Clinic appointments

Following completion of your treatment for breast cancer you will not need to be seen for regular follow up appointments. This is because research informs us that returning to hospital for appointments can cause many people unnecessary worry and anxiety. Research also indicates that very few problems
related to breast cancer recurring are picked up by attending routine follow up appointments.

Instead of routine follow up appointments, you will have an ‘open appointment’ with us. This means that at any time in the future you develop a concern or problem that you feel may be related to your breast cancer or its treatment you can call us to book an appointment to see a doctor. Therefore you have open access to our clinics. You can either phone our clerical team to book an appointment on 0117 414 7000 (pick option 1) or if you wish to discuss your concern with your breast care nurse first before making an appointment please telephone her direct.

Mammograms

You will be booked into our mammogram follow up service. You will be called for a mammogram one  year after the date of your surgery and then each year until you are five years from surgery. If at that time you are you are under the age of 50 you will continue to have yearly mammograms until you reach screening age (47 - 50). If you are aged over 50 years you will then be able to access mammograms through the NHS Breast Screening Programme. During the time that you are having mammograms via our service you should not attend the NHS Breast Screening mammograms (although they will continue
to call for you).

How to help yourself

Self-examination

We would ask you to check your breasts regularly for any changes. Some women find it emotionally difficult to do this so please contact your breast care nurse for advice/support if you wish to talk this through with her.

If you have had surgery as well as radiotherapy to your breast you may find this is firmer and ‘lumpier’ than your other breast. This is due to both the radiotherapy and surgery. Your first self-check will then make you aware of what is ‘normal’ for you and you will be more aware of any new changes.

This may be a new lump in the breast tissue or any change in shape. If you have had a mastectomy (with or without reconstruction) be aware of any new lumps or nodules on the skin.

The department has a number of different leaflets to help you on what changes to look for. If you notice changes you can either ring to discuss your concerns with your breast care nurse or telephone our clerical team to book an appointment (0117 414 7000). We will always ensure that you will be seen
in the next available clinic.

Other symptoms

If you experience any of the following problems it may be useful to telephone the Breast Care Centre to book an appointment to see a doctor.

• An increasing pain for more than three weeks in a bone that does not ‘come and go’ but gets steadily worse over time. The pain may be a dull persistent ache that often gets worse at night when the muscles are relaxed
• Loss of appetite or weight loss as well as feeling really tired (lethargy)
• Increasing breathlessness and/or a continuing cough
• A new lump or change in your breast(s)
• If you have had a mastectomy any new lumps/nodules in the skin
• A swelling by your collar bone (clavicle)

It is very important to remember that any of these symptoms or any others you are worried about does not mean this will be cancer. Bone pain can be arthritis, strain or injury. Breathlessness can be caused by a cold or flu. If you come to the clinic it is not uncommon for you to be advised to have tests such as a bone scan or CT scan. This will be done as quickly as possible to minimise the ‘worry time’ for you.

Medication

If you have been prescribed any of the breast cancer tablets and experience any problems with these your doctor will be happy to see you in clinic to discuss your concerns.

If you have been prescribed Tamoxifen, which is a drug used to reduce the risk of breast cancer in women before they go through the menopause. This can be changed to a different drug if you become post-menopausal (this would be when you have not had a period for at least 12 months). If this happens to you please ring the Breast Care Centre to book an appointment with your doctor on 0117 414 7000 (pick option 1).

Emotional support

Breast cancer treatment can be an emotional ‘roller coaster’ and coming to the end of treatment can be a relief but also can feel frightening. Please do not forget that your breast care nurse is able to help with supporting you through this time and the patient support group Bosom Buddies always welcomes new people.

© North Bristol NHS Trust. This edition published June 2022. Review due June 2025. NBT002955

Our NHS People

In addition to the internal staff wellbeing programme available to all NBT colleagues, national support is also available to all of our workforce, including free access to apps, staff common rooms and dedicated support lines for staff.

Support is also available nationally for Black, Asian and Minority Ethic colleagues including culturally sensitive apps and staff common rooms.

To find out more visit NHS England » Supporting our NHS people. 

HSBC Financial Support

HSBC currently offer free webinars to all staff on a wide range of topics including debt management, savings, investments, budgeting, pensions, cost-of-living, first time home buyers, retirement, growing your wealth and credit reports. Several sessions are offered every weekday and you can book your place through their online calendar. They also offer Financial Health Checks.

Wagestream

To help staff improve their financial wellbeing and have more control and flexibility over their pay, NBT have partnered with Wagestream. By downloading the free Wagestream app you’ll get access to a toolkit of simple-to-use financial products and services for managing your money easily, securely and more effectively.

If you have any further questions please email nbtwellbeing@nbt.nhs.uk.

Wisdom App

Our Employee Assistance Programme, Health Assured provide all NBT staff with exclusive access to a revitalised app - Wisdom. The app is designed to help you track your wellness, improve your mental health, and stay resilient during tough times.

Weight Management

NHS staff are now able to sign up to the NHS Digital Weight Management Programme. This is a service for people who would like to lose weight and improve their health and wellbeing. Staff who have a BMI of 30 or greater (or 27.5 or greater for staff from Black, Asian and other minority ethnic groups), can access a free, online 12-week weight management programme which is personally tailored to support their journey to a healthier lifestyle. Once you have your NBT email address, you can find out more information and self-register, by visiting the NHS Digital Weight Management Programme Staff Self Referral Site. 

Carers support

At NBT we have a range of support available for our staff carers, for example, our EAP can support with legal and emotional issues relating to caring, we also have access to the Carers UK Digital Resource for Carers, providing you with useful materials and support that you may find helpful when balancing caring responsibilities at work, this can be accessed through the Carers UK Digital Resource website, you will need to create a new account, using the unique access code: DNHS9166.
We’ve also introduced our Staff Carers Passport at NBT, contact us at mailto:staffcarers@nbt.nhs.uk for more information.

Staff Wellbeing Psychology Team

Staff Psychology Team: Our Staff Psychology Team offer a range of specialist psychological support for both teams and individual wellbeing, including:

• 1:1 support for work-related issues.
• ACT for wellbeing course.
• Bespoke consultation and workshops for teams.
• Support for managers.
• Coordinate trauma support following work-based incidents.

Contact the team via email at StaffPsychologyTeam@nbt.nhs.uk or call 0117 414 4892. Further information can also be found on LINK, our intranet, once you have computer access. 

Employee Assistance Programme (EAP)

We’ve partnered with Health Assured to provide you with 24/7 free and confidential support with any of life’s challenges, from free counselling to legal information, bereavement support and online CBT (including support for your dependents and legal partner); call 0800 030 5182 to access support today.

Schwartz Rounds

Schwartz Rounds are facilitated group sessions, where all staff from across the trust are invited to come together to discuss the emotional and social impact of working in a healthcare setting. Staff who regularly attend Schwartz Rounds feel less stressed and isolated at work. Check the LINK calendar for upcoming Schwartz Round sessions.

Physio Direct

The simple way for staff to access physiotherapy services here at NBT, with rapid access via self-referral, covering new and existing musculoskeletal conditions including joint, muscle and spinal problems.
To book a physiotherapy appointment please call 0117 342 3400. 

Green gym 

Our onsite Green Gym provides an outdoor space for colleagues to exercise, made up of five pieces of gym equipment, suitable for all staff regardless of experience or fitness level. Located behind the Learning & Research building, a map of the site is available. 

Doing our Bit

We've signed up to#DoingOurBitthe free online fitness sessions for staff -designed by the NHS, for the NHS. With over 40 unique workouts given to the NHS by Britain’s leading personal trainers. #DoingOurBitprovides a great choice of workouts from yoga to HIIT training, family-run to core and relaxation sessions. Once you have your NBT email address you can register today at DoingOurBit.

You will be sent an invitation with a detailed programme of sessions, dates and times.  Please check your email spam/junk folder as it has been known for the invitation to end up there.  If you have not received your induction invite by the Wednesday before your start date, please get in touch at staffdevelopment@nbt.nhs.uk

Induction takes place in our Learning and Research Building, a site map is available.

Non-clinical staff

Induction usually takes place on your first day of employment, where you will be introduced to the Induction Team and welcomed to the NBT. The day consists of welcome from the Senior Team, information sessions, networking, and various mandatory training modules. You will also have your photograph taken to produce your NBT ID badge.

Your Manager will reach out to you before Induction to confirm your workplace arrangements. Please feel free to contact your manager direct if needed.

A local orientation will be completed to include all you statutory and mandatory training. This is done in conjunction with your manager.

Clinical staff

Induction usually takes place on your first day of employment, where you will be introduced to Induction Team and be made to feel welcomed to NBT. The day consists of welcome from the Senior Team, information sessions, networking and various mandatory training modules. You will also have your photograph taken to produce your NBT ID badge.

Registered staff attend up to a four-day induction, support staff attend up to a ten-day induction - depending on their job role. If you are transferring training/skills through from an existing NHS hospital you will be asked for these when you are sent your induction invitation from the team.

Your manager will reach out to you before induction to confirm your workplace arrangements. Please feel free to contact your manager direct if needed.
 

What does being a Veteran Aware Hospital mean?

For you, our staff

If you would like us to, we can record your veteran/reservist status in the Electronic Staff Records (ESR).

• We are committed to the wellbeing of our veterans and have dedicated information on LINK, our internet, available once you have computer access, signposting for help and support for veterans and their families (search “veterans” ).
• We have a dedicated HR reservist policy.
• We are part of the Employer Recognition Scheme and are committed to supporting the Armed Forces family.

For patients

• We are committed to recording veteran status in our patient record system (EPR).
• We are committed to understanding the needs of veterans in terms of health and wellbeing and have relevant information on LINK, our intranet, available once you have computer access. 
• We are committed to signposting veterans and their families to specialised support and have a dedicated information.
• NBT has signed the Armed Forces Covenant as an individual NHS Trust and as part of a partnership with Bristol City Council. We are active members of the Armed Forces Covenant Partnership Groups in Bristol, South Gloucestershire and North Somerset.

If you would like to help improve the experience of veterans at NBT please get in touch by email at veteranaware@nbt.nhs.uk.

At NBT we do not tolerate abuse of any kind, whether from patients, visitors or even colleagues.
This includes bullying, harassment and discrimination, which can be racist, sexist, homophobic, transphobic, disablist or targeting your religion or belief.

Red Card to Racism and Abuse campaign

We have re-launched our Red Card to Racism and Abuse campaign - please wear a campaign badge with pride to show we stand together against abuse. You can collect one from the Job Shop or Security Office in the Brunel building or the Library in L&R.

Freedom to Speak Up

It is important that we all speak up if we see anything that makes us uncomfortable - this should happen at the time so that it can be addressed straight away. Initially, you should speak to your line manager if you have any concerns, and our Freedom to Speak Up Guardians are also here to help you.

Policies

We have a public policy in place to protect everyone (The Prevention and Management of Violence & Aggression Policy - HS08), where any abusive patients or visitors will receive a verbal then written warning, followed by an acceptable behaviour contract and ultimately exclusion from the trust if their abuse continues. We also have a Protocol for Managing Violence & Aggressive Persons at NBT (Protocol CG162).

Clinically challenging patient behaviours

As a healthcare environment, we recognise that there are times when a patient’s behaviour may be linked to or influenced by their clinical condition.  As one of our patient safety priorities, we have been delivering a programme of training for clinically facing staff on how to identify, prevent and safely respond to clinically challenging patient behaviours.

Early Conflict Resolution

We also have internal HR processes in place should abuse occur from one staff member to another. Your first course of action in this instance should be to speak to your line manager, and you can use our Early Conflict Resolution guidance to support these conversations.

Datix reporting system

All staff are encouraged to speak up and report any abuse, whether they experience it themselves, witness it or are a manager of someone who has experienced abuse - our Datix reporting system can allow you to record the specific abuse encountered.

People who can support you

There are lots of people who can support you, including: 

• Harassment & Bullying Advisors.
• Trade Union representatives.
• People Team and People Partners.

We also have lots of staff network groups, including Black, Asian and Minority Ethnic staff network, LGBT+ staff network and Disabled and Neurodiverse staff network - please email Inclusion@nbt.nhs.uk to find out more.

Further information is available on LINK, our intranet, once you have computer access. 

The period following registration as a healthcare professional can be an anxious and challenging time. We all know that good support and guidance during this period is essential. Managing your transition successfully will lead to you providing effective care more quickly, enable you to feel better about your new role, and aid your career progression. 

The North Bristol NHS Trust Progress Preceptorship programme has been designed to assist you in your transition from student/ learner to a registered practitioner in the Trust.  It is a 12 month programme that will help you to develop your professional and reflective skills. Our programme has been awarded the Gold standard mark by the National Preceptorship Framework team.

.

What does it involve?

• A full induction programme including statutory & mandatory training.
• Support & supervision from a Preceptor in your place of work.
• Attendance at 4 Progress Preceptorship Days run by the Preceptorship Team and other senior Trust staff  - book via LEARN 
• Links to organisational policy & procedures
• Links to external regulatory requirements
• Aligned to National Preceptorship Framework

More information along with the Preceptorship workbook in available on LINK, our intranet, once you have your computer access.  

To contact the Preceptorship team please contact preceptorship@nbt.nhs.uk.