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When we provide services, we want to make them easy, useful and reliable. Where services are delivered on the internet, this sometimes involves placing small amounts of information on your device, for example, computer or mobile phone. These include small files known as cookies. They cannot be used to identify you personally.

These pieces of information are used to improve services for you through, for example:

1. enabling a service to recognise your device so you don't have to give the same information several times during one task
2. recognising that you may already have given a username and password so you don't need to do it for every web page requested
3. measuring how many people are using services, so they can be made easier to use and there's enough capacity to ensure they are fast analysing anonymised data to help us understand how people interact with government services so we can make them better

Which cookies do we use?

By understanding how people use the website, we can improve the information provided. We use the following cookies on our website. Most of these are set by third-party suppliers.

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.

At North Bristol NHS Trust, we respect and value the diversity of our workforce, patients, service users, relatives, carers and visitors and are committed to:

• Serving our community in a way that is appropriate, accessible and responsive
• Making best use of the range of talent and experience available within our workforce and potential workforce
• Ensuring that our legal obligations are fulfilled

It is recognised that individual and institutional discrimination obstruct the fundamental aims and objectives of NBT as a public service provider.

We are mainstreaming equality into all our functions and policies with the intention of achieving a fully inclusive organisation. A zero tolerance policy towards harassment and bullying towards anyone on Trust premises is endorsed throughout the organisation.

The Trust is committed to taking positive action for disabled people and has been awarded the Two Tick disability symbol. We have also signed up to the Mindful Employer charter as we are positive about mental health and take steps to increase awareness of mental health at work. For more details about the charter visit www.mindfulemployer.net

Equality & Diversity Committee

The Equality and Diversity Committee is the main forum through which progress on equality, diversity and human rights is managed. It’s principle function is to ensure that the Trust Board is informed of its legal duties and to promote the mainstreaming of equalities in all of our activities for patients, visitors and staff. It provides direction on equality for the Trust including strategies to develop consultation and involvement.

The Equality and Diversity Committee is made up of members of senior staff, including those from equality groups and others from the community.

Donations are welcome for supporting research into brain tumours at Bristol. Current work in progress is looking at a particular molecular marker in malignant glial tumours in collaboration with the University of Bristol.

Please make cheques payable to 'The Brain Box Fund' and send it to:

'The Brain Box Fund'
c/o Jackie Scholes
Secretary to Mr V Iyer
Consultant Neurosurgeon
Southmead Hosptial
Westbury-on-Trym
Bristol, BS10 5NB.

Please contact Jackie Scholes if you require any further information.

To contact the MDT co-ordinator for all MDTs with any queries about patient referrals please ring Rachael Eldridge on 0117 4140531. Working hours are Monday to Friday 8.00am to 4:00pm. Please leave a message on the answer machine outside these hours, or if the issue is more urgent please contact the On-call Neurosurgical Registrar at Southmead Hospital through the Switchboard (0117 950 5050) and ask for extension 45726.

If there are any questions about specific disease conditions please refer to 'Meet the Team' Page to contact the appropriate specialist.

Most of the information in this section pertains to intrinsic brain tumours such as Gliomas or metastases. For tumours such as meningiomas, acoustic neuromas and pituitary adenomas even though general principles of intracranial surgery apply, there will be specific issues pertaining to these tumours that will be detailed in the relevant sections. The first treatment for most brain tumours is either surgery to remove the tumour or a biopsy to obtain a small sample of tumour. The tumour tissue that is removed is used to determine the exact type of tumour. Find out more about surgery for suspected brain tumours here:

There are several types of equipment available to the neurosurgeon. Specialised equipment is used to accurately localise the tumour within the brain and to track the margins of normal and abnormal tissue. This is similar to a satnav while driving, where the position of your car is shown relative to the street map. This is known as Image guidance (or Neuro navigation) and it increases safety and accuracy of tumour resection. Ultrasonic aspirators can be used to break up and suck out the tumour. High-powered microscopes may be used to better see the tumour tissue and surrounding nerves and blood vessels. Because the tentacle-like cells of an astrocytoma grow into the surrounding tissue, complete resection of these tumours is difficult to achieve without also removing normal brain tissue. Therefore a compromise has to be made between removing tumour tissue and preserving normal tissue. At surgery visibly abnormal looking tissue is removed. If the image guidance equipment shows that what looks visibly like normal brain could also represent abnormal tumour, then that area is also removed if it is felt by the surgeon that it will not lead to any compromise in neurological function. If the abnormal looking area on image guidance is an area that is vital for important bodily functions, then it is left intact, and treated non surgically depending on the type of tumour. Partial removal can help decrease symptoms and confirm the type of tumour.

Useful Links

AAC Charities

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Other Charities

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Manufacturers and Suppliers Sites

Other AAC related websites

Weight loss surgery isn’t a ‘quick fix’ or a certainty that you will lose weight. It is a tool to help your weight loss. Successful weight loss will be entirely down to you making good dietary choices and being as physically active as possible. In the initial period after surgery you will only be able to eat very small portions and will probably not feel hungry. Both these factors may change with time.

It is important to realise that we don’t always eat because we are hungry.  We might eat out of habit or because we have learned to turn to food as a comfort when we are bored, or upset, or even happy.  This “head hunger” does not disappear with surgery and you must learn to overcome this if you want to be successful with your weight loss.

You should start to practice the following skills in preparation for surgery. These are designed to help you adapt to life after the operation.

• Have three small meals a day. Choose quality over quantity – go for healthy, great tasting, textured food in smaller but delicious servings.
• Avoid snacking between meals unless you are genuinely hungry. Try to choose a piece of fruit or other healthy option.
• Eat slowly: put a small amount of food in your mouth at a time and chew this very well. Eating at a table without any distractions (no TV) and putting down cutlery between mouthfuls can help.
• Do not aim to eat until you are ‘full’. After surgery, overeating will stretch your stomach pouch, causing discomfort and may make you vomit.
• Do not drink with meals. Wait at least 30 minutes after a meal before you have a drink. Make sure you have at least 2 litres of fluid a day.
• Avoid all fizzy drinks.
• Choose textured foods that satisfy your stomach. Drinking high calorie liquids or eating foods that ‘melt’ (crisps, chocolates, cakes, biscuits, ice-cream) will mean that you won’t lose weight. These foods slip straight through, don’t make you full and result in a very high calorie intake. Your dietician will provide information on appropriate ‘textured’ foods.
• Get out and be active! Swap computer and TV time with active time to improve fitness and energy levels and get the most out of your weight loss.

Certain foods can be a problem for some people. These can include chewy meats, soft white bread, rice, fibrous fruit and vegetables, nuts and seeds. These should be avoided at the beginning and re-introduced slowly once a ‘normal’ diet has been established. Everyone is different as to what they can manage and you will need to find out what is right for you by trial and error.

You will be given lots of help and information about the pre and post-operative diets that need to be kept to by our dieticians and nurses.

Most people recover very quickly after weight loss surgery and feel ready to go back to normal activities after a few days. It is important to remember though that you have had a major operation and to take it steady for a few weeks.

Wounds - The small wounds on your abdomen will either be glued or covered with a waterproof dressings after the operation. The dressings should be left for two- three days from the day of the operation (only change if the wound is oozing or the dressing has lifted off and is no longer waterproof). By that time, the wounds are usually healed enough to remain uncovered and the stitches used are dissolvable. You can shower as normal from the day of surgery but avoid baths until wounds are fully healed approximately 6 weeks after surgery. If you notice any sign of wound infection (pain, redness, swelling or pus) you are advised to visit your Practice Nurse or General Practitioner for a wound check.

Exercise - Gentle outdoor exercise is important as well as getting plenty of sleep and keeping your fluids up. You should gradually try to increase your exercise until you are walking for 30 minutes per day. You should aim to walk at a speed that makes you slightly short of breath and sweaty.

Driving - You may drive as soon as you can comfortably wear a seat belt and are able to perform an emergency stop. You should check with your insurance company for their specific advice about driving after keyhole (laparoscopic) surgery. It is advisable to avoid heavy lifting for at least two months after abdominal surgery.

Pregnancy - Losing weight can increase fertility but we strongly recommend that you do not become pregnant for 2 years following surgery as weight loss may have effects on the unborn child. If you do not already have regular contraception it may be worth visiting your local family planning centre for advice. If you get pregnant with a gastric band, the band can be deflated during the period of pregnancy to ensure the baby gets sufficient nutrients and that you can breastfeed afterwards. The band can then be re-inflated when the time is right.

Emotion – It is common for patients to feel tearful, irritable and vulnerable in the first few weeks after surgery. This is a normal response as surgery is a life changing event. This is usually temporary and improves once you start eating more solid food and get back to your normal routine. Please contact a member of the team if you need reassurance or are finding it difficult to cope

Partying – Being socially active is very important to positive emotional wellbeing, but be careful not to overdo it. We advise you not to drink any alcohol for 3-6 months after surgery and may be more prone to the intoxicating effects of alcohol than you used to be. Also bear in mind that alcohol contains calories without any nutrients and can be high in sugar. You may resume sexual activity as soon as you feel comfortable.

Follow up

We look after our patients closely after surgery and are always available for any problems or questions you may have. The first check up after your operation is generally at six to eight weeks. After that the follow up regime will vary and you will be given further details at the time of your operation. You will require regular blood tests for the rest of your life after bariatric surgery.  It is important that you attend any follow up appointments or let us know if you can’t attend so that we can re-arrange it for you and offer the original appointment to another patient.

We are funded to support patients for two years following surgery.  After this time your care will be handed back to your GP.