General Pharmaceutical Council www.pharmacyregulation.org
Royal Pharmaceutical Society www.rpharms.com
United Kingdom Clinical Pharmacy Association
College of Mental Health Pharmacy www.cmhp.org.uk
Guild of Healthcare Pharmacists www.ghp.org.uk
UK Medicines Information www.ukmi.nhs.uk
North Bristol NHS Trust uses medicines according to the BNSSG Joint Formulary, which can be found at www.bnssgformulary.nhs.uk/. The BNSSG Joint Formulary is regularly updated and monitored by the BNSSG Joint Formulary Group, which includes NBT, University Hospitals Bristol NHS Foundation Trust, Weston Area Health NHS Trust and the local Clinical Commissioning Groups (formerly Primary Care Trusts).
The BNSSG Joint Formulary promotes medicines which are safe, effective and value for money. It is a joint venture between primary and secondary care ensuring that patients have continuity of medicines whether at home or in hospital.
Clinical trials are undertaken to develop better medicines, an improved understanding of medicines' studies and to improve the safety of medicines.
All trial protocols are assessed by the Local Research Ethics Committee (LREC) to ensure that the trial will be safe and will add to the sum of knowledge about medicines.
Only when the LREC is satisfied can patients be recruited for the trial. Each trial is run according to a strict protocol and procedures are in place to ensure that all records are kept up to date. Only Senior Doctors are permitted to introduce a patient to a trial.
Speak to the person treating you to see if there is a research trial or study suitable for you.
All registered clinical pharmacists have undergone a degree in Pharmacy followed by a Pre-Registration period of one year. Most pharmacists have also undertaken a postgraduate clinical diploma qualification. They work in conjunction with pharmacy medicines management technicians looking after a patient’s drug supply and therapy whilst they are in hospital.
Most wards receive a daily visit by a clinical pharmacist. The pharmacist will check a patient’s drug therapy whilst they are in hospital to ensure they are taking the medication that patients were having at home.
Pharmacists work closely with the medical, nursing and other healthcare teams to make sure the patients are taking the right medicines and they are all ok to be taken together, as well as plan for the patients discharge.
Many pharmacists have a specialist role in a particular field and so work as part of a team in that area with the doctors and nurses.
Medicines management technicians are qualified in NVQ level 3/BTEC in pharmacy and registered with the General Pharmacy Council. They are ward based and are part of the ward team. They help improve workflow in the dispensary by planning ahead for discharge.
When patients are admitted the technician will obtain details of the patient’s medication prior to admission from a variety of sources: patient, patients own medication, carers, relatives, GP surgeries, nursing homes and community chemists. This information is referred to the ward pharmacist who then reconciles the information within 24 hours after admission as guided by the ‘Safer Patient Initiative’
We encourage patients to bring in medication at admission so that the technician can assess its suitability for future use, both during their stay and at discharge and also to highlight compliance issues. Medication is stored in individual medication lockers located at the bedside.
Technicians monitor the drug chart for missed doses, supply, omissions, and endorses important instructions against each medicine regarding appropriate administration.
Technicians provide counselling to patients on how to take their medication.
Approaching the discharge stage, technicians and pharmacists can help with organising the ‘take home’ medication in a timely manner.
www.diabetes.org.uk - 
Diabetes UK is the leading diabetes charity in the UK. They have an excellent website that covers all aspects of diabetes care for both Type 1 and Type 2 diabetes. We recommend that if you want further information on any area of your diabetes you use this website first.
www.runsweet.com - To find out more information about sporting activities and diabetes.
www.bertieonline.org.uk - To find out more on the basic principles of carbohydrate counting.
www.ukdrn.org - Find out more about our research.
If you drive and are on medication for diabetes you may need to inform DVLA.
The following sources give further information about driving with diabetes:
Diabetes UK Careline 0845 120 2960
DVLA: www.gov.uk/diabetes-driving
progress.freestylediabetes.co.uk - To learn more about how to get the most from using the FreeStyle Libre flash glucose monitoring system.
www.nice.org.uk/guidance/TA151/chapter/1-guidance - To review current guidance for the use of insulin pumps in diabetes.
The North Bristol Lung Centre runs a number of general respiratory and specialist respiratory outpatient clinics. These include clinics run by doctors, specialist nurses, pharmacists, physiotherapists and other healthcare professionals. The clinics take place at:
Contact details
For outpatient appointments : 0300 555 0103
Respiratory secretaries: 0117 414 2016
AAC WEST has a range of products, developed by the centre’s experienced specialists.
The Frenchay Screening Tool for AAC
This tool has been designed for use by professionals working with people with communication disorders who wish to assess their clients’ suitability for using AAC.
This simple and easy to use tool brings together a range of specific assessment areas in one simple tool. This robust and meaningful tool allows the administrator to look at areas such as the patient's physical access, visual acuity, visual processing, symbol versus written word identification, categorisation etc. The results from this screen can be used to ensure appropriate onward referrals are made to specialist AAC assessment centres. The Screening Tool costs £100 +VAT and P&P (£15.00 p&p for 1, please ask for p&p quote if ordering more then 1x screening tool). The Frenchay Screening Tool can be purchased by contacting the AAC WEST Service on 0117 4145850.
Frenchay Alphabet Board (F.A.B)
This is a positive finger location spelling board suitable for anyone who wants a simple, low tech communication aid that can be taken anywhere. As this device contains no batteries it will act as an ideal back up for anyone who uses a high tech text based communication aid. The FAB will be useful for any person who is literate but unable to speak. This may include people who have vocal cord damage, tracheostomy, stroke or those who are ventilated. The positive finger guard location means that the F.A.B is the only alphabet chart on the market that will allow people with progressive neurological diseases such as Parkinson’s disease, Multiple Sclerosis or early Motor Neurone Disease to access this form of low tech device as the guards aid access to individual keys.
The FAB has been designed to be compliant with infection control standards and is therefore ideal for use on hospital wards or in nursing homes as it is fully washable and MRSA and E Coli resistant
FAB has been developed in conjunction with E2L products. Visit www.e2l.uk.com/FAB/index.html to watch a video. FAB can be purchased from Logan technologies www.logan-technologies.co.uk or Ability World www.ability-world.com.
E-Tran (Frenchay Eye Transfer Frame)
This is a simple but effective low tech eye pointing system of communication designed for those who are no longer able to access AAC devices via traditional means. In cases of progressive illness, it ensures that avenues of communication with family, friends and care staff remain open, despite other physical deterioration.
The system displays the alphabet which is divided into groups, and colour coded within these. A letter is identified by first looking at the group containing the letter, and then clarifying by looking at its colour. Words and sentences can be built up in this way. This is a low tech eyepointing system of communication, which can also be used as a backup to any electronic device which might be recommended.
The E-Tran frame is available to be purchased on-line from a number of different suppliers.
E-Tran (Frenchay Eye Transfer Frame), can be bought from ROMPA or Winslow Resources.
The Stroke Association - Charitable organisation providing free Information for Individuals & Families www.stroke.org.uk
South Gloucester Council - A directory of useful services. Search 'stroke' to access their directory www.southglos.gov.uk
Bristol Area Stroke Foundation www.stroke-bristol.org
Living (dlc) - Formerly the Disabled Living Centre www.thisisliving.org.uk
Home from Hospital service - (British Red Cross) www.redcross.org.uk
Purple Pages www.thecareforum.org
What is Stroke Rehabilitation?
Stroke rehabilitation is the process of adjusting to the damage caused by a stroke and finding ways to keep as much independence as possible. This may mean re-learning lost skills, finding alternative ways of doing things, or adapting your situation.
Common areas that are considered are:
Rehabilitation cannot be done for you. Your body needs to recover and you have to be motivated. It is often hard work and it takes practise and time. Being ill and in hospital leads to a loss of your fitness, and your treatment needs to be paced for you. Stroke can affect your mood and confidence. Setting goals to work for can help to keep you motivated.
Progress depends on the severity and type of stroke you have had, but also your previous health, your ability to engage with the rehabilitation process and your own determination. It is an individual process.
Unfortunately, it is not always possible to regain your independence. Progress can be restricted if you have had a large stroke, if you become unwell or due to side effects of a stroke such as fatigue.
You may need specialist equipment to help you, or adaptations to your environment. The therapists will advise on this.
How can my family be involved?
We encourage your family to be involved. Your family can play an important role helping your awareness of your usual life. You may like them to bring photographs from home, keep you-up-to date with news at home and tell us about your lifestyle.
They are invited to progress meetings so they can support you, help plan your discharge and for your future.
They are welcome to attend some of your therapy sessions. It can help them understand how the stroke has affected you.
How long will I need to stay in hospital?
Your individual discharge plan will depend on how independent you become and your own social circumstances. Everyone is different.
Preparing for discharge begins as soon as you arrive. We use our expertise to predict the likely course of your progress and your future requirements. It is usually possible to make this judgement based on the severity of a person’s illness. However, plans may alter to reflect changes in conditions.
For discharge from hospital you will need to be medically well enough to be safe and have reached a point when you don’t require inpatient treatment.
What Will Happen After Hospital?
Change after a stroke can take a long time and you may have goals that still require therapy after you leave hospital. If you need personal help at home or you require a care home, your Social Worker will plan this with you and your family. Services available after leaving hospital will be explained at your meetings and planned before discharge.
Your GP will be responsible for your medical care after discharge and will receive a letter from the hospital. You will get a new prescription. It is important that you continue to take your prescribed medications and follow any advice you have been given.
Information packs
You will be given a stroke information pack at your progress meeting. It has useful information about stroke and useful contacts following discharge. We are always happy to for you to call us for advice.
If you need to stay in hospital beyond a few days, you may move from the Hyper Acute Stroke Unit (HASU) to the Acute Stroke Unit. Here, an assessment will be carried out by our expert team of therapists and other stroke specialists to determine any ongoing needs you may have for ongoing rehabilitation, care and support. This assessment will be provided to our community partners, including the Integrated Community Stroke Service (ICSS) and the Stroke Sub-Acute Rehab Units (SSARUs) , who will decide how these needs can be met outside the acute hospital.
We and our partners will aim to support you to leave the acute hospital as soon as possible, so that your care can continue in the most appropriate and supportive setting. Throughout this process you will be supported by our Integrate Discharge Service, who will work with clinicians to provide you with information about what to expect on leaving hospital.
If your needs cannot be met by community service straight away, you will continue to receive care and, if this will be beneficial, intensive specialist rehabilitation until you can be provided with what you need outside the acute hospital. This may be because you need further inpatient specialist medical and nursing care, for example.”
Therapy
Dependng on how your stroke has affected you, you might need to be treated by any combination of our therapists, depending on how your stroke has affected you. Rehabilitation is a 24 hour process, not just when you are seeing the therapists, and the nurses will encourage you to practise your activities on the ward and to do what you can for yourself.