May 2025 at 9:00am- Book here with Eventbrite

We are pleased to be able to offer this free online training course via Microsoft Teams.

The course is a full day. We will cover tools for setting and evaluating goals, choosing appropriate vocabulary sets and several strategies for AAC implementation including resources.

The focus will be mostly practical and appropriate for therapists and assistants. It will be applicable for those supporting paediatric and ALD caseloads who are mainly symbol users.

We will ask those attending to bring with them a case study to share and relate their learning to. A template for case studies will be sent out to attendees a week before the course date. There will be opportunities to ask any specific questions and have discussions in small groups.

Available dates:

Wednesday 8th May 2024 - Book here with Eventbrite

Wednesday 27th November 2024 - Book here with Eventbrite

AAC awareness training for staff in schools and settings.

Do you have a Child or Young person (CYP) using a communication aid who is due to start in your class or setting?

Are you familiar with AAC and how to support a CYP in your setting?

You can register for a short presentation that has been designed with new team members in mind.

Focus on CYP moving to a new class or setting with a new team of staff (open to the team around the child or young person) such as teachers/ sencos/ teaching assistants/ key workers, and any LSLT's new to post etc.

Book Here:

No current dates, Please check back here for future dates.

The Research office is located within the Learning & Research building here at Southmead Hospital.

Just a stone’s throw away from the Brunel building where most of our patients are treated, Learning & Research is home to an array of facilities that provide medical and healthcare training, teaching accommodation and dedicated study space, as well as a full suite of research facilities.

The building was completed in 2014, alongside the redevelopment of Southmead Hospital, and features sleek interior spaces and a vibrant external design by Avanti Architects. This purpose-built facility represents the Trust’s ongoing commitment to research and is shared between NBT staff and the medical students of Bristol University.

Alongside our office base in Learning & Research, we also manage the adjacent Clinical Research Centre. If you’re taking part in one of our research studies, one of our staff may direct you there as a part of your visit. Our Clinical Research Centre enables us to:

• Look after our research participants in a tranquil and calm environment outside of the main building.
• Bring together researchers from all disciplines from across the Trust, enabling them to work more closely and share best practices.
• Develop the next generation of registered nurses and allied health professionals.
• Give our research participants the best possible experience of taking part in a research study at the same time being given additional advice and support about their diagnosis.

Our team strives to be welcoming, friendly and offer the best possible experience of taking part in research. We look forward to your visit.

Travel information can be found by visiting the Our Hospitals page of our website.

Information for patients

If you have any questions after reading this information, please speak to your nurse.

Why you are having IV iron

You have been found to be anaemic with low iron levels. IV iron is given to patients when oral iron does not work or is poorly tolerated, or where iron stores need to be built up quickly e.g. in preparation for an operation. Anaemia, with the associated risk of a blood transfusion during/after an operation, is associated with poorer outcomes and improving your iron stores helps treat that anaemia.

How IV iron will be given

• Your vital signs (blood pressure, temperature, pulse and oxygen levels) will be taken before you receive IV iron.
• The IV iron will be given as an slow injection through a cannula (plastic tube) inserted into your hand/arm; the injection is given over 30 minutes.
• Your vital signs will be taken again after the injection and you will be observed for 30 minutes to make sure you feel well.

Please let your nurse know if you feel unwell whilst the injection is running.

Possible side effects with IV iron

Like all medicines IV iron can cause side effects.

Common (may affect up to 1 in 10 people)

• Nausea
• Rash
• Discomfort at the cannula site during the injection
• Irritation or mild infection at site of injection
• There is a 1 in 10 chance of leaking of iron into the skin at the site of the injection (extravasation), which causes permanent staining of the skin

Uncommon (may affect up to 1 in 100 people)

• Headache, fatigue
• Flushing, fever, shivering
• Non allergic reaction (Fishbane): symptoms may include facial flushing, chest tightness, shortness of breath and/or joint pains. This usually settles quickly if the injection is stopped and/or continued more slowly.
• Dizziness, blurred vision, altered sense of taste, numbness
• Stomach pain, vomiting, diarrhoea, constipation
• Low or high blood pressure, or increased heart rate
• Hives and itching
• Low phosphate levels

Rare (up to 1 in 1000 people)

• Palpitations, hoarseness, tremor, seizure
• Flu like illness a few hours to a few days after the injection e.g. fever, aches and pains in muscles and joints
• Serious allergy (anaphylaxis): swelling of face, mouth, tongue and difficulty breathing

Please seek medical help if you feel unwell at home within 48 hours after the injection or experience any of the above side effects badly.

The clinical service is staffed with 5 Consultant Haematologists for interpretation and advice.  The technical and clinical service is provided by Biomedical Scientists (BMS), Clinical Scientists (CS) , Associate Practitioners (APs) and Medical Laboratory Assistants (MLA).  The annual workload is in excess of 700,000 request items per year with 8-10% growth each year.  The Department has been approved for Biomedical Scientist and Clinical Scientist Training by the HCPC.  The BMS staff are State Registered with HCPC and the Trainee BMS staff are trained in accordance with the IBMS and HCPC regulations.  There is active encouragement for staff to follow further education courses e.g. MSc (Haematology) and management qualifications.

The Department is well equipped with modern instrumentation and has a replacement program to maintain and improve the level of service provided.

The Department is UKAS accredited and assessed for compliance by MHRA against the Blood Safety and Quality Regulations 2005 and also participates in all appropriate External Quality Assurance Schemes accredited to ISO17043 for which performance is closely monitored.

Clinical Head of Service
Dr Alastair Whiteway

Blood Sciences Manager
Mrs Allison Brixey

Blood Sciences Operational Manager
Mrs Joanne Skingley