Frequently asked questions about the Pain Management Service: 

I would like a review of my medication, can you help?

Why should (would) I see a psychologist?

Can you help me get more investigations for my pain?

Have I been referred to your service because the pain is ‘just in my head’?

I have had physiotherapy before, and it did not help. How would pain management physiotherapy help me?

What will happen after pain management?

© North Bristol NHS Trust. This edition published January 2025. Review due January 2028. NBT003762

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.

This page contains information about how to use different features of the Badger Notes app to access your maternity care record. 

Get the Badger Notes app or visit the website: 

Badger Notes - Access your healthcare records

Creating a new account

If you have used Badger Notes at a different trust or in a previous pregnancy, please see "Adding your pregnancy to an existing account" section below. 

You will need:

• The passphrase given to you by your midwife or booking clerk.
• Your mobile phone to receive your verification text. 

To create your account: 

1. Open Bader Notes app and tap "Crease account."
2. Agree to the terms and conditions if you are happy to.
3. Enter the email address you gave to the midwife or booking clerk and use the activation phrase given to you.
4. You will be asked how you would like to register. Please register with Badger Notes. We do not recommend registering with NHS login.
5. Enter the verification code you received via text. 
6. Create your password.
7. Create your PIN. 

Changing language

You can change you Badger Notes language through the tab with your current chosen language:

1. Tap/click on the three lines at the top left of the screen.
2. Tap on English (this is selected as the default).
3. Select the language you require.
4. Tap continue. 

Adding your pregnancy to an existing account

You will need:

• A new activation phrase from your midwife or booking clerk

To add your pregnancy: 

1. Log in with the same details used in your previous Badger Notes account.
2. Tap on the three lines on the top left of the screen.
3. Select Add a care record.
4. Add new activation phrase provided by your midwife.
5. Your current pregnancy is now added to your old record.

Pre-booking questionnaire

You will have the opportunity to complete your pre-booking questionnaire before your booking appointment with your community midwife. You can return to the questionnaire and update up to the day of your booking appointment. 

Edit profile

You can change your phone number or email address associated with your Badger Notes log in through the Edit Profile tab.

(This does not update the phone number or email address that the hospital has on record for you, to do this you will need to speak to your community midwife). 

Key Details

Your care provider may ask you for key details such as your hospital number, if you contact them over the phone. 

The key details are:

• Your key information, e.g. NHS number, hospital number, due date etc.
• Your circle of care, for example GP and Named Midwife. 
• General health history.
• Medical history.
• Plan of care for your pregnancy.
• Current management plan(s).

To find these details:

1. Tap on the Maternity Record tab at the bottom of the app.
2. Select My Key Details.

Notifications

We recommend you have push notifications switched on to allow appointment reminders and important updates from our maternity unit.

To change notification settings:

1. Tap on the three lines on the top left of the screen.
2. Select Settings.
3. Enable or disable the options and save.
4. Notifications can be found in the bell icon on the top right corner of the Care Plan page.

Care Plan

In the Care Plan tab, you can see a weekly summary of your pregnancy.

For example at 28 weeks, you will be offered routine screening blood tests and recommended to read the information leaflet on screening.

You will be able to:

• Write some thoughts (only visible to you) into the diary by selecting Add photo or diary entry.
• Upload an image for your own purposes (this is not visible to your maternity staff).

Conversations

In the conversations tab, you can:

• Write antenatal, postnatal and birth plan thoughts and notes to speak with your midwife or doctor about at your next appointment.

Your midwife or doctor will be able to see these notes however they will not be notified of an entry therefore it is very important not to put any urgent messages in this area.

 

Maternity Record

A summary of your maternity notes can be found within the Maternity Record tab. 

To view your antenatal care summary:

1. Tap on the maternity record tab and scroll down to the summary
2. Scroll to the row you would like to view.
3. Click to open and scroll to view the details. 

You may need to turn your phone landscape to make viewing easier.

Leaflets

Our hospital maternity leaflets are available in the Badger Notes Library tab. 

These can be viewed throughout your pregnancy and after birth.

You can also access the Glossary to help you understand any new medical terms you may see in your notes.

Leaflets which have been specifically recommended to you by your midwife or doctor can be found by:

1. Tapping on the Care Plan tab.
2. Tap on recommended reading at the top of the page.

Hospital Contacts

To view your hospital contacts, including emergency phone numbers:

1. Tap on the three lines on the top left of the screen.
2. Select the Hospital Contacts tab.

Badger Notes Helpline

If you have any problems accessing your Badger Notes, please use the Badger Notes Helpline where someone will be able to help you.

Please note this is a non-urgent helpline for Badger Notes access queries only.

Phone 0117 342 9301

Email badgernotessupport@uhbw.nhs.uk

Open hours: 

• Monday to Friday, 10:00 to 16:00
• Saturday and Sunday, 11:00 to 15:00 

© North Bristol NHS Trust. This edition published December 2024. Review due December 2027. NBT002914.

Vascular Surgery Research Team

Our Surgery Research team is a dedicated group of nurses, administrators, and surgeons, conducting studies across specialities including Colorectal, Upper Gastrointestinal (UGI) and Vascular.

Our research is supported by the Department of Health with our research projects encompassing a wide breadth of both laboratory-based and clinical work, to improve patient health, wellbeing and care.

We work on a range of commercial and non-commercial, qualitative and quantitative projects and collaborate with colleagues locally, nationally and internationally in order to improve outcomes for patients suffering from various conditions. 

Our work benefits patients not only here in the NHS, but also increases care standards globally.

The team has a wealth of experience conducting research studies and trials, and improving training, guidelines, and patient outcomes.

Our staff work in close collaboration with a number of partners, primarily linked with the University of Bristol and University of the West of England (UWE) as well as a number of other NHS Trusts.

Team Members:

Samantha Loud

Dr Marcus Brooks

Chris Twine

Helen Cheshire

Seeve Suppiah

Gosia Slowinska

Alice Smith

This page is for patients and their families when preparing for a cardioversion.

What is a cardioversion and how is it done?

Cardioversion is done in hospital under a short general anaesthetic (you will be asleep) to treat an abnormal heart rhythm. 

The doctor will place electrode ‘sticky pads’ on the front and back of your chest and send electrical energy through the chest to the heart. This energy is synchronised (works at the same time) with your own heartbeat and should return your heart to the normal regular rhythm. 

Cardioversion is usually done as a day case, so that you come to hospital and go home the same day. Occasionally it is necessary to stay overnight.

Why do I need to have a cardioversion?

You may have been having palpitations or an irregular heart beat for some time. Your doctor may have prescribed a course of tablets such as amiodarone, digoxin, bisoprolol, or diltiazem to control your heart rhythm. These are not always successful and if you are troubled by palpitations, breathlessness, chest discomfort, or reduced activity then cardioversion may help. By restoring your heart’s normal regular rhythm (sinus rhythm) your symptoms can improve.

Will it be successful?

The cardioversion is more likely to be successful if your heart has been in an abnormal rhythm for only a short while, like a few months. The effectiveness varies, but in 9 out of 10 people the cardioversion will restore the normal regular rhythm.

However, some of these people will go back to how it was in the next few days or weeks. In a few cases the procedure will not be successful at all.

For 5-6 people out of 10 who have cardioversion, their heart will likely still be in the normal regular sinus rhythm 12 months later.

The best results are seen in patients with normal heart structures seen on an echo scan. Patients with structural heart impairment, for example leaky valves or enlarged heart chambers, have a lower chance of long-term success.

Before you come into hospital

Your doctor will prescribe a blood thinning medication called oral anticoagulant, for example apixaban or dabigatran. These are taken twice a day for 4-6 weeks before the cardioversion and you will continue taking them afterwards. It is important that you don’t miss doses of the anticoagulant as this can increase the slight chance of having a stroke following the cardioversion.

You will be seen by a cardiology pre-op assessment nurse, before your procedure date. Usually, the procedure is done as a day case procedure (home on the same day).

The nurse will talk to you, take a blood sample, do an ECG recording, and check that that you can get to the hospital, and someone can take you home. You will not be able to drive yourself home.

Important information

• You must not eat or drink for at least six hours before your admission to prepare for the general anaesthetic.
• Take your regular medications as usual, early on the morning of your cardioversion with a small sip of water.
• If you are taking digoxin, you should stop taking it 48 hours before you come to hospital.
• If you are diabetic, the pre-assessment nurse will explain what you need to do before you come into hospital.

When you arrive at hospital

You will be seen by a nurse and a doctor who will talk about the procedure and answer any questions you have. You will then be asked to sign a consent form to show that you are happy to have the treatment.

The anaesthetist will talk to you about what will happen and ask you about your health and any allergies you may have.

You will be attached to a cardiac monitor to record your heart rate. Staff will take your blood pressure and record your breathing rate.

The anaesthetic will be given through a small needle in the back of your hand and as you drift off to sleep the electrical cardioversion will be done. The procedure takes about 5 minutes. You will then be taken to the recovery area.

What happens next?

You will sleep off the effects of the anaesthetic and wake up in your own time. When you wake up you will probably be lying on your side and wearing an oxygen mask. The nursing staff will monitor your blood pressure, heart rate, and breathing rate.

When you are fully awake you will be told how the procedure went and staff will be happy to answer any questions. Some people feel slightly sick after anaesthetic, but you will be given a drink and something to eat when you feel able to.

When you have recovered, you will have another ECG done to see if the procedure has been successful.

As long as you feel well enough, you will be able to be collected and go home 2-4 hours after your treatment.

Even if the treatment has been successful, the doctor may tell you to continue taking some or all of your tablets for a while longer.

An outpatient appointment will be arranged for you to see your hospital doctor who recommended the cardioversion and you can ask about your medicines then.

Please remember it takes a while to recover from a general anaesthetic.

For 24 hours after cardioversion:

• You must not drive.
• You must not operate any potentially dangerous devices as your reflexes may be reduced.
• You must not make any important decisions or sign any legal documents.
• Do not drink alcohol.
• Do not boil a kettle or use anything that involves heat.
• When rising up to sitting or standing, do it slowly as you may feel dizzy if you get up too quickly
• We advise you to rest for the remainder of the day after your treatment and to take the next day off work.

What risks are there?

Cardioversion is a safe procedure which has been done in most hospitals in the UK for many years.

Complications are rare, but there are risks that you need to think about before you sign the consent form.

These risks are higher in patients who are very unwell or have certain medical conditions. You need to weigh up the risks of having the procedure or leaving the condition untreated, against the potential benefit of the procedure.

Below are approximate complication rates for patients having cardioversion. However, you need to remember that these numbers include all patients, regardless of how ill they were to start with.

• Risk of an anaesthetic problem or death is one in every 100,000 patients.
• Risk of having a stroke or another type of blood clot problem is approximately one in every 1000 patients.
• There is a minor risk of slight burns to the chest from the paddles or adhesive pads used during the procedure.
• Rarely, some patients may require a temporary pacing wire to be inserted if the heart beats too slowly.
• Rarely the procedure causes a more serious, life threatening abnormal heartbeat. This is so uncommon that there are no available statistics.

References and further information

Cardioversion - BHF

© North Bristol NHS Trust. This edition published December 2024. Review due December 2027. NBT002341

Surgery Research Team

Our Surgery Research team is a dedicated group of nurses, administrators, and surgeons, conducting studies across specialities including Colorectal, Upper Gastrointestinal (UGI) and Vascular.

Our research is supported by the Department of Health with our research projects encompassing a wide breadth of both laboratory-based and clinical work, to improve patient health, wellbeing and care.

We work on a range of commercial and non-commercial, qualitative and quantitative projects and collaborate with colleagues locally, nationally and internationally in order to improve outcomes for patients suffering from various conditions. 

Our work benefits patients not only here in the NHS, but also increases care standards globally.

The team has a wealth of experience conducting research studies and trials, and improving training, guidelines, and patient outcomes.

Our staff work in close collaboration with a number of partners, primarily linked with the University of Bristol and University of the West of England (UWE) as well as a number of other NHS Trusts.

As part of our Colorectal & Upper Gastrointestinal portfolio, we also work closely with Bristol’s Haematology and Oncology Centre (BHOC) and operate a shared care research pathway between us so patients can receive the highest standard of care whilst taking part in a research study.

Colorectal & Upper Gastrointestinal (UGI) Research Team:

Dr Anne Pullyblank

Kathryn McCarthy

Ann Lyons

Andy Smith

Angus McNair

Jodie Rawlings

James Hopkins

Suzie Royle

Vascular Surgery Research Team:

Dr Marcus Brooks

Chris Twine

Helen Cheshire

Seeve Suppiah

Cross-Portfolio Team:

Samantha Loud

Gosia Slowinska

Alice Smith

Information for patients whose initial preparation of your bowel has not been sufficient to produce a diagnostic result from your examination, a further 24 hours of additional bowel preparation is required.

Please follow these instructions to continue bowel preparation for your examination. 

Diarrhoea may occur so make sure you have easy access to a toilet. 

It is important to drink plenty of clear fluids during the entire period and aim for at least three pints of clear fluid every day. Examples of clear fluids are water, fruit squash, clear soup (e.g. Oxo, Marmite or Bovril), fizzy drinks (such as lemonade or cola), tea, or coffee. You should continue with any prescribed medication throughout.

On the day of the original appointment (today):

• Continue Low Residue Diet (see the information below). 
• Drink plenty of clear fluids. 
• Prepare and drink water and Gastrografin mixture:

1. In a glass, mix one bottle of Gastrografin (20ml) with 200ml (half a pint) of water. (You can add fruit squash/cordial if you prefer). 
2. Drink the mixture with a meal.

Day of re-booked examination:

• Please drink plenty of clear fluids. 
• No solid food. 
• Prepare and drink water and Gastrografin mixture: 

1. In a glass mix one bottle of Gastrografin (20ml) with 200ml (half a pint) of water. (You can add fruit squash/cordial if you prefer). 
2. Drink this mixture at least 2 hours before your new appointment time.

Low Residue Diet for CT Colonography preparation

Please continue this diet to prepare for your new appointment. Eat no solid food on the day of your new appointment.

You will be given further advice if you are undergoing other treatments such as dialysis. If you are diabetic avoid all foods marked with a *.

Foods allowed

Foods not allowed

© North Bristol NHS Trust. This edition published December 2024. Review due December 2027. NBT003567.

This page has information for patients with constipation referred for CT colonography at North Bristol NHS Trust. 

Please follow these instructions to ensure adequate bowel preparation for your examination. Diarrhoea will occur so make sure you have easy access to a toilet.

It is very important to drink plenty of fluid during the entire period. You may become dehydrated otherwise. It also helps ‘flush’ the bowel through. Aim to drink at least three pints of clear fluid every day. Clear fluids include water, fruit squash, clear soup, fizzy drinks, tea or coffee.

Gastrografin and Citrafleet instructions: 

You will be given 2 medicines to prepare your bowel for your examination. You will need to prepare these as advised below and drink them as instructed further down the page. 

Gastrografin

1. Pour 1 bottle of Gastrografin (20ml) into a glass. 
2. Into the same glass add at least 200ml or half a pint of water. You can add fruit squash/cordial as well if you prefer. 
3. Stir with a spoon until mixed well.

Citrafleet

1. Empty all of the powder from 1 sachet into a glass.
2. Into the same glass add water (at least 150ml). 
3. Stir with a spoon until the powder is completely dissolved. 

Two days before your appointment:

Begin following the Low Residue Diet.

• Drink plenty of clear fluids.

Day before your appointment:

Continue following the Low Residue Diet Drink plenty of clear fluids (at least 3 pints/1.7 litres). 

• You will have 2 Gastrografin and 2 Citrafleet mixtures today. 
• Drink 1 Citrafleet mixture in the morning. 
• Drink 1 Gastrografin mixture with your morning meal. 
• Drink your next Citrafleet mixture in the evening. 
• Drink your next Gastrografin mixture with your evening meal.

Day of your examination

You must have no solid foods from midnight. 

• Drink plenty of clear fluids. 
• At least 2 hours before your appointment drink one Gastrografin mixture.

Low Residue Diet foods and drinks

The table below contains foods which you are not allowed to eat while preparing for a CT Colonography. Not following these instructions could result in your scan being unsuccessful and delaying your examinations and/or treatment.

Patients with diabetes should avoid all foods marked with a*. You may have sugar-free alternatives for example pure fruit spread without skin or pips, instead of jam.

Patients with kidney failure or on renal dialysis, should only select foods and drinks from the lists which are normally allowed in your diet. Keep to your normal fluid allowance.

Low Reside Diet foods and drinks

© North Bristol NHS Trust. This edition published July 2024. Review due July 2027. NBT003570

This page has information for patients referred for CT colonography at North Bristol NHS Trust with a 20ml bottles of Gastrografin for preparation. 

Please follow these instructions to ensure adequate bowel preparation for your examination.

To prepare your bowel for your CT Colonography you will need to drink mixtures of water and Gastrografin. The instructions for this are below. Gastrografin often causes diarrhoea. The amount of diarrhoea is very variable. Please make sure you have easy access to a toilet during this 2 day preparation period.

It is very important to drink plenty of fluid during the entire period. You may become dehydrated otherwise. It also helps ‘flush’ the bowel through. Aim to drink at least three pints of clear fluid every day. Clear fluids include water, fruit squash, clear soup, fizzy drinks, tea, or coffee.

You also need to follow a Low Residue Diet for the 2 days of preparation, which involves eating foods with little to no fibre. Eating food with fibre may result in failure of bowel preparation, which can delay your scan and/ or treatment.

While completing this preparation you should continue to take any of your normal medication as prescribed. If you normally take laxatives for constipation, continue to take these.

How to prepare your Gastrografin mixtures:

1. Pour 1 bottle of Gastrografin (20ml) into a glass. 
2. Into the same glass add at least 200ml or half a pint of water. You can add fruit squash/cordial as well if you prefer. 
3. Stir with a spoon until mixed well. 

Two days before appointment

• Start Low Residue Diet. 
• You will have 2 Gastrografin mixtures today. 
• Drink one Gastrografin mixture with your morning meal. 
• Drink your next Gastrografin mixture with your evening meal. 
• Remember to drink plenty of clear fluids.

Day before appointment

• You will have 2 Gastrografin mixtures today. 
• Drink 2 Gastrografin mixture with your morning meal. 
• Drink your next Gastrografin mixture with your evening meal. 
• Remember to drink plenty of clear fluids.

Day of appointment

• You must have no solid food from midnight. 
• At least 2 hours before your appointment, drink 1 Gastrografin mixture.
• Keep drinking plenty of clear fluids.

Low Reside Diet foods and drinks

The table below contains foods which you are not allowed to eat while preparing for a CT Colonography. Not following these instructions could result in your scan being unsuccessful and delaying your examinations and/or treatment. 

Patients with diabetes should avoid all foods marked with a*. You may have sugar-free alternatives for example pure fruit spread without skin or pips, instead of jam. 

Patients with kidney failure or on renal dialysis, should only select foods and drinks from the lists which are normally allowed in your diet. Keep to your normal fluid allowance.

Table of foods and drinks allowed on Low Residue Diet

© North Bristol NHS Trust. This edition published December 2024. Review due December 2027. NBT003569

This page has information for patients referred for CT colonography at North Bristol NHS Trust with a 100ml bottle of Gastrografin for preparation. 

Please follow these instructions to ensure adequate bowel preparation for your examination.

To prepare your bowel for your CT Colonography you will need to drink mixtures of water and Gastrografin. The instructions for this are below. Gastrografin often causes diarrhoea. The amount of diarrhoea is very variable. Please make sure you have easy access to a toilet during this 2 day preparation period.

It is very important to drink plenty of fluid during the entire period. You may become dehydrated otherwise. It also helps ‘flush’ the bowel through. Aim to drink at least three pints of clear fluid every day. Clear fluids include water, fruit squash, clear soup, fizzy drinks, tea, or coffee.

You also need to follow a Low Residue Diet for the 2 days of preparation, which involves eating foods with little to no fibre. Eating food with fibre may result in failure of bowel preparation, which can delay your scan and/ or treatment.

While completing this preparation you should continue to take any of your normal medication as prescribed. If you normally take laxatives for constipation, continue to take these.

How to prepare your Gastrografin mixtures:

You will be given a 100ml bottle of Gastrografin and a measuring cup to make the mixture yourself at home. This will give you enough for 5 drinks over the two days before, and the day of your appointment. To prepare the Gastrografin mixture: 

1. Pour 20ml of Gastrografin into the measuring cup then pour this from the cup into a drinking glass. 
2. Into the same glass add at least 200ml or half a pint of water. You can add fruit squash/cordial as well if you prefer.
3. Stir with a spoon until mixed well.

Two days before appointment

• Start Low Residue Diet. 
• You will have 2 Gastrografin mixtures today. 
• Drink one Gastrografin mixture with your morning meal. 
• Drink your next Gastrografin mixture with your evening meal.
• Remember to drink plenty of clear fluids.

Day before appointment

• You will have 2 Gastrografin mixtures today. 
• Drink 2 Gastrografin mixture with your morning meal. 
• Drink your next Gastrografin mixture with your evening meal. 
• Remember to drink plenty of clear fluids.

Day of appointment

• You must have no solid food from midnight. 
• At least 2 hours before your appointment, drink 1 Gastrografin mixture. 
• Keep drinking plenty of clear fluids.

Low Reside Diet foods and drinks

The table below contains foods which you are not allowed to eat while preparing for a CT Colonography. Not following these instructions could result in your scan being unsuccessful and delaying your examinations and/or treatment. 

Patients with diabetes should avoid all foods marked with a*. You may have sugar-free alternatives for example pure fruit spread without skin or pips, instead of jam. 

Patients with kidney failure or on renal dialysis, should only select foods and drinks from the lists which are normally allowed in your diet. Keep to your normal fluid allowance.

Table of foods and drinks allowed on Low Residue Diet

© North Bristol NHS Trust. This edition published December 2024. Review due December 2027. NBT003568