The Neurology Department here at North Bristol NHS Trust is responsible for providing outpatient and inpatient services to the whole of Bristol for adults with neurological problems. 

Specialist and general Neurology Clinics are carried out at various locations within North Bristol NHS Trust including:

• Brunel Building, Southmead Hospital
• Bristol Brain Centre, Southmead Hospital
• Bristol Royal Infirmary
• Thornbury Hospital
• Clevedon Hospital
• Gloucester Royal Hospital

We also offer an Emergency Specialist Registrar Clinic Service which can be accessed via your GP. 

Inpatient Services are located across several wards in the Brunel building:

• Gate 25a, Level 2 - Neurology and Neurosurgery Inpatients
• Gate 6b, Level 2 - Neurosurgery Inpatients
• Gate 7a, Level 3 - Neurology and Stroke Inpatients
• Gate 9a, Level 5 - Stroke Rehabilitation

There are 23 Consultant Neurologists within the Department supported by staff including Specialist Registrars, SHO’s, Specialist Nurses, Secretarial and Administrative Staff. 

The Institute of Clinical Neurosciences (ICN) is responsible for promoting and coordinating clinical research and is based at Southmead Hospital Bristol.

An active programme of research in clinical neuroscience is conducted both at North Bristol NHS Trust and at the University of Bristol.

This is a short information film about what it is like to have an MRI of your breasts at Southmead Hospital. You will be met at reception by your Radiographer and escorted to the MRI scanner suite. The scanner is very noisy and you are likely to hear it as you enter the MRI suite.

Having a Breast MRI - Text alternative

At North Bristol NHS Trust, all health care support workers, also known as HCA’s, and housekeepers, complete the Care Certificate providing them with the skills, knowledge and behaviours to enable them to provide high quality safe patient care and support.

The Care Certificate can begin as part of the two week induction, and consists of classroom based learning, practical activities and a variety of learning opportunities to help new staff build their knowledge of their role and an understanding of the Care Certificate standards.

Existing staff are also able to complete the Care Certificate, and this will start at your appraisal. A Care Certificate handbook is then used to gather evidence of knowledge and competency in practice. Once completed, staff may progress to an apprenticeship, competency package or other individualised pathway to continue their development.

New staff will:

• Complete most of the handbook in the two week induction training, including MLE e-learning activities.
• Be supported to complete all of the handbook within the first two months.
• Have their competency sheet signed off by their 'Buddy' and Manager to provide evidence of competence in practice. (This should also include an example and comments.)
• Submit their completed handbook within two months to the Care Certificate Team.

Existing staff will:

• Receive a self-assessment booklet as part of their appraisal.
• Need to complete the self-assessment form and bring it to their appraisal with any supporting evidence, e.g. completed Care Certificate handbook and certificate, qualification certificates such as vocational qualifications, MLE e-learning records, records of study days attended, competency packages etc. This will help to identify any areas for development or gaps in knowledge.
• Review the self-assessment form with their Manager and agree a plan for any training or development to meet the standards. This may including completing part(s) or all of the Care Certificate handbook.
• Be signed off by a trained 'Buddy' on the ward, or their Manager.
• Submit a portfolio to the Care Certificate Team. This should include the self-assessment tool and supporting evidence such as MLE records, copies of certificate, self-reflections etc.

Care Certificate 'Buddies'

Staff undertaking their Care Certificate will receive support from 'Buddies', who are experienced Health Care Support Workers who have previously completed the certificate, and have experience in supporting others in learning and development.

'Buddies' will:

• Have completed the Care Certificate themselves and have worked in a healthcare support role for at least one year.
• Act as a mentor to support staff undertaking the certificate.
• Record workplace examples of how participants have met Care Certificate standards.

Care Certificate Standards

Healthcare support workers will need to demonstrate they are meeting the following standards in their work:

• Understand your role
• Your personal development
• Duty of care
• Equality and diversity
• Work in a person centred way
• Communication
• Privacy and dignity
• Fluids and nutrition
• Awareness of mental health, dementia and learning disabilities
• Safeguarding adults
• Safeguarding children
• Basic life support
• Health and safety
• Handling information
• Infection prevention and control

The breast reconstruction team We are a dedicated team specialising in breast reconstruction the team is

• Three consultants
• Registrars
• Two breast reconstruction nurses
• Breast Reconstruction Secretary
• Waiting List co-ordinater

Caroline Lewis, Plastic Surgery Breast Reconstruction Nurse Specialist, Registered Nurse with The Nursing and Midwifery Council (NMC)

 

Year of qualification: 2008 from The University of the West of England (UWE)

Qualifications: UWE 2008 Dip HE Adult Nursing, 2012 UWE BS(Hons) Specialist Nursing, 2014 Birmingham City University, PG Adult Plastic Surgery 

Specialty: Plastic Surgery

Clinical interests: Breast Reconstruction, Medical Tattooing, Camouflage Make-Up

Caroline’s professional background is in Burns and Plastic surgery at North Bristol NHS Trust (NBT).  Currenty she is a Specialist Breast Reconstruction Nurse here at Southmead Hospital, caring for pre-opertaive and post-operative patients. This involved liaise with the Multidisciplinary Team (MDT) and working closely with Caroline Oates the Breast Reconstruction Nurse Practitioner, together with the Plastic Breast Reconstruction Consultants Mr Sherif Wilson, Miss Elena Prousskaia and Miss Catalina Estela. This enables her to understand the care needs of her patients and facilitates her nurse led clinics.

She is present at most out-patient’s appointments and Keeping Abreast support group proving information and support for patients and their relatives.

As part of Caroline’s role she has been involved in setting up the Breast Reconstruction the Enhanced Recovery After Surgery (ERAS) program to ensure patients receive research based care. The ERAS is regularly audited and the information is reviewed and disseminated to the MDT. This has facilitated staff and patient educational programs. 

Caroline believes that communication is key to providing patient centered care.

Caroline Oates, Plastic Surgery Breast Reconstruction Nurse Practitioner, Registered Nurse with The Nursing and Midwifery Council (NMC)

 

Year of qualification: 1985 at Southmead Hospital

Qualifications: Swansea (1999) Adult Plastic Surgery, Bournemouth (2004), Nurse Practitioner Degree Gloucestershire University (2006)   Breast Cancer Care

Specialty: Plastic Surgery/Breast Reconstruction

Clinical interests: Breast Reconstruction, Medical Tattooing, Tissue expansion, seroma drainage.

Caroline’s professional background is in Plastic surgery at North Bristol NHS Trust (NBT). Currently she is a Plastic Surgery Breast Reconstruction Nurse Practitioner here at Southmead Hospital, caring for pre-operative and post-operative patients.

Her role is to facilitate and triage all referrals received by GP’s, Consultants and breast care nurses to ensure that patient are seen as soon as possible. She is also responsible for ensuring that immediate breast cancer patients are seen and operated on within Cancer target guidelines.

She books in CT scans, pre-assesses patients, clinically exams and completes blood test on patients as well as several other extended roles, similar work to a Junior Doctor under taking ward rounds and facilitating discharging patients home. She is also responsible for organizing the referrals for the oncoplastic meetings which take place every two weeks between Plastic surgery and the local Breast care team discussing the appropriate care pathway for each individual patient. This is then disseminates to the whole team.

Caroline runs several nurse led clinics at Southmead and Gloucester Royal Hospital, throughout the week as well as a telephone clinic for patients with concerns and problems. She is also available during consultant led clinics for advice and support.

She has regular contact with the surrounding breast and plastic surgery units to ensure communication and patients care are always at the forefront of treatment.

She is actively involved with the enhanced recovery program by introducing patients to this in pre-assessment and explaining their care pathway. As part of Caroline’s role she has been involved in setting up the Breast Reconstruction the Enhanced Recovery After Surgery (ERAS) program to ensure patients receive research based care. The ERAS is regularly audited and the information is reviewed and disseminated to the MDT. This has facilitated staff and patient educational programs.  Caroline believes that communication is the key to providing patient centered care and she is passionate about the care of her patients.

Wendy Rodman, Breast Reconstruction Team Secretary

 

Wendy has worked at North Bristol NHS Trust for 31 years as a medical secretary. Currently she works for the Plastic Surgery Breast Reconstruction Team working for Mr Sherif Wilson since 2005 when he became a Consultant Plastic Surgeon. At that time we had one Breast Reconstruction Specialist Nurse Caroline Oates whom I also work for.

Over the years the Breast Reconstruction service has grown immensely and we now have additional Consultants to our team, Ms Elena Prousskaia and Ms Catalina Estela whom Wendy also secretary to, with the addition of another Specialist Nurse Caroline Lewis.

They are a very close knit team and work well together. The booking of appointments for our patients needing breast reconstruction to seeing them in the clinic, to their surgery and aftercare is held within her remit. 

 

 

Andrea Thompson, Patient Pathway Coordinator

We want to prepare you as much as possible before surgery.

Before surgery

Prior to surgery you will be taught how to perform strengthening abdominal exercises. The aim of these exercises is to strengthen the blood vessels which supply the abdominal muscles. These vessels are used during your surgery and there is thought that by strengthening them you have improved outcomes and a quicker recovery.

The class will also allow the team to advise you of your future journey, teach you breathing exercises to perform after your operation and how to get out of bed.

After surgery

The post-operative class is available for ladies at least 8 weeks after their operation. This gives time for the abdomen to sufficiently heal before commencing abdominal exercises.

Not all women feel a weakness in their abdomen long term but with any surgery the abdominal muscles can become weak. This class aims to teach you a progressive exercise programme for your abdominal muscles as well as check your progress with regards to shoulder movements.

The ward Physiotherapist will have taught you shoulder exercises prior to being discharged home.

These classes are made possible by Keeping Abreast.

Bra-fitting Service
We offer a bra-fitting service to pre and post-mastectomy surgery and for those undergoing breat reconstruction. Women are measured by Jackie Pool, an experienced breast care fitting specialist who is a volunteer for Keeping Abreast. The fittings take around 45 minutes to an hour in the Apple Room as the Macmillan Wellbeing Centre. Appointments for the service are limited and are held teice a month on a Friday at 12 noon. To book an appointment telephone Jackie on 07919 280144 or email jackie@nicolajane.com

Keeping Abreast, South West
Keeping Abreast provide support information giving meetings which are run by volunteer women who have undergone breast reconstruction at southmead hospital. The group is base at Bristol and Gloucester which are relaxed and open for women and their Family & friends to come along. There is the opportunity to meet and talk with other women who are considering, undergoing or post reconstruction. The group provides practical help and advice for those considering breast reconstruction, including the opportunity to share the experiences of others. For women who feel uncomfortable in a group situation Keeping Abreast volunteers can provide a one to one support. 
For more information visit www.keepingabreast.org.uk

Breast Cancer Care
A Free and confidential service, run by specially trained nurses.
Website: www.breastcancercare.org.uk
Helpline telephone: 0808 8006000
Text phone: 0808 800 6001

Macmillan Cancer Support
Provides practical, medical, emotional and financial support
Website: www.macmillan.org.uk
Freephone: 0808 800 0000
Text phone: 0808 808 0121

Macmillan - Benefits and other financial support
Website: www.macmillan.org.uk/information-and-support/organising/benefits-and-financial-support/benefits-and-your-rights

British Association of Plastic Reconstructive and Aesthetic Surgeons (BAPRAS)
Website: www.bapras.org.uk

Maggies Centre
Maggie’s Cheltenham provide a free unique programme of information, practical and emotional support to people with cancer and their love ones.

Someone Like Me
Someone Like Me can put you in touch with someone else who’s had or been affected by primary breast cancer – with a network of around 200 trained volunteers, they’ll find someone who has more in common with you and understands your particular concerns.
Website: www.breastcancercare.org.uk/information-support/support-you/someone-talk/someone-me
 

We want to ensure that you are as fit as possible for surgery before being admitted on your operation day and that you are also well informed and know what to expect.

We will give you information about coming into hospital and allow you and your family time to ask any questions you have about your surgery.

You should allow up to two hours for your visit, although the time you will spend with us will depend on your medical history and how many tests are needed.

You will be given a questionnaire to complete about contact details for yourself and your relatives. You will then have your

• blood pressure checked
• pulse checked
• height checked
• weight checked
• your nostrils and groins swabbed for MRSA.

You may have an ECG (Electro-Cardiograph) which takes a trace of your heart as well as bloods taken.

The nurse will assess you by going through the questionnaire with you and asking further questions. This assessment also includes checking your medication and advising you about any tablets you need to stop before your surgery.

Please make sure that you bring an up to date prescription or your medications with you.

The assessment helps us to understand your health situation and decide if further tests are needed to make sure you are fit for your surgery. You will also be given some information leaflets – please do read them carefully when you get home.

We will let you know what you need to bring into hospital, what to expect whilst you are an inpatient; how the surgery is performed and post-operative care that you will receive.

You will also be given instruction on what you can and cannot do once you get home so that you can arrange support for you and your family whilst you recover. Following major breast reconstruction surgery you will have to restrict all normal activities for up to six weeks after your surgery. You may need to ask for help from family and friends.

As a breast reconstruction patient we wil discuss the Enhanced Recovery Programme (ERP) which involves you drinking specific drinks before and after surgery.

The Medical Tattooing Clinic is run by the Breast Reconstruction Nursing Team who are qualified in 2D and 3D tattooing following nipple and areola reconstruction using semi-permanent pigments.

The 3D tattooing creates an appearance of an areola and nipple for patients who do not wish to have a reconstruction of the nipple.

The whole process of tattooing takes about an hour and we use a local anaesthetic cream on the area first. You will require a minimum of up to 3 treatments, which are booked 6 weeks apart to allow the pigment to settle into your skin.

As we use semi-permanent pigments the pigment will fade over time and you and you may require a top up at a later day.

Please be aware that the tattooing needles contain nickel and the pigments are oxides based. If you think that you may be allergic to these produces we can offer you a patch test which need to be undertaken 24 hours before.

The Plastic Breast Reconstruction Nurse Led Clinic is run on a Monday 8am to 5 pm, and on Wednesday and Friday 8am to 12 noon at Gate 24, Level 1, Brunel building, Souhtmead Hospital. 

This clinic is specifically for patients who have had surgery in the previous week to 10 days.

We will review your wound and change the dressings please do ask any questions, if you need to.

We also offer a phone consultations for patients to answer any concerns before and after surgery. If you have any issues please do call the Nurses.

Patients attend the Breast Reconstruction Follow Up Clinic, to be reviewed by the plastic surgery team following surgery, up to three months after surgery. 

This clinic provides you with the opportunity to discuss your surgical results or further treatment plan.

It is often quite a busy clinic and the wait can sometimes be up to 3 hours therefore please feel free to have someone accompany you.

Mr Sherif Wilson who is the lead consultant for plastic breast reconstruction also runs a monthly follow-up clinic at Gloucestershire Royal Hospital (www.gloshospitals.nhs.uk). If you are in this catchment area you can contact Wendy Rodmen, Mr Wilson’s secretary, to book this appointment.