www.arthritiscare.org.uk Arthritis Care exists to support people with arthritis. It is the UK’s largest organization working with and for all people who have arthritis. It is a user led organization which means people with arthritis are at the heart of the work – they form the membership, are involved in all of the organisation’s activities and directs it does.

www.backcare.org.uk BackCare is a registered charity that aims to reduce the burden of back pain by providing information and support, promoting good practice and funding research. The charity acts as the hub between patients, (healthcare) professionals, employers, policy makers, researchers and all others with an interest in back pain.

www.fibromyalgia-associationuk.org Fibromyalgia Association UK is a registered charity administered by unpaid volunteers. FMA UK was established in order to provide information and support to sufferers and their families. In addition, the Association provides medical information for professionals and operates a national helpline.

www.painconcern.org.uk Pain Concern provides information and support for pain sufferers, those who care for them and about them, free factsheets and leaflets to help you manage your pain.

www.patient.co.uk This provides non-medical people in the UK with good quality information about health and disease. The authors (all medical professionals) do this by writing evidence based information leaflets. They also review health and illness related websites and link to many of these from the web directory included on this website.

www.patients-association.com The Patients Association is a national charity providing patients with an opportunity to raise concerns and share experiences of healthcare.

www.patientvoices.org.uk This website has many health-related stories from ordinary people. The idea is that people working in health and social care will see these stories and carry out their duties in a more informed and compassionate manner.

selfmanagementuk.org Free self-management courses providing tools and techniques to help you to take control of your health and manage your condition better on a daily basis. The majority of the courses are delivered by trained tutors who have experience of living with a long-term health condition.

www.taoist.org/uk Website for the Taoist Tai Chi Society of GB, a registered charity that teaches tai chi to the community to help people improve their health and wellbeing.

www.u3a.org.uk U3As are self-help, self-managed lifelong learning co-operatives for older people no longer in full time work, providing opportunities for their members to share learning experiences in a wide range of interest groups and to pursue learning not for qualifications, but for fun.

The North Bristol NHS Trust HIV/Aids Service is based at Southmead Hospital Bristol.

Where patients are known to be HIV positive they should be referred to the HIV Specialist nurses via email: brecon.nurses@nhs.net

HIV/Aids fax number: 0117 4149426

Palliative Care Home Support Service

The Palliative Care Home Support Service (PCHS) provides personal care and emotional support for patients who wish to be at home in the last 4 to 6 weeks of life. The team visits patients across the Bristol and South Gloucestershire areas.

The service can provide 1 to 3 care visits to patients between 9am and 9pm for patients registered with a Bristol GP and 1 to 2 care visits to patients between 9am to 5pm for patients registered with a South Gloucester GP.

The service accepts patients with any diagnosis however; they must meet the following criteria:

• 18 years of age or older
• Assessed as being in the last 6 weeks of life
• Registered with a GP in the Bristol or South Gloucestershire area

Referrals can be made by any health or social care professional; by either fax or by telephone.

Bristol Care Co-ordination Centre (BCCC) for End of Life Care, co-ordinates the care for patients considered to be within the last 3 months of life.

• Marie Curie
• Hospice at Home
• The Fast Track Team who link closely with BCCC

Southmead Emergency Department (ED) & Minor Injury Unit (MIU)
Gate 35, Level 0, Brunel building, Southmead Hospital, BS10 5NB.

ED Main Reception
Telephone:  0117 4145100 or 0117 4145101

ED Observation Unit
Telephone: 0117 4144120 or 0117 4144121

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.

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.

Diabetes General Links

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.
 

Driving and Diabetes

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

Diabetes Technology

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.

An EBUS is a procedure that allows the doctor to look into your lungs (similar to a bronchoscopy) but them to take samples of the glands in the centre of your chest (mediastinum) using the aid of an ultrasound scan, these glands lie outside the normal breathing tubes (bronchi).

A flexible tube (bronchoscope), which is about the size of a man’s little finger, is passed into your lungs via your mouth (you will have a mouthguard and some protective glasses on) with you lying as flat as possible. A small camera at the end of the bronchoscope enables the doctor to look directly into your windpipe (trachea) and breathing tubes (bronchi). A small ultrasound probe
on the end of the camera allows the doctor to see the glands in the centre of the chest (mediastinum) and take samples under direct vision. Occasionally, it is useful to look down your gullet (oesophagus) at the same time with the same camera (the anesthetic in your throat allows this), as sometimes the glands can be sampled from the gullet which often causes less coughing and is more comfortable for patient with breathing difficulties (if this is a possibility, it would be discussed with you beforehand by the doctor).

Most commonly, Endobronchial ultrasound-guided transbronchial needle aspiration is done to take samples from the central lymph glands in the centre of your chest (mediastinum) which may be enlarged for a variety of reasons. In 9 out of 10 cases, we would expect this test to give a helpful answer to the problem. Very occasionally, another test may be needed.

During the procedure

• This test is done under sedation (unlike normal bronchoscopy).
• A combination of 2 sedatives are given. 1 of these also helps reduce coughing. Some patients go off to sleep more or less completely, others simply find that they feel comfortable and relaxed. Following sedation patients may not remember anything about the test.
• Some anaesthetic spray will be gently put in the back of your throat – there may be a taste similar to bitter bananas. There will be a different sensation to breathing and swallowing as the throat becomes temporarily “frozen” but you will be able to breathe and swallow normally (it may just feel a little different). It is also fine to cough, which will subside later during the procedure.
• During the bronchoscopy you may feel some slight discomfort as the bronchoscope is passed through your mouth. This may make you cough, but as the anaesthetic takes effect your throat will relax and you will be able to breathe normally.
• Further anaesthetic is put down at the level of the voice box which may make you cough to start with but will quickly settle down.
• The whole procedure takes about 20-30 minutes.

You will receive a follow up appointment in approximately two weeks afterwards, when the results will be discussed with you.

For more information, download patient information leaflets: https://www.nbt.nhs.uk/our-services/a-z-services/respiratory-medicine/respiratory-patient-information/endobronchial-ultrasound-guided-transbronchial-needle-aspiration-ebus-tbna