Information for patients and carers

You have been directed to this page because you are being seen by the Hyper Acute Rehab Team (HART). 

We are a multi-disciplinary team of therapists with specialist expertise in brain, spinal cord, and traumatic injuries. Our service sees patients on wards 6b and 25a. 

Our aim is to provide early, specialist assessment and rehabilitation for patients with complex needs in the acute phase of their hospital journey.

The team will work closely together to coordinate your care and establish your ongoing needs. This may include directing you to other organisations or supporting with referrals to inpatient units or community teams.

Meet the team 

Our team includes: 

• Physiotherapists.
• Occupational Therapists.
• Speech and Language Therapists.
• Therapy Support Workers.
• Rehabilitation Medicine Doctors.

You may not need to be seen by all of these professionals. The therapists you see will depend on how your injury has affected you. 

It many be useful to write down your therapy team's names. Please note you may be seen by more than one therapist from each profession.

Occupational Therapists

Physiotherapists

Speech and Language Therapists

Rehabilitation Medicine Doctors

How we can support your discharge from Southmead

Part of the role of your therapy team is to help establish your onward rehabilitation needs. The options available to you will depend on factors such as where you live and the type of rehabilitation you require.

Some people can go directly home from Southmead Hospital. This may be with the support of family/friends and/or community therapy teams.

Other people may require a further period of assessment and/ or rehabilitation at an in-patient facility. The type of unit will depend on your injury and recovery so far.

You or your relative will likely have many questions about the next steps following the acute phase of your hospital stay. Your therapy team will be happy to discuss their recommendations and the options available to you.

Repatriation

Southmead Hospital is the specialist centre for the South West for people with neurosurgical and major trauma injuries. The repatriation (returning) of patients to their local hospital enables Southmead to use their resources to provide lifesaving interventions to other patients newly admitted.

Repatriation may also make it easier for your friends and family to visit you and can allow for a more coordinated approach as you near the point of discharge or transfer to local services.

Frequently asked questions:

How often can I expect to be seen?

Will all of the team work with me?

Will I have a named keyworker?

What happens if I am moved to another ward?

What if English is not my first language?

Feedback

We are keen to know which parts of our service are working well for patients and what areas need improvement. To give us feedback please visit: Survey (ratemynhs.co.uk)

© North Bristol NHS Trust. This edition published June 2024. Review due June 2027. NBT003619.

What is a sputum induction test? 

A 'sputum induction' test is a simple test that involves producing a fresh sample of sputum to be analysed. 

Why do I need to have this test? 

The doctor has requested that you have this test to analyse your sputum for different cells found in your lungs. 

What happens during the test?

Before the test starts the Physiologist will explain the test to you in detail and will answer any questions that you may have. The sputum induction test is a painless procedure.

Preparing for the test

What should I do before the test?

Please inform the clinic coordinator (phone number on your appointment letter) if any of the following apply to you:

• You have coughed up any blood in the last 2 months. 
• You have been told you have a collapsed lung. 
• You have used your GTN spray in the last few months for chest pain. 
• You have been told you have a blood clot. 
• You have had a heart attack in the last 2 months. 
• You currently or have had recently had a chest infection requiring antibiotic treatment. 
• You have had any surgery in the last 2 months (including eye surgery). 
• If you feel unwell on the day of the test.

Please follow these important instructions:

• Do not smoke for 4 hours before the test. 
• Do not drink alcohol for 4 hours before the test.
• Do not do any vigorous exercise 30 minutes before the test.
• Do not eat a substantial meal 2 hours before the test. 
• Do not wear lipstick or nail varnish to the appointment.

What should I wear to my test?

You should wear normal comfortable clothing.

Will I experience any discomfort or side effects?

The saline used can cause narrowing in your airways. To prevent this you will be given a medication (salbutamol) to open up the airways at the start of the test. 

There are no long term side effects of performing the test. You may however find it tiring because of the repeated coughing, and it can irritate the throat. You will be given time to recover between tests.

After the test

What happens after the test?

If we are able to produce a sample, it will be sent for analysis.

When/how will I receive the results of the test?

You are usually told your results at your next clinic appointment or a letter may be sent to the healthcare professional who referred you for the test.

What happens if I don’t want the test?

It is your decision but if you do not attend, we will not be able to pass important diagnostic information to your clinical team. This may affect the medical treatment you receive.

Is there a different test I could have?

There are no other simple tests that provide the same information.

References

© North Bristol NHS Trust. This edition published July 2024. Review due July 2027. NBT002337.

Within North Bristol NHS Trust (NBT)

• Samples for Blood Sciences: (Biochemistry, Haematology and Immunology) and Infection Sciences: (Bacteriology, Virology, Antimicrobial assays (ARL) and Mycology (MRU)) should be sent via the air tube unless the sample type/reason appears in the list below.
• Samples that MUST NOT be sent via the air tube include:
  • Urine for TB or suspected TB.
  • Viral haemorrhagic fever.
  • Histology or cytology.
  • Category 4 microbes.
  • Volumes over 100ml.
  • Samples which need to remain frozen (e.g. via dry ice).
  • Samples which need to be kept warm - special flasks are available for the transport of samples which have essential requirements to be kept warm (i.e. cryoglobulins, patients with cold agglutinins) - contact the Immunology or Haematology departments for these.
• Samples for COVID-19 can be sent via the air tube, but these MUST be double-bagged, sealed and sent in a new leak-proof carrier.
• Blood components and products will be transported in an appropriate, validated container packed by the Transfusion Laboratory.

For Primary Care locations where Pathology Services are provided by North Bristol NHS Trust (NBT)

Sample collections are made by the Pathology’s appointed medical courier Delivery Direct Logistics (DDL). For queries regarding this service please email Allison Brixey, Blood Sciences Manager, Allison.Brixey@nbt.nhs.uk.

This information is for anyone who has been referred for tests by their GP with a suspicion of cancer. 

It explains what you might expect in the days after your referral, and how you can get further support and advice. 

Many people we see will not have cancer. It is important that we find out either way as quickly as possible, so you have been referred to us on a Fast Track pathway. 

If you require this information in a different format please contact pals@nbt.nhs.uk.

You can watch a video about the Fast Track pathway here: Fast Track referrals for cancer information video | North Bristol NHS Trust (nbt.nhs.uk)
The video is available in different languages including British Sign Language. 

Helpful information 

• Please remember you are welcome to bring someone with you to each test, scan, and appointment. 
• If you need a reasonable adjustment due to a disability or other health condition, please let your appointment team know. 
• We welcome questions at North Bristol NHS Trust, and will support you to understand what is happening at each of your appointments . 
• It may be helpful to write down any questions you have and bring these along with a pen and paper to your appointment.

What happens now? 

Day 1

• Your GP refers you to hospital for tests. We aim to do these within 2 weeks from the date you were referred. 
• The hospital will phone or send you a letter to make an appointment if the GP has not made one for you.

Day 10 

• Phone the hospital if you have not been contacted after 10 days. 
• Fast Track appointment team: 0117 414 0538 

It is important that you are seen as soon as possible. We encourage you to accept the earliest available appointment. 

Day 28 

• We aim to confirm your test results with you. 

You do not have cancer: 

• Other referrals will be made for you if needed.
• Contact your GP if you still feel unwell. 

Cancer is diagnosed:

• Next steps and treatment will be discussed with you. 

Waiting for your test, scan, or appointment

It can be a worrying time waiting for investigations and appointments for possible cancer. 

Research shows that being as healthy as possible while waiting for your test, scan, or appointment can maintain and improve wellbeing. 

Even small improvements can have a positive impact on your health. You do not need to stop your usual activities, unless advised otherwise. 

If you feel worried or want more information while you are waiting, please see the contact details and information links below.

Who to contact 

For appointments

For support and information

Helpful NHS websites

© North Bristol NHS Trust. This edition published August 2024. Review due August 2027. NBT003669.

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

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

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

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

The department is committed to maintaining high quality standards and is accredited by UKAS to ISO:15189 (accreditation number 8191).

8191 Medical Single (ukas.com)

All relevant activities are licensed by the Human Tissue Authority, license 12413.

The Neuropathology Department takes part in the following External Quality Assessment (EQA) schemes:

• UKNEQAS for Cellular Pathology Technique: Neuropathology
• UKNEQAS for Cellular Pathology Technique: Muscle Histochemistry
• UKNEQAS ICC: Neuropathology
• UKNEQAS Bolt-on Scheme: Frozen Sections and Mega Blocks

We hope that you never have reason to feel concerned about any of our services. However, if you do have an issue, the best thing to do is speak with a senior member of team (Neuropathology Team | North Bristol NHS Trust (nbt.nhs.uk). If you do this as soon as possible we can hopefully resolve the matter immediately. 

Please see additional links below.

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

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

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

You can also contact the Trust's Patient Experience Team pals@nbt.nhs.uk or 0117 414 4569

The Gynae Oncology team at North Bristol NHS Trust (NBT) are a team who are experienced in providing comprehensive, specialist services of individuals who are either undergoing investigations for suspected gynaecological cancers or those who have been diagnosed with a cancer of the ovary, cervix, womb, vulva, vagina, and some rare gynaecological cancers. 

We understand that waiting for test results and appointments can be a worrying time. We are available to support you from the moment of referral, until you are either discharged from our service or your care has been taken over by the gynaecological cancer team at St Michaels Hospital, UHBW and/or the Bristol Haematology and Oncology Centre.

As NBT is not the main cancer treatment centre for Bristol, there will be different people involved in your care and we therefore act as a ‘link’ to improve communication between them, you and the wider cancer team. We are here to answer any queries or concerns and provide support and information for you, your family, and carers.

Meet The Team

Amy Slater – Miss Amy Slater, MBChB, MRCOG.

"I am a Consultant Gynaecologist, and lead for the Gynaecological Cancer Services at NBT. 

"You may meet me or one of my other colleagues at North Bristol NHS Trust, but I am often involved in co-ordinating your care behind the scenes. We know that undergoing investigation for suspected cancer and treatment for cancer is stressful and worrying but my team of professional and caring colleagues and I are here to support you through this challenging time and ensure you receive the highest standards of care."

Clinical Nurse Specialist Team (CNS) – Our role is to provide support and information to you if you are undergoing investigations for suspected gynaecological cancers or have been diagnosed with a cancer of the ovary, cervix, womb, vulva, vagina and some rare gynaecological cancers. We will act as your keyworker until you are either discharged from our services or your care has been taken over by the gynaecological CNS team at St Michaels Hospital, UHBW and/or the Bristol Haematology & Oncology Centre.

Leanne Hopkins – Lead Gynae-Oncology Nurse Specialist

Emily Cunningham – Gynae-Oncology Nurse Specialist    

Amelia Daniel – Gynae-Oncology Nurse Specialist

Questions to ask

When you come to see the team at NBT(North Bristol NHS Trust) or UHBW (University Hospital's Bristol and Weston NHS Trust), you may have a lot of questions. It is not uncommon to find it difficult to remember things at the time of and/or after your appointment so here are some tips to help you. These ‘Questions to Ask’ may be accessible in a language of your convenience. Please contact the Gynae-Oncology CNS team if this is needed.

Before your appointment

During your appointment

After your appointment, don't forget the following

Ideas of questions to ask at the time of your appointment

Tests, such as blood tests or scans

What next

Contact Us

Phone number: 07899011805

Email: GynaeonCNS@nbt.nhs.uk

Useful links

Here are some useful organisations and websites that we feel you may find helpful. If you've come across any other useful resources not listed here that you think could benefit others, please inform us.

• Gynaecology cancer at UH Bristol.
• Cancer Research UK.
• Macmillan Cancer Support.
• Jo's Cervical Cancer Trust.
• Target Ovarian Cancer.
• Ovarian Cancer Charity.
• Gynaecological Cancer Research Charity.
• Ovarian Cancer Action.
• Sarcoma UK.
• Penny Brohn UK.
• The Harbour – Counselling for death, dying and bereavement in Bristol.
• A leading cancer support charity - Look Good Feel Better.
• Willow – We create precious memories in the toughest times.
• You Tree Cancer Support.
• The Cinnamon Trust.
• Rent or hire a wheelchair British Red Cross.
• St Peter's Hospice.
• Weston Hospicecare.

Who are we? 

The Pain Management Centre is linked to the Pain Clinic at North Bristol NHS Trust and provides rehabilitation treatments for people suffering with chronic pain. We offer assessments at Southmead Hospital and Cossham Memorial Hospital. This service is delivered in conjunction with UBHW NHS Foundation Trust and some of our groups take place there in the Central Health Clinic.

The clinical team includes:

• Psychologists.
• Physiotherapists.
• Occupational Therapists.
• Clincal Nurse Specialists.
• Assistants. 

What does the Pain Management Centre do? 

The Pain Management Centre is linked to the Pain Clinic at North Bristol NHS Trust and provides rehabilitation treatments for people suffering with chronic pain. We offer assessments at Southmead Hospital and Cossham Memorial Hospital. This service is delivered in conjunction with UBHW NHS Foundation Trust and some of our groups take place there in the Central Health Clinic.

What happens next?

After attending an information session your first appointment at the Pain Management Centre will last for roughly an hour. You will be assessed by one of the specialist clinicians in the team. They will ask you about the nature of the pain you have been suffering and about the effects this has on your everyday life. We do not offer a cure for your pain and you will not be given any direct treatments for pain relief. 

Our focus is on helping people improve their lives despite having chronic pain. 

In the past you may have been asked to undergo a physical examination or to demonstrate how the pain is affected by affecting your movement and posture. You will not be asked to do this at your first appointment here. 

The assessment meeting provides an opportunity for you to meet with a member of our team with a view to seeing if a different approach to managing your situation may be worth investigating and what it could offer you. We will be happy to try and answer any questions you may have. We will then think about what the next steps might be, which could include joining a group or working with a member of the team in a 1:1 setting.

What do people who have seen us before say?

“Living with pain that doesn’t go away can be hard and make you feel miserable. The support written about in this leaflet can really help you find ways of coping and make your life easier. It’s up to you, but after doing the course you’ll have lots of tools to help give you a better quality of life. Can you afford not to go for it? Come and find out more about how you can make simple changes that will help make life easier!” (Sandra)

“When I was offered a place on the Self Management Programme I was unsure whether I would find it helpful. I went along and found the course leaders very welcoming and friendly. I knew the sessions would not stop my chronic pain, but I hoped I would gain some advice or strategies to help me cope. I was surprised by how interesting and helpful I found the programme. It has given me lots of ways to help cope, including lifestyle changes, helpful thinking and relaxation techniques. I enjoyed learning with a group of people which helped me realise others have the same problems as I have.” 
(Diane)

These are quotes from two of our patients who both attended one of the pain management groups. Not all of our patients attend these courses, and other approaches are available.

What should I do if I can’t attend my appointment?

Please contact the service administrator for the Pain Management Service on 0117 414 7357 who will be happy to help you.

© North Bristol NHS Trust. This edition published December 2023. Review due December 2026. NBT002045.

Information for patients who've been advised to take phosphate binders.

Why do I need to take phosphate binders?

Phosphate binders are tablets to help keep the phosphate level in your blood within the normal range. You may not have any symptoms of a high phosphate but taking your phosphate binders may prevent problems with your bones, blood vessels and heart. The normal range for blood phosphate is between 0.8mmol/l and 1.5mmol/l.

How do phosphate binders work?

They work by binding to the phosphate in your food, allowing it to pass out in your stool. You may also be advised to reduce your intake of phosphate containing foods. Your renal dietitian can provide you with information if this is needed.

How do I take my phosphate binders?

To work properly phosphate binders will either need to be chewed or swallowed whole either before, during or immediately after any meals, snacks or drinks containing phosphate. Your renal dietitian can guide you based on the phosphate binders you have been prescribed by the doctor. See the information below. Take your prescribed dose daily and spread your tablets throughout the day when you eat. Your renal dietitian can guide you on how to take these tablets with your usual meal pattern and food choices. See the information on page 4. You do not need to take your phosphate binders if you miss a meal. If you forget to take your binders with a meal try to remember to take the next dose at your following meal.

Practical tips

• Keep a container of binders in each of the places you eat.
• Keep a container of binders in your bag/pocket/in the car ready for when you eat out. 
• Set an alert on your mobile phone to remind you to take your binders when you eat.

Phosphate binders and other medication

Phosphate binders and some tablets should not be taken at the same time. Some tablets will need to be taken 1 to 3 hours before or after taking your phosphate binders. Check the patient information leaflet provided with your phosphate binders for information. You can also ask your pharmacist or doctor or dietitian. 

You or your health care professional can complete the following pages to remind you when and how to take your phosphate binders. Follow the advice of your pharmacist, doctor or dietitian.

Things you should write down:

• The name and daily dose of your phosphate binder.
• When to take your phosphate binders: meals/snacks, the binder, and the recommended dose. 
• The timing of your phosphate binders with meals/snacks: before, during, or after.
• How to take your phosphate binders: chew well or swallow whole. 

© North Bristol NHS Trust. This edition published March 2023. Review due March 2026. NBT003419.

Managing your fluid intake is an important part of your treatment 

Drinking less can:

• Help you breathe more easily. 
• Prevent your ankles swelling.
• Help you keep your blood pressure stable.
• Help prevent faintness or cramp on dialysis. 

It is also very difficult to control your fluid intake if you eat a lot of salt. Try not to add salt to cooking or at the table. Speak to your dietitian for more information on how to eat less salt. Your doctor nurse or dietitian can advise you how much fluid to have.

Write down the amount of fluid you have been advised to have. 

Useful measurements

• Standard cup = 150ml.
• Standard mug = 250ml.
• Standard tumbler = 250ml.
• Standard wine glass = 125ml.

Other helpful amounts

• 600ml = 1 pint.
• 1000ml = 1 3/4 pints.

Remember liquid foods could as part of your food allowance

Some typical servings

If you are feeling thirsty, try one of these first

• Slice of lemon or orange.
• Frozen grapes or pineapple cubes.
• Boiled sweets or sugar free mints.
• Chewing gum.

Try this to help space your drinks through the day

1. Pour water into a jug in the morning that is the same as the amount of fluid you can have daily.
2. Every time you have a drink such as squash, tea, coffee, milk, pour away the same amount of water from the jug.
3. This will help you keep track of the amount you are drinking and how much fluid you have left in your allowance for that day.

Helpful tips

• Use a small cup or glass for drinks. This should be about 150mls (5½fl.oz).
• Keep a record of your fluid intake to help you see how much you are consuming.
• Spread your fluids through the day and have smaller drinks.
• Remember spicy foods can make you feel thirsty. Try to reduce these foods.
• Use plastic ice cubes in drinks to save on fluid.
• Brushing your teeth or rinsing your mouth with water or mouthwash can help to freshen your mouth.
• If you have a dry mouth, artificial saliva sprays such as Glandosane (available on prescription) can help.
• Try swallowing tablets with food instead of fluid.
• If you drink less on one day, save some of your fluid allowance for the next day.
• You can drink sociably, but choose smaller drinks and try to drink less before or afterwards.

© North Bristol NHS Trust. This edition published July 2023. Review due July 2026. NBT003381.