Information for patients and families

You may have been directed to this page because you, a family member, or someone else in your life has had care from North Bristol NHS Trust (NBT) that we would like to learn from. This is because some of the care may not have gone to plan. 

It is important for us to learn from the experiences of patients at NBT. We do this with a patient safety learning response.

What is a patient safety learning response?

A patient safety learning response is when we look at someone’s care to understand how and why things happened. When we understand the how and why, we can learn how to improve the care. 

There are different types of learning response and they take different amounts of time. A member of staff will explain what type we are doing and how long it will take.

Should I be involved in the learning response?

You can decide if you want to be, and how much to be involved. Some people have questions about the care that we can aim to answer through the learning response. Others choose to only receive the final report. Some people choose not to be involved at all.

We value input from patients and families into our learning responses. You have a unique view of the care provided and can often fill in gaps in the information that we do not have. We all want to learn from this, to improve the care for others we see in the future.

Whether you decide to be involved or not, we recognise how difficult this time can be. We will offer you and others support where needed.

What can I expect as part of the learning response?

NBT will offer you:

• A named point of contact, usually who is writing the report.
• The opportunity to meet to discuss the learning response process and answer any questions about this.
• The option to ask questions that can be addressed as part of the learning response.
• Share the findings of the learning response.
• The opportunity to meet and discuss the findings, and how we will learn from these.
• Support throughout the learning response process.

Next steps

Your named point of contact should get in touch with you to talk through what will happen next. We can arrange a time that works for you. (You should write down the details of your point of contact). 

Where can I find more information?

Learn Together 

Supporting involvement after safety events in healthcare website: 

Learn Together – Serious Incident Investigation resources

NHS England Patient Safety 

NHS England » Patient safety

© North Bristol NHS Trust. This edition published May 2025. Review due May 2028. NBT003622

Within North Bristol NHS Trust (NBT)

• Sample Transport Rules for Couriers and Porters.pdf141.5 KB
  North Bristol NHS Trust Pathology Specimen Transport Policy.pdf101 KB
• 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)

UN3373, UN2814 and any other dangerous goods labelling must be fully visible at all times and not hidden behind sealing tape or address labels.

Sample collections from external locations (e.g. primary care, community) 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.

Bristol 3D Medical Centre is a dedicated centre for in-house medical 3D design and 3D printing. It is one of the first of its kind, which was made possible with help from Southmead Hospital Charity. It hosts a variety of medical device design software, state-of-the-art 3D printers, high-performance 3D surface scanners and advanced technology used to aid healthcare.

This newly opened centre has unlocked the advancement in patient treatment options via pre-planning complex procedures that reduces surgical time, improves accuracy of surgery using surgical guides and visualisation through 3D software, 3D models and virtual/augmented reality.

With the ability to provide these services for all departments within the local hospital Trusts, Bristol 3D Medical Centre offers healthcare professionals to access:

• Processing and manipulation of individual patient data (Computed Tomography (CT), Magnetic Resonance (MR), surface scans etc.).
• Creation of digital and physical 3D medical anatomical models.
• Digital 3D design of custom-made devices, surgical guides and splints.
• Digital 3D planning of surgical procedures.
• Digital 3D planning of osseointegrated implants for prosthetic retention.
• Virtual planning and visualisation of patient specific anatomy.
• Creation of custom surgical moulds.
• 3D printing custom-made medical devices (such as splints and orthotic helmets).
• 3D printing custom-made medical implants (such as cranioplasty plates and craniofacial implants, titanium, PEEK and more).

Bristol Helmet Service

Bristol Helmet Service is now located in Bristol 3D Medical Centre and is one of the only NHS services for the assessment and provision of helmets for infant head shape differences (such as plagiocephaly and brachycephaly). 

Frequently Asked Questions

Patients

How can I arrange for my infant to have a head shape assessment for helmet therapy?

Please contact a healthcare professional such as your GP, Health Visitor or Paediatrician for a referral to our service for head shape assessment. We will only be able to book an appointment with a referral from a healthcare professional. This service is provided on the NHS.

Can I buy a medical model of my own anatomy?

It may be possible for you to buy a model of your own anatomy if you have the appropriate data for us to use after your treatment. You will need to cover the full cost of this, as this will not be part of your NHS treatment.

When and why is this service part of my NHS treatment?

Bristol 3D Medical Centre will be part of your treatment if your associated healthcare professional requires our services to plan your treatment or operation. In this case, you may be invited to view some of the digital 3D planning or 3D printing to help visualise your treatment or operation.

Healthcare Professionals

How can I arrange medical models, digital 3D planning or virtual visualisation of specific patients?

Please contact us through our email address with the patient’s details and information about the models, planning or visualisation you require. We will get back to you to arrange discussion in person or online regarding the services we can provide.

I am a Healthcare Professional not based in Bristol or the surrounding areas, can I still use your service?

Please contact us and we may still be able to help. Our ISO13485 accreditation is in progress, which will enable us to provide a number of services outside of hospital Trusts.

Are your materials medically tested and safe for use in and around the body?

Yes, we only use biocompatible medical printing resins for our 3D printed medical devices and implant-grade titanium and PEEK for our 3D printed implants. Please contact us for the details and we can provide the data sheet information to you on request.

Even though you are well enough to leave hospital, you are still at risk of developing a Deep Vein Thrombosis (DVT) or Pulmonary Embolism (PE). This risk will continue until you return to your usual level of mobility.

What is a DVT?

A DVT is a blood clot that forms in a vein. It is possible for a DVT to form in any vein but it most commonly occurs in the leg.

What is a PE?

A PE is a blood clot in the lungs, caused when part of a DVT breaks off and travels in the bloodstream to the lungs.

What can I do to reduce my risk of getting a DVT or PE?

• Stay as mobile as possible. If walking is difficult, exercise your legs and feet by flexing your knees and ankles, rotating your feet and wriggling your toes. Do this as often as you can.
• Drink plenty of fluids, as dehydration increases the risk of getting a DVT or PE (Renal patients, please check your fluid allowance with your renal clinical team).
• If you have been given stockings or injections to reduce the risk of getting a DVT or PE, please use them as instructed.
• Eat a healthy diet and maintain a healthy weight.
• Don’t smoke.

How do I know if I have a DVT or PE? 

Signs of a DVT include:

• Pain.
• Swelling.
• Discolouration of the skin (red, purple, or blue).

Signs of a PE include:

• A cough with or without blood-stained phlegm.
• Breathlessness - more than usual for you.
• Chest pain. Collapse (this is an emergency - phone 999).

If you develop any of the symptoms of either a DVT or PE, please get medical advice the same day. Phone 111 or your GP surgery, or go to the nearest A&E Department.

© North Bristol NHS Trust. This edition published October 2022. Review due October 2025. NBT002899

This page has information about what to do for some common issues with AAC devices. If you are advised to contact us please see the details at the bottom of the page. 

Mounting problem

Issue with a current mount? 

• Contact AAC WEST Tech Team 

Need a new mount? 

• Contact your Speech and Language Therapist who can complete a re-referral form. 

Hardware problem 

Issues with:

• Screens
• Camera
• Charger
• Turning device on

Contact AAC WEST Tech Team

Software problem

First try:

• Power off and turn it on.
• For iPads, try a hard shut down.
• Complete all hardware and software updates. 

If not resolved first contact:

• The local team, for example teacher, support worker, and local speech and language therapist.
• The supplier.

If not resolved:

Contact AAC WEST Tech Team. 

Editing

First explore:

• Editing and training videos: Software Training | North Bristol NHS Trust (Remember the Do and Don't list at the bottom of the page.

If not resolved first contact:

• The local team, for example teacher, support worker, and local speech and language therapist.
• The supplier.

If not resolved:

• Contact AAC WEST Tech Team. 

Supporting AAC users

First explore:

• AAC WEST - Training videos
• Emails and/or reports from AAC WEST

If not resolved first contact:

• The local team, for example teacher, support worker, and local speech and language therapist.
• The supplier.

If not resolved:

• Contact AAC WEST Tech Team. 

Supplier contact details 

Check your device for the company name. Suppliers can support with a range of issues. If you give them consent they can have remote access to your device to provide support. 

• Smartbox (Grid)
  • info@thinksmartbox.com
  • 01684 578 868                   
  • www.thinksmartbox.com
• Jabbla UK (previously called Techess)
  • info@jabbla.co.uk
  • 01476 561 991
  • www.jabbla.co.uk
• Tobii Dynavox
  • support.uk@tobiidynavox.com
  • 0114 481 0011
  • www.uk.tobiidynavox.com
• Liberator
  • info@liberator.co.uk
  • 01733 370 470
  • www.liberator.co.uk 

AAC WEST contact details 

Please contact us if the above do not resolve your device issue. 

Admin

• For admin, appointments, and referral queries.
  • aacwestadmin@nbt.nhs.uk
  • 0117 414 5850

Tech Team

• For hardware issues like faulty batteries, broken screens, missing equipment, and frozen iPads.
• aacwesttech@nbt.nhs.uk                                     
• 0117 414 5850

Support

• Support for software issues like missing grid sets/cells, Dropbox/account issues, and connectivity.
• aacwestsupport@nbt.nhs.uk
• 0117 414 5850

© North Bristol NHS Trust. This edition published October 2025. Review due October 2028. NBT003817.

Falls prevention in hospital

The aim of this page is to advise you how we will help reduce the risk of you falling whilst you are in hospital. 

Reducing falls is important for maintaining everyone’s health, wellbeing, and independence. Older people often have more falls and are more at risk of injury. Falls can become recurrent and cause injuries including hip fractures and head injuries. Falls can be life changing through the injuries they cause and the fear of falling that they create. 

A fall happens when someone accidentally ends up on the ground or a lower surface. It’s not caused by a major health issue like a stroke or a dangerous situation. Falls can happen to anyone and can be just a natural part of how our bodies work.

Falls often happen because of multiple risk factors. These include:

• Muscle weakness.
• Poor balance.
• Visual impairment.
• The use of certain medications or a combination of several medications.
• Environmental hazards such as steps, trailing cables, or wet floors.
• Some specific medical conditions might make people more likely to fall, such as dementia, stroke, or Parkinson’s disease

Each month North Bristol NHS Trust supports around 29,400 admitted patients. Around 180 falls are recorded for these patients each month (2023 data).

Can we prevent falls?

Like in normal life, it is not possible to prevent all falls in hospital. However, we can work together to reduce the chances of this happening.

Research has shown that the best chance of reducing falls is when staff such as doctors, nurses, and therapists work together. You and your family can also help by being aware of the risks and the actions you can take, as well as talking to the people looking after you about falls prevention.

North Bristol NHS Trust sees preventing falls as a priority and aims to reduce the risk of falls during your hospital admission by:

• Assessing all patients when admitted for the risk of falls and delivering individual care to manage this.
• Regularly reassessing patients if their condition changes.
• Responding quickly to hazards.
• Patients with higher risk of falls will be identified and provided with the appropriate level of care. This can include additional checks, supervision or moving to more visible area on the ward.
• Patients will be assessed individually for equipment, bed rails, and aids.
• Making the hospital environment as safe as possible. Training staff with regular updates.
• Encouraging staff, patients, and visitors to report any falls. This allows us to learn from previous falls

What can we do together?

This list can be used by patients, their carers, and families.

Hospital staff will ask you as part of your assessment. Tell the staff if you have

• Fallen in the past year.
• Are worried about falls.
• Have a history of falls.

Talk to staff if you feel confused or disorientated

• This could be a sign on delirium, and staff can give support for this.
• If you are a visitor and notice your friend or relative is not acting themselves, please alert the staff.

Use your call bell

• Use your call bell if you need help to move.
• Especially if you need help going to the toilet.
• When ward staff or visitors leave, make sure they leave your call bell where you can reach it.

Use your glasses

• Make sure your glasses are clean and used as prescribed.
• Ask for help if you are having trouble seeing.
• Use a night light to make sure you can see in dim light.

Use your walking aid

• Keep your usual walking aid close by.
• Check for wear and tear, particularly on the rubber feet.
• Never lean on hospital furniture as it often has wheels.
• Ward staff can provide walking aids to use while you’re in hospital.

Footwear

• Make sure your shoes and slippers fit well, grip well, and don’t fall off.
• Ask relatives to bring in well fitting shoes or ask the ward staff for socks with grips.

Do simple exercises before getting out of bed

• Point your toes and release them a few times.
• Tighten the muscles in your calves and then release them.
• Move your legs up and down if you can.
• This will get the circulation going.

Getting out of bed

• Sit up straight for a few moments on the edge of your bed before standing.
• Get up slowly.
• Make sure you feel steady before walking.
• Ward staff may check your blood pressure while sitting and standing as part of the falls assessment.

Eating and drinking

• Drink and eat regularly.
• Staff will provide jugs of water and can give you light snacks.

Going to the bathroom and toilet

• Take care when using the bathroom and toilet.
• Ask for help if you need assistance.

Keep active during your stay

• Complete exercises in the chair.
• Take opportunities for supported walks with visitors or staff. This helps you maintain your strength.
• Be aware of your environment and ask for clutter to be moved if your path isn’t clear.
• If you feel dizzy: stop, sit down, let the ward staff know.

If you fall whilst in hospital

Despite our best efforts some patients will fall whilst in hospital. If you do fall, the nurses and doctors will check for signs of injury and provide treatment if needed. We will record the fall in your medical notes as well as on our incident reporting system. With your consent we will inform your chosen representative (usually a friend or family member).

What you can at home

STEP is an exercise programme you can do sitting in a chair. If you feel well enough, you can start them in hospital and carry on when you return home. The exercises aim to increase your strength and balance and they are designed for people who find it difficult to get out and about.

To find out more about STEP go to: Start Today Exercise Programme (STEP) - Sirona care & health

© North Bristol NHS Trust. This edition published July 2024. Review due July 2027. NBT002264.

Information for patients referred for treatment with Monofer (ferric derisomaltose) at North Bristol NHS Trust. 

What is ferric derisomaltose?

Monofer (ferric derisomaltose) is dark brown intravenous iron. It is used to treat iron deficiency – when your body does not have enough iron.

It is used when other treatments like tablets aren’t suitable, or if you need treatment quickly.

The Monofer we use is 100mg/ml solution.

Why am I being treated with Monofer? 

Your healthcare professional has recommended you have treatment with Monofer to correct the level of iron in your body. 

Why do I need iron?

Iron is important for the formation of red blood cells, and allows red blood cells to carry oxygen around the body. It is also found in enzymes in the body, helps produce proteins in the muscle (myoglobin), and helps the immune system. The human body has around 3-4 grams of iron, and two thirds of this is in red blood cells. You may need to have your iron stores improved for upcoming surgery.

A lack of iron can cause:

• Tiredness.
• Dizziness.
• Irritability.
• Not being able to sleep.
• Dry skin.
• Hair loss.

Before your treatment

You do not need to do anything special to prepare. You can eat and drink as normal – make sure you are well hydrated. 

Continue taking all your usual medications but stop any iron tablets at least a day before your appointment. 

Wear loose, comfortable clothes and a short-sleeved shirt. You can also bring along a book, or something to watch during and after your treatment.

You will go through your medical history with a member of the team. Please ask them if you have any concerns or questions about your treatment. 

How is Monofer given? 

It is an intravenous treatment, meaning it goes directly into your vein through a drip. A nurse will monitor you. It should not hurt but you may feel a cold sensation in your arm.

How long will it take? 

It usually takes around 30 minutes. You will wait for 30 minutes afterwards to make sure you are well enough to go home. 

Are there any side effects? 

Like all medicines Monofer can cause side effects, although not everyone will get them. A member of the team will discuss these side effects with you before starting treatment.

There is a low risk of an allergic reaction. Symptoms include breathing difficulty, dizziness, and swelling in the mouth. You will be monitored closely to make sure you are responding well to the treatment.

Around 1 in 100 people have a Fishbane reaction. This can make you feel flushed. This is not an allergic reaction and is very common. If this happens the infusions can be paused, and continued once the flushing has stopped.

Another uncommon risk is iron leaking and causing a permanent stain to your skin.

Please tell a member of the team if you notice any leaking or have any side effects like flushing, pain, or discomfort. They can stop the treatment if necessary and look after you.

A few days after the treatment you might have a headache, mild fever, or joint pain. These usually go away on their own.

What happens after treatment?

A few weeks or months after treatment you will have a blood test to see if your iron levels are back to where they should be.

Some people may only need one treatment, this depends on whether you have ongoing issues that affect your iron levels.

If you normally take oral iron tablets this will need to be stopped for 7 days after the infusion. Please ask your healthcare professional for more information.

If you become unwell in the days following your iron infusion, please contact your GP surgery or NHS 111. In an emergency phone 999 or go to your nearest Emergency Department.

Further information and references

© North Bristol NHS Trust. This edition published April 2025. Review due April 2028. NBT003783

The Metabolic Biochemistry Laboratory (previously Biochemical Genetics) at Southmead Hospital provides a regional diagnostic and monitoring service for the investigation of inherited metabolic diseases. Routine analyses performed include urine organic acids (including quantitative methylmalonic acid, if required), bloodspot/plasma acylcarnitines (including free carnitine), plasma/urine/CSF quantitative amino acids, qualitative galactosaemia screening test, plasma free fatty acids and 3-hydroxybutyrate.

In addition, the laboratory provides specialist testing for the investigation of peroxisomal disorders (plasma very long chain fatty acid analysis, including pristanic and phytanic acids), Smith-Lemli-Opitz syndrome (plasma 7-dehydrocholesterol and 8-dehydrocholesterol)

The Metabolic Biochemistry department is a Centre for Galactosemia investigations and offers a variety of tests for the diagnosis and monitoring of disorders of galactose metabolism including:

• first line galactosaemia screens,
• quantitative galactose-1-phosphate uridyltransferase activity for confirmation of classical galactosaemia;
• urine galactitol for screening and monitoring of galactokinase deficiency or screening for classical galactosaemia if infant has been transfused;
• galactokinase activity for confirmation of galactokinase deficiency;
• galactose-1-phosphate for monitoring treatment of classical galactosaemia.

The Metabolic Biochemistry Laboratory at Southmead Hospital is a member of the UK National Metabolic Biochemistry Network (MetBioNet). 

The Metabolic Biochemistry laboratory works very closely with the Southwest Newborn Screening Laboratory to aid in the diagnostic testing to support the newborn screening programmes and monitoring of patients identified though the Inherited Metabolic Disease screening programmes. Bloodspot monitoring for PKU (Phenylalanine and tyrosine) and CAH (17-OHP) for known patients and testing for hypothyroidism on bloodspot (TSH)

We provide a comprehensive advisory service and welcome enquiries to discuss appropriate patient investigation and result interpretation. Clinical and laboratory advice is available during working hours, via contacts listed.

Details of Sample Requirements and Transport can be found under “Requesting” and “Test Information” via the menu at the top of this page.

For any urgent analyses or additional testing on samples already received, please telephone the laboratory to discuss.

(Source: CSF amino acid reference intervals from the Cardiff Working Group, MetBioNet)

User Handbook

Request form

User Survey

Useful Links

National Metabolic Biochemistry Network (MetBioNet)
British Inherited Metabolic Diseases Group
Cardiff Porphyria Service

This page contains information for patients who have had a CT colonoscopy at North Bristol NHS Trust.

What can I expect after CT colonoscopy?

You can return to normal activities as soon as the scan is finished. You can return to your normal diet, but we suggest you eat little and often to reduce nausea and bloating. Drink plenty of water for the next 24 hours, as the preparation diet and medication can cause mild dehydration.

Feeling bloated and abdominal (tummy) pain

You may feel bloated, have tummy pain, or pass wind (fart) after the test because of the gas we put in your bowel. This should settle quickly, usually within 2 hours. Eating and drinking normally will help. Food may pass quickly through you for several hours after the examination. If you have diarrhoea up to 4 days after the procedure, contact your GP.

If you have any of these in the 5 days after your examination, phone NHS 111, your GP, or go to the nearest Emergency Department (A&E):

• Severe abdominal pain.
• Bleeding from your rectum (bottom) which is not normal for you.
• Sweating and/or feeling sick or generally unwell.

Possible symptoms from the hyoscine butylbromide (Buscopan) injection 

You may have been given an injection of hyoscine butlybromide (Buscopan) to help relax the muscles of the bowel, to get clearer images.

If you have any of these side effects please tell the radiographer:

• Blurred vision - if this happens you need to wait before driving. This side effect is very rare, and your vision should return to normal quickly.
• Sudden difficulty breathing or increased heart rate.
• Feeling faint.

If you have any of the following symptoms in the next 24 hours, please call NHS 111, your GP, or go to to the nearest Emergency Department (A&E):

• A skin rash and/or itching.
• Difficulty breathing and/or increased heart rate.
• Increased pressure behind the eye and/or eye pain (see below).

If you have eye pain in the next 24 hours it is important you go to your nearest eye hospital immediately. Take this leaflet with you as we will write down the drug information you need.

Bristol Eye Hospital is open 7 days a week 08:30-16:30. Outside of these times go to the nearest Emergency Department to you and you will be referred to the on-call eye team.

Alternatively call NHS 111. If you are unsure if you need to go to the Eye Hospital, please call 0117 923 0000.

Please be reassured that these side effects are very rare.

Possible symptoms from the contrast media injection

You may have been given an injection of contrast media to give us a more detailed scan. Complications are rare but some people may experience an allergic reaction.

Please tell the radiographer if you experience weakness, sweating, skin reactions, shortness of breath, or increase in heart rate.

If you have any of these symptoms at home please call NHS 111, your GP, or go to the nearest Emergency Department (A&E). Take this leaflet with you.

Your results 

The radiologist will examine the images from your scan in detail and send the results to the doctor who referred you. Waiting times can vary.

• If you were referred by an outpatient department at North Bristol NHS Trust, they will contact you with an appointment or to discuss the results.
• If your GP referred you, they will contact you. If you do not hear from them please call them directly.
• If you have come from the Bowel Screening Programme (BCSP) the results will be sent to the specialist screening practitioner who will contact you.

If you have any side effects or symptoms that require medical assistance from your GP or Emergency Department, please tell the Imaging Department by phoning 0117 414 8989.

The Imaging Department staff will write down

• If you have had hyoscine butylbromide (Buscopan):
  • The batch number
  • The expiry date
  • The dose
• If you have had contrast media:
  • The batch number
  • The expiry date
  • The dose

© North Bristol NHS Trust. This edition published July 2024. Review due July 2027. NBT003705.