Step Inside Macmillan Wellbeing Centre
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This tour allows you take take a virtual walk through the Bristol Brain Centre.
Haematology HIT Guidance
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Haematology HIT Guidance
At North Bristol NHS Trust the test used to investigate a potential clinical diagnosis of HIT is an ELISA for heparin/PF4 antibodies.
A pretest probability should be calculated and the need for investigation discussed with a haematologist. The assay will not be performed without a 4Ts score.
Estimating the pretest probability of HIT: the ‘four Ts’
|
|
Points |
||
|
2 |
1 |
0 |
|
|
Thrombocytopenia |
> 50% fall or platelet nadir 20–100x 109 per l |
30–50% fall or platelet nadir 10–19x 109 per l |
fall <30% or platelet nadir <10x 109 per l |
|
Timing* of platelet count fall or other sequelae |
Clear onset between days 5 and 10; or less than 1 d (if heparin exposure within past 100 d) |
Consistent with immunisation but not clear (e.g. missing platelet counts) or onset of thrombocytopenia after day 10 |
|
|
Thrombosis or other sequelae (e.g. injection site lesions) |
New thrombosis; skin necrosis; post heparin bolus acute systemic reaction |
Progressive or recurrent thrombosis; erythematous skin lesions; suspected thrombosis not yet proven |
None |
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No other cause for platelet count fall is evident |
Possible other cause is evident |
Definite other cause is present |
|
Pretest probability score: 6–8 = high; 4–5 = intermediate; 0–3 = low. |
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If the pretest probability is low consider whether a HIT heparin/PF4 antibody assay should be performed. If the pretest probability is high, heparin should be stopped and an alternative anticoagulant given whilst laboratory tests are performed.
The immunological tests have high sensitivity, 80–100%, for heparin/PF4 antibodies but the diagnostic specificity for the clinical syndrome of HIT is low. A strongly positive test indicates a much greater likelihood of HIT than a weakly positive test.
Gastrointestinal (GI) Physiology
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A-Z of Services
Gastrointestinal (GI) Physiology
Gastrointestinal (GI) physiology is an outpatient service offering investigations and support for patients experiencing symptoms such as:
- Constipation
- Faecal incontinence
- Difficulty swallowing
- Acid reflux.
Tests offered
- Hydrogen breath tests (SIBO/lactose intolerance/fructose intolerance)
- Anorectal physiology +/- biofeedback
- Trans-anal irrigation
- Oesophageal manometry & overnight pH/impedance testing
All the above tests can be offered on the NHS or privately. For private patients, please contact us for further information.
Useful links
Contact GI Physiology
Gate 36, Level 1,
Brunel building,
Southmead Hospital,
Bristol
BS10 5NB
Phone: 0117 414 8801
Email: GIphysiology@nbt.nhs.uk
Regional CEN Information
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All Wales Speech Sound CEN
Contact email address:
allwalesspeechsoundcen@gmail.com
Child Speech Disorder Research Network representative on CEN:
No information provided
Key information:
- Frequency: AGM once a year; Study days twice a year; Working group/committee meetings may happen more regularly if undertaking a project
- Duration of events: 1 day
- Location: Online
- Means of communication: email / basecamp / Teams
Membership information:
Annual membership fee = £15. Open to SLTs across the UK.
Events offered:
Study days twice a year (for example, NDP3 training 2021; Core Vocabulary Training 2022)
Costs:
Membership = £15/year
Study day costs vary but usually £20-£30 for members
Organisation:
No details provided
Recent / forthcoming topics and speakers:
Core Vocabulary Therapy for Inconsistent Phonological Disorder by Dr Jan Broomfield – 26/10/2022 and 27/10/2022 (Online)
Key projects:
All Wales Speech Sound Pathway and User Guide. Last updated 2019. Currently working on further update within CEN working group/committee.
Shareable resources:
All Wales Speech Sound Pathway and User Guide
Online presence with links:
N/A
RCSLT link:
https://www.rcslt.org/members/get-involved/clinical-excellence-networks#section-2
Cleft Palate and Craniofacial Anomalies (Cleft CEN)
Contact email address:
Please use the contact form on the cleft CEN website to get in touch: https://cleftcen.org.uk/contact/
Key information:
- Frequency: The Cleft CEN offers bi-annual study days in Spring and Autumn to share research and audit, discuss evidence based-practice, and offer opportunities for collaboration and networking
- Duration of events: The Spring study day typically runs as a full-day face-to-face programme and includes the Annual General Meeting (AGM). The Autumn study day is currently run as a half-day virtual event.
- Location: The Spring study day takes place at the location of each year’s CFSGBI Scientific Conference. Autumn study days are currently run as virtual events.
- Means of communication: The CEN keeps in touch via email and through updates on the members’ area of its website and social media (@cleftslt on Twitter)
Membership information:
Membership is open to registered RCSLT members (including student SLT) who have an interest in speech, language and communication needs associated with cleft palate and craniofacial conditions or speech disorders arising from velopharyngeal dysfunction.
Membership costs £20 per year and includes free attendance at the Autumn study day as well as other resources and benefits. Please see the membership area of the website for further information: https://cleftcen.org.uk/about-cleft-cen/membership-join/
Events offered:
The Cleft CEN offers bi-annual study days that cover a range of topics related to working with children and adults with cleft palate and craniofacial conditions or non-cleft velopharyngeal dysfunction, including opportunities for discussion and networking.
Costs:
The cost of attending Autumn study days is included in members’ annual membership costs (£20). For non-members, attendance at the Autumn study day is £35.
Spring study days are linked to the annual CFSGBI Scientific Conference and details about each year’s CEN day cost can be found on each year’s conference website. For more information please visit: https://craniofacialsociety.co.uk/
Organisation:
The organisation of the CEN relies upon the CEN committee. For more information please see: https://cleftcen.org.uk/about-cleft-cen/the-cleft-cen-committee
Recent / forthcoming topics and speakers:
Recent and upcoming study day presentations have included a wide range of topics including:
- Evaluation of an intensive 1-day generalisation pilot group for young adults with Cleft Speech Characteristics
- The impact of a chiari 1 malformation on velopharyngeal function
- Speech outcomes for children post-tonsillectomy
- Using quality improvement methods to improve access to therapy intervention for children for cleft speech characteristics
- Early language indicators and their relationship with Speech and Language Therapists’ ability to judge velopharyngeal function in children born with cleft palate at age 18-24 months
Developing resources to support psychological well-being in adults with craniosynostosis
Key projects:
The aims of the Cleft CEN are:
- To provide opportunities for CPD
- To respond to relevant issues on behalf of RCSLT at their request and in liaison with the CFSGBI and the Cleft SLT Leads group
- To exchange and discuss information concerning this client group
- To improve standards of care for this client group on a national basis
- To promote advances in speech and language therapy management of this client group, including discussion of new equipment and techniques from national and international sources
- To provide peer support for speech and language therapists working with this client group
- To encourage members to undertake and participate in research/audit projects and share their findings
- To disseminate information on national research initiatives
- To provide some financial support for members to attend related conferences and study days (nationally and internationally)
Shareable resources:
Resources can be found in the members’ area of the website, including slides from previous study day presentations: https://cleftcen.org.uk/
Online presence with links:
https://cleftcen.org.uk/
https://twitter.com/cleftslt
RCSLT link:
https://www.rcslt.org/members/get-involved/clinical-excellence-networks#section-2
London Speech Disorders CEN
Contact email address:
Secretary Maria-Katharina Fortunato-Carpio, londonspeechdisordersCEN@outlook.com
Child Speech Disorder Research Network representative on CEN:
Pam Williams
Key information:
- Frequency: 3 x year
- Duration of events: Variable
- Location: Online - (when possible again we will be holding some of the meetings at the RCSLT HQ in London)
- Means of communication: email list
Membership information:
We are currently operating a pay as you go system as this is easier to manage virtually.
Otherwise we are operating an annual membership system of £10 for the calendar year or £10 if only attending one meeting; we do not have a membership form.
Events offered:
None at present
Costs:
Membership: £10
£5 per meeting for non-members, CPD events with certain speakers may require a supplement.
Organisation:
We have a CEN committee that is made up of a Chair, Treasurer and Secretary.
We also have volunteers for tasks.
Events are circulated to the mailing list/membership and booked via Eventbrite.
Recent / forthcoming topics and speakers:
- Q&A on DVD
- Presentation on Worster–Drought syndrome
- Dr Joanne Cleland on bio-feedback and use of US/EPG
- Lucy Rodgers re DLD/SSD research
Dates for 2023 are planned as follows:
- 05.07.2023
- 07.12.2023
Key projects:
None at present
Shareable resources:
Recordings/handouts from past events are available to members
Online presence with links:
None at present
RCSLT link:
https://www.rcslt.org/members/get-involved/clinical-excellence-networks#section-2
Midlands Speech Sound Disorder CEN (England)
Contact email address:
Child Speech Disorder Research Network representative on CEN:
Emma Pagnamenta
Key information:
- Frequency: 3 x year
- Duration of events: Approx. 2 hours
- Location: Online
- Means of communication: email list
Membership information:
The CEN is open to all. Membership is £20 annually and members are able to attend meetings for free. SLTs do not need to be a member to sign up to the mailing list. It is also possible to pay for specific meetings and attend as a non-member.
Events offered:
None at present
Costs:
Membership: £20
£5 per meeting for non-members, CPD events with certain speakers may require a supplement.
Organisation:
There is a CEN committee which anyone is welcome to join. Committee members are nominated for specific roles at the AGM.
Recent / forthcoming topics and speakers:
None at present
Key projects:
None at present
Shareable resources:
Recordings/handouts from past events are available to members
Online presence with links:
- Twitter: @SSDmidlandsCEN
- Facebook: Midlands Speech Sound Disorder CEN
RCSLT link:
https://www.rcslt.org/members/get-involved/clinical-excellence-networks#section-2
Older Children, Young People and Adults with Developmental SLCN
Contact email address:
Gillian.earl@nhslothian.scot.nhs.uk (membership secretary)
v.joffe@essex.ac.uk (chair)
Child Speech Disorder Research Network representative on CEN:
N/A
Key information:
- Frequency: approximately annually
- Duration of events: 1 day
- Location: various locations, hybrid meetings to allow virtual access
- Means of communication: RCSLT basecamp
Membership information:
SLTs and non-SLTs with an interest in developmental SLCN in older children, young people and adults
Members are invited to post comments via RCSLT basecamp, share information and attend meetings as they wish.
Events offered:
Annual hybrid event – various short presentations on topics decided in advance around a shared theme – speech sound disorders may feature but are not generally the primary focus.
Costs:
Membership is free and involves joining Basecamp.
Small administrative cost for those who attend events in person
Organisation:
N/A
Recent / forthcoming topics and speakers:
January 2022: SHINING A SPOTLIGHT ON RESEARCH, PRACTICE, AND INNOVATION IN WORKING WITH OLDER CHILDREN, YOUNG PEOPLE AND ADULTS WITH SLCN with speakers including: Liz Wood, Melanie Cross, Jan Wood, Ros Merrick and Rachel Sievers
No information on forthcoming events currently available.
Key projects:
Raising awareness of the needs of older children, young people and adults with SLCN.
Shareable resources:
Various – available on RCSLT basecamp
Online presence with links:
N/A
RCSLT link:
https://www.rcslt.org/members/get-involved/clinical-excellence-networks#section-2
Scottish Speech Sound Disorder CEN
Contact email address:
Child Speech Disorder Research Network representative on CEN:
No information provided
Key information:
- Frequency: Two per year
- Duration of events: various
- Location: Online & various locations
- Means of communication: email and Twitter (@ScottishSSDCEN)
Membership information:
Annual membership fee = £10 per year, £5 students normally.
Meeting are normally included in this cost but there may be additional costs for guest speakers.
Events offered:
UK wide CEN in Spring or Summer with Sara Masso, date TBC
Costs:
Membership = £10 per year, £5 students normally.
Organisation:
No details provided
Recent / forthcoming topics and speakers:
Past events:
- Tricia McCabe treatment for CAS
- Pam Williams Nuffield Dyspraxia Programme
- Ellie Sugden Working with Parents
- Helen Stringer Phonological Awareness
Key projects:
None at present
Shareable resources:
None at present
Online presence with links:
N/A
RCSLT link:
https://www.rcslt.org/members/get-involved/clinical-excellence-networks#section-2
Speech CEN: North East (England): SCENNE
Contact email address:
Child Speech Disorder Research Network representative on CEN:
Jan Broomfield
Key information:
- Frequency: 3 x year, 1 per school term
- Duration of events: Full day
- Location: Online / Glebe Centre (SR7 9BX) / other on occasion
- Means of communication: Email; RCSLT Bulletin
Membership information:
- Membership gives access to 2 member-only study days at no cost
- And one training day at reduced cost per year
- Membership year: September to August
- Membership applications are open June to August
- We have over 50 members from North East England, North West England and further afield
Events offered:
- Study days usually internal, training / workshop / info share
- Training days are led by an external speaker
- Training days are open to non-members if space allows
Costs:
- Membership: usually £20
- Cost of annual training day varies depending on necessary expenditure such as speaker, venue & catering costs as need. Usually maximum of £40, with reduced cost for members
Organisation:
- Membership committee, comprising
- Rep from each organisation across the region (7)
- Rep from the North West
- Rep for ‘out of area’ members
- Rep for Independent practice
Recent / forthcoming topics and speakers:
- Inconsistent Phonological Disorder and Core Vocabulary Intervention; Dr Jan Broomfield
- Nuffield Dyspraxia Programme; Dr Pam Williams
- ReST; Dr Tricia McCabe
- Working with Vowel Disorder; Dr Sally Bates
Key projects:
N/A
Shareable resources:
Currently unavailable
Online presence with links:
N/A
RCSLT link:
https://www.rcslt.org/members/get-involved/clinical-excellence-networks#section-2
Northern Ireland SSD CEN
Contact email address:
linda.mulgrew@southerntrust.hscni.net (Chair)
edyth.haddock@southerntrust.hscni.net (Secretary)
Child Speech Disorder Research Network representative on CEN:
Jill Titterington
Key information:
- Frequency: 2 events per year (Spring and Autumn)
- Location: Seamus Heaney HomePlace, Bellaghy, Co. Derry
- Means of communication: Email circulation list
Membership information:
CEN events are open to all.
The membership process is currently under review.
Events offered:
None at present
Costs:
Costs are dependent on venue/speaker but are generally kept to a minimum as many SLTs are self-funding.
Organisation:
There is a CEN Committee which consists of Chair, Secretary and Treasurer plus Honorary Chair Jill Titterington. Posts are held for a 2 year period.
Recent / forthcoming topics and speakers:
None at present
Key projects:
None at present
Shareable resources:
None at present
Online presence with links:
None at present
RCSLT link:
https://www.rcslt.org/members/get-involved/clinical-excellence-networks#section-2
Specific Speech Impairment South West CEN (England)
Contact email address:
Child Speech Disorder Research Network representative on CEN:
Yvonne Wren
Key information:
- Frequency: 1 x year
- Duration of events: Half day/full day
- Location: Online
- Means of communication: Email list
Membership information:
The CEN is open to all. There is no membership fee, but costs may be requested for events to cover speakers costs. The aims of the CEN are:
- To focus on SLT Services to children with specific speech impairment
- To provide mutual support, help and encouragement to all members
- To exchange ideas and information
- To discuss policy with regard to working with children with specific speech impairment
- To create more interest in, and knowledge of SLTs role with children with specific speech impairment
- To improve multi-disciplinary communication and understanding of children with specific speech impairment
- To promote and participate in projects linked to the welfare and treatment of children with specific speech impairment
- To raise awareness of all aspects of children with specific speech impairment
- To liaise with RCSLT Advisors
Events offered:
None at present
Costs:
No information at present
Organisation:
The CEN is currently running with a small committee:
- Chair – Jo Lamb
- Assistant Chair – Alex Tolley
- Secretary – vacant
- Treasurer – Henrietta McLaughlin
Recent / forthcoming topics and speakers:
None at present
Key projects:
None at present
Shareable resources:
None at present
Online presence with links:
None at present
RCSLT link:
None at present
Vascular Testing - For Clinicians
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Services & Referral
Vascular Testing
Please make referrals to vascular testing for investigations via the ICE system.
Clinicians can refer to the Vascular Network via NHS eReferrals where possible, or by refer a patient.
Please visit Vascular Services - For Clinicians for more details and urgent referrals
To speak to a member of the Vascular Testing team to discuss referrals or results, please call 0117 414 5300
Our opening hours are 8 am – 6 pm Monday to Friday. Any referrals made after 4:30 are not guaranteed to be performed on the same day. Any urgent referrals made after 4:30, please call the department. Please leave a voicemail outside of these hours if necessary and we will return your call.
Deep vein thrombosis scan
Requests are no longer accepted by primary care. Please refer to GP Care for this assessment by visiting Deep Vein Thrombosis - GP Care.
Work Experience
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Work Experience
We work closely with local schools and colleges to provide opportunities for young people to gain knowledge and experience of different roles and raise awareness of career options and job opportunities within the NHS.
There are over 350 potential career options in healthcare and opportunities for work experience include clinical and administrative areas, allowing participants to learn about working in the NHS, develop new skills, learn about their strengths and weaknesses and increase their confidence.
Learning and Development organise various opportunities for young people to gain experience of the NHS and our Trust. These include:
- Tours of departments.
- Careers events.
- Work shadowing.
- Taster/observation days.
- Mock interviews and work experience programmes, including traineeships and sector-based academy learners.
To find out more about work experience opportunities within our Trust, please email workexperience@nbt.nhs.uk.
Apprenticeships
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Apprenticeships
We are proud to deliver clinical apprenticeship training and education through our partnership with the South West Association of Training Providers (SWATPro), as well as non-clinical apprenticeships training under our own Apprenticeship Centre, which has been awarded the Matrix Accreditation, in recognition of the high-quality information, advice and guidance they offer.
Ofsted inspectors have recently praised us for our employer-led apprenticeship delivery, saying: "Senior Trust leaders are highly committed to delivering apprenticeships to improve the skills, knowledge and behaviours of staff. Apprentices enjoy working in Southmead Hospital and are valued members of staff".
Our apprenticeships are a fantastic opportunity for existing staff to build skills and confidence and offer a route to a new career for those looking to join the Trust.
We currently deliver apprenticeships in:
- Senior Healthcare Support Worker (Level 3).
- Business Administration (Level 3).
- Customer Service (Level 2).
- Leadership Management (Level 3 Team Leader/Supervisor).
We also work with external training providers to develop staff in a wide range of apprenticeships in the following areas:
- Trainee Nursing Associates (Foundation degree in Science qualification level 5).
- Assistant Practitioners (Foundation degree in Science qualification level 5).
- Registered Nurse Degree (Batchelor of Science qualification level 6).
- Advanced Clinical Practice (Master of Science qualification level 7).
What is an apprenticeship?
An apprenticeship is a paid job where the employee learns and gains valuable experiences. Alongside on-the-job training, apprentices spend at least six hours of their working week completing off-the-job learning to enable them to meet the skills, knowledge and behaviours within their chosen apprenticeship standard.
North Bristol NHS Trust offers a range of clinical and non-clinical apprenticeships to help you progress in your career. A typical programme of learning will last between 15 and 18 months.
Apprenticeships make a big difference to staff
- Earn while you learn.
- Receive recognised qualifications.
- Benefit from ongoing and personalised support.
- Gain real work experience.
- Improve your employability.
- Develop your skills.
The need-to-knows
- Apprenticeships are fully funded – staff do not have to pay for their apprenticeship.
- All NBT staff who are eligible are offered the opportunity to undertake a programme of learning.
- Apprenticeships take place during work time (off-the-job) – you will be allocated time away from your duties to complete your studies.
How does the off-the-job training work?
Off-the-job training is a statutory requirement for apprentices. It is training, which is received by the apprentice, during their normal working hours, to achieve the knowledge, skills and behaviours of the apprenticeship.
It is gained by attending study sessions, completing role play or simulation exercises, undertaking online learning, practical training such as shadowing and mentoring and writing assessments or workbooks.
Apprenticeships help employees, managers and teams in several ways
- Staff develop skills relevant to their organisation.
- Improved productivity and quality.
- Training can be adapted according to the needs of your department.
- Staff are motivated to learn new skills.
- Helps to expand and upskill your workforce.
All our apprenticeship roles will be advertised on our current vacancies and on the Government Find an Apprenticeship website.
For more information, please email our apprenticeship team ApprenticeshipTeam@nbt.nhs.uk.
Vascular Testing Frequently Asked Questions
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Where will I be seen?
If you are an inpatient, you will be seen by a member of the team on the ward with a portable scanning device. You may be asked to attend our department at gate 5a but this will be communicated to you and you will be transferred by the hospital portering service.
If you are sent an outpatient appointment letter, it will advise you on the outpatient setting that you should attend and how to check in for your appointment.
Once checked in, you will come to our dedicated vascular testing waiting room. Here there are toilets, including disabled facilities next to the waiting room.
For your appointment, you will be taken to one of the ultrasound rooms where it will be explained to you what investigation is going to be performed. Depending on the type of investigation you will be advised as to what clothing or jewellery needs to be removed. You may be asked to lie/sit on the couch or stand next to it. If you find a particular position uncomfortable, please let us know so we can adapt the scanning position to make you more comfortable.
The vascular scientist or technician will put ultrasound gel on the area to be examined and will place a soft-faced transducer or probe, which is attached to the ultrasound machine, on your skin to create the ultrasound images or sounds as required so that a diagnosis can be made.
Occasionally there may be medical or other students observing. All staff present will be introduced to you and you will be asked if you mind students being present during the investigation. If you prefer not to have students observing, it is fine to tell the examiner and it will not affect your treatment in any way.
How long does the test take?
The type of test and how long it will approximately take will be indicated in your appointment letter.
Your visit to Vascular Testing could take anything from 15 minutes for a simple Doppler test up to 90 minutes for a full scan of both legs. If you require more details, please contact us.
Are there are special preparations?
Minimal patient preparations are required for the test. You can eat, drink and take medication as normal, however, if you are coming for a Duplex scan of your legs or abdomen you may want to have a light breakfast or lunch and avoid fizzy drinks.
If you are diabetic, please ensure you bring your medication, food or money to purchase food in case of delays.
Will I need to undress?
An ultrasound needs direct contact with the skin. You will be asked to remove specific items of clothing or jewellery so we can get clear access to your skin in the areas where the investigation needs to be performed. It is recommended that you wear something comfortable which is easy to take on and off. The vascular scientist or a support worker can help you if you have any difficulty.
The dignity and privacy of our patients is of the utmost importance and the examination will be performed in a private scanning room. You will be given a towel if you are asked to remove an item of clothing. If you would specifically prefer a male or female member of staff, please let us know, preferably by contacting us prior to your appointment.
Can I bring someone with me?
There is room in the scanning room for one friend or relative if you require additional support during the scan.
I have dressings – will you change them?
We are unable to redress any leg wounds or ulcers. Please arrange with your health centre to have any dressings reapplied or changed at a convenient time after your appointment.
Will it hurt?
No, for a vascular ultrasound scan there are no injections, no needles and no chemicals or x-rays. Depending on how deep the blood vessels are the vascular scientist or technician may need to press quite firmly and this can sometimes feel a bit uncomfortable but they will do their very best to keep any discomfort to a minimum.
The worst part of the scan for most people is the gel and that is because it’s cold. The gel will be wiped off after the test, it is water-based and does not stain clothing.
Is the test safe?
Vascular ultrasound tests are safe and non-invasive (no injections).
Do I have to go in a tunnel?
No, there are no tunnels or confined spaces involved.
Can I drive afterwards?
Yes – unless you have been told by your doctor not to because of your condition.
When will I receive the result?
At the end of the scan, if you would like to know the findings, we can discuss the scan with you and will try to answer any questions you may have.
We cannot tell you what your treatment will be as this is a discussion between you and the referring doctor however we can try and answer any questions you may have regarding the different types available.
We cannot discuss any potential treatment options as this will be a discussion between you and the referring doctor.
The test result will be communicated to the referrer and the result will be available to view on the hospital reporting systems within 24 hours.
Who will book my hospital transport?
We do not book hospital transport but please call the vascular testing administration team if you will be booking transport as we may need to rearrange your appointment time. This is to avoid late return journeys home which cannot be guaranteed if your appointment is after 2pm. The vascular testing administration telephone number can be found in your appointment letter.
If you are attending on transport please bring regular daytime medication, food or money to purchase food should there be any delays.
If you require hospital transport this must be arranged by you but remember to call and let us know. The number for transport is in your letter.
Contact Vascular Testing
Gate 5a
Brunel building
Southmead Hospital
Westbury-On-Trym
Bristol
BS10 5NB
Telephone: 0117 4140851