The permissions or approvals required will depend on the type of research you are undertaking.

Permissions may include:

• NHS R&D approval
• NHS Research Ethics Committee
• NIHR Portfolio Adoption
• Medicines and Healthcare Products Regulatory Authority (MHRA)

For general information on all of the above permissions see: http://www.nres.nhs.uk/applications/approval-requirement

Integrated Research System (IRAS)

Most applications can be made via the (IRAS)  http://www.myresearchproject.org.uk.

IRAS was developed to bring all the research regulatory application forms together in one place.  By completing a checklist of questions, the system will generate the forms you need to complete based upon your responses including the:.

• Portfolio Adoption Form (PAF)
• Research & Development (R & D) Form
• Site Specific Information (SSI) Form

An IRAS training module is available (approx 60 minutes) that will lead you through the system and show you how all of the forms are generated.  It also explains how certain information is pre-populated throughout the form to save having to repeat certain text.

NIHR Portfolio Adoption

All researchers with funded research projects should be encouraged to apply for NIHR portfolio adoption.  This is important in order to bring additional funding into the Trust to support the delivery of research.

On the first page of their IRAS application you can choose to have your project assessed for NIHR Clinical Research Network (CRN) support and inclusion in the NIHR Clinical Research Network (CRN) Portfolio. 

Research studies funded by NIHR and NIHR partners are eligible to be adopted on to the NIHR Portfolio. Other criteria for adoption include who is funding the research, if funding is awarded in open competition, if the study has received a peer review and if the research is of value to the NHS and fits within the needs and realities of the NHS.  A portfolio adoption form (PAF) should be completed and submitted via IRAS. One application is required for the entire research project from the lead site, where the Chief Investigator is based. For more information visit:http://www.crncc.nihr.ac.uk/about_us/processes/portfolio/p_how

If your research study meets the criteria for portfolio adoption, it is important to submit the PAF form at an early stage (prior to the R & D form & SSI form) in order to be processed via the ‘Coordinated System for gaining NHS Permission’ (CSP) system for R&D approval, and funding received from the NIHR.

During the sponsorship review NBT may recommend that your research is submitted for NIHR Portfolio adoption. 

• Strong links with the Musculoskeletal Research Unit at Southmead Hospital Bristol (part of the School of Clinical Sciences, University of Bristol)
• Our research interests at the Musculoskeletal Research Unit at Southmead Hosptial Bristol include bone density and fractures in children, osteoporosis and vertebral fractures in older people, high bone mass, hypermobility, scoliosis and the genetics of bone development.
• We support and participate in multicentre clinical observational and interventional studies in rheumatoid arthritis, inflammatory myositis, systemic sclerosis, psoriatic arthritis and ankylosing spondylitis.
• North Bristol Trust Rheumatology department is part of several UK/European networks (the Early Rheumatoid Arthritis Network (ERAN), BIAS, TRACE, TCL and (genetic predictors of response to anti-TNF) with collaborations with:
  • University of the West of England (UWE)
  • University Hospitals Bristol Foundation Trust
  • Royal National Hospital for Rheumatic Diseases in Bath
  • University of Oxford
  • University of Nottingham

• North Bristol NHS Trust hosts an Academy within the University of Bristol Medical School. In rheumatology we help deliver the musculoskeletal element of the Musculoskeletal Diseases, Emergency Medicine and Ophthalmology (MDEMO) course. We host 3rd year medical students for 9 weeks in four blocks throughout the year.
• We organise and run teaching and training sessions for junior doctors at North Bristol NHS trust and rheumatology trainees from across the Severn Deanery region. In addition we run teaching sessions for doctors taking their postgraduate examination.

The role of the Neuro-Oncology Clinical Nurse Specialist (CNS) focuses on providing support, information and advice to patients and relatives with a diagnosis of a malignant primary brain tumour.  Currently there are two Specialist Nurses within the team and a Support Worker. We work closely with both the Neurosurgeons at Southmead and the Oncologists at the Bristol Oncology Centre.

We primarily support patients who live within the Bristol, North Somerset and Somerset region. For patients outside of these areas we handover to the local specialist team to take over and continue support locally.

The Neuro-Oncology Specialist Nurse Team at Southmead Hospital can be contacted on 0117 414 7352. This will be answered by one of the team between the hours of 08:30 to 15:30 hrs Monday to Friday.

We do not work on Weekends or Bank Holidays.

Outside of these hours there will be an answering machine on this number and any messages left on this answer machine, will be picked up on the next working day, except on Bank Holidays. 

This service is not for emergencies and patients / carers should contact the nearest A&E or local GP or in case of a medical emergency dial 999.

Radiation

The majority of high-grade gliomas (WHO grade 3 and 4) require radiotherapy following surgery. Although radiotherapy rarely cures glioblastoma, studies show that it doubles the median survival of patients, compared to supportive care alone. A recent important study (known as the 'Stupp' trial) showed a benefit for chemotherapy using temozolomide in patients with glioblastoma multiforme. In the study, the median survival of patients who received temozolomide in addition to radiotherapy was increased by 2.5 months and two-year survival by 16 percent. For grade 3 gliomas the options for treatment following surgery would involve radiotherapy alone or chemotherapy alone followed by surveillance (i.e. keeping an eye with regular scans). Following surgery to obtain tissue for biopsy or to resect a grade 4 glioma (or glioblastoma), the patient is scored on their general well being (WHO performance status) and those with performance status of 0 or 1 are offered high dose radiotherapy treatment along with Temozolomide tablets during the treatment.

Further details about radiotherapy can be obtained by viewing this booklet which has been designed specifically for patients treated at the University Hospitals Bristol NHS Foundation trust:

Chemotherapy

Chemotherapy is an integral part of the treatment of Cancer and the decision on when to use it is dependant again on the type of tumour, but also on the clinical status of the patient (i.e. how well is the patient and will he/she be able to tolerate the treatment). For grade I gliomas no chemotherapy is currently indicated. For grade 2 gliomas, the role of chemotherapy is limited and is currently restricted to clinical trials. For grade 3 gliomas (Astrocytomas, Oligo-astrocytomas amd Oligodendrogliomas) the options for treatment include either initial radiotherapy followed by chemotherapy with either Temozolomide or PCV (Procarbazine, CCNU and Vincristine). The exact management plan is arrived at after the Clinical Oncologist is able to have a full and complete discussion with the patient and family about the pros and cons of each treatment. For grade 4 gliomas, following surgical resection of the tumour where appropriate, a decision about additional treatment is made by the Clinical Oncologist depending on the general fitness level of the patient (see links to WHO performance status above). The current standard of treatment in a fit patient would be Radiotherapy to the tumour bed and concomitant administration of Temozolomide (i.e. Temozolomide taken orally during the administration of Radiotherapy) followed by a few cycles of adjuvant Temozolomide orally over a period of time. Additional information about Temozolomide can be found here:

Awake Craniotomy

This is a highly specialised procedure performed when tumours are present very close to areas of the brain that control movement, speech and language, to minimise injury to these areas and preserve function. An important part of the brain, which controls voluntary movement of the opposite side of the arm, leg, face and tongue, is called the motor cortex. (See fig below)

The anatomical region of the brain known as Area 4 (coloured red in the figure above) was given the name primary motor cortex after the Canadian Neurosurgeon Dr Wilder Penfield showed that focal stimulations in this region elicited highly localized muscle contractions at various locations in the body. The motor cortex also includes Area 6, which lies in front of Area 4 and is divided into the premotor area (or premotor cortex) and the supplementary motor area. The premotor cortex is believed to help regulate posture by dictating an optimal position to the motor cortex for any given movement. The supplementary motor area, for its part, seems to influence the planning and initiation of movements on the basis of past experience. The mere anticipation of a movement triggers neural transmissions in the supplementary motor area. Tumours in the Premotor and supplementary motor areas can be removed in most instances without any significant loss of function to the patient, though there may be some temporary weakness on the opposite side of the body if these areas are removed on the dominant side (i.e. in the majority of people (both right and left handed) the left half of the brain is dominant). However tumours in the primary motor cortex are difficult to remove without loss of function of the opposite side of the body. Any injury to the primary motor cortex is in most instances likely to lead to irreversible loss of function of the arm, hand , leg or face of the other side of the body.

If a glioma is present very close to the primary motor cortex then an 'Awake craniotomy' can be performed to minimise injury to this area. In this procedure the patient is awake (but pain free) during parts of the operation to remove the tumour. The surgeon and his team are able to talk to the patient while the operation is in progress. The surgeon stimulates various areas of the brain and looks for muscle contractions in the patient and sometimes correlates with electrical recordings obtained from specific muscle groups in the arm and leg. The patient is also asked to move the arm, hand, and leg repeatedly to observe for any decrease or loss of function while removal of the tumour is underway. In this way the surgeon is able to obtain a map of the opposite side of the body on the brain surface and is able to avoid injury to areas of the brain that he/she knows is responsible for movement. This is known as 'Cortical mapping'. This procedure is also performed when tumours that are very close to the speech / language areas of the brain have to be removed. In this case the patient is asked to repeat a variety of small simple tests (like naming objects, counting numbers etc) while the operation is underway to help prevent any injury to the speech & language areas of the brain. The risk of developing a neurological disability like weakness of arm / leg or difficulty in speech can be significantly reduced by performing this procedure where appropriate, but the risk can never be completely eliminated.

Gliadel

Carefully selected patients with a suspected malignant glioma on an MRI scan may be eligible for application of Gliadel wafers in the tumour cavity at the time of surgery to resect the tumour. A team of experts at the Multi disciplinary meeting will make the decision about the suitability for this treatment. If the patient is assessed and found suitable for this treatment then the Neurosurgeon will discuss this in detail with the patient and family at the initial consultation. Gliadel is a form of topical chemotherapy containing the drug called Carmustine (or BCNU), which has shown some benefit in clinical trials. NICE has approved this treatment in selected cases of newly diagnosed malignant glioma. 

Download this diagram:

Download this diagram:

Download this diagram:

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How can I control and delete cookies?

We will not use cookies to collect personal identifiable information about you.
However, if you wish to restrict or block the cookies which are set by our websites, or indeed any other website, you can do this through your browser settings. The ‘Help’ function within your browser should tell you how.

Alternatively, you may wish to visit www.aboutcookies.org which contains comprehensive information on how to do this on a wide variety of browsers. You will also find details on how to delete cookies from your machine as well as more general information about cookies.

Please be aware that restricting cookies may impact on the functionality of our website.
If you wish to view your cookie code, just click on a cookie to open it. You'll see a short string of text and numbers. The numbers are your identification card, which can only be seen by the server that gave you the cookie.

For information on how to do this on the browser of your mobile phone you will need to refer to your handset manual.

To opt-out of third-parties collecting any data regarding your interaction on our website, please refer to their websites for further information.

For further queries please email NBTCommunications@nbt.nhs.uk

The NHS Equality Delivery System (EDS) is designed to help NHS organisations improve equality performance and embed equality into mainstream NHS business so that we can provide a better service that meets the requirements of people from diverse communities. North Bristol NHS Trust has worked through the framework to provide evidence to support our grading.

This was used to devise our Equality Objectives.

NBT aims to work in partnership with a wide range of local communities including marginalised and seldom-heard groups.

The Trust works closely with other NHS partners to deliver the EDS and engages with them to gather feedback from communities on the quality of our service delivery.  This offers local stakeholders the opportunity to be fully involved in the process where important decisions are made about the planning, developing, commissioning, management and delivery of health services.

We also engage with staff to ensure they can help to plan, develop and manage working environments and activities that aim to improve their working lives.