GMC Number: 4638410

Year of first qualification: 1999, University of Newcastle-upon-Tyne

Specialty: Renal Medicine

Clinical interests: Supportive and end of life care

Secretary: Olivia Wootten 

Telephone: 0117 414 7697

GMC Number: 6053019

Year of first qualification: 2002, University of Liverpool

Specialty: Radiology

Clinical interest: Musculoskeletal Radiology

Secretary: Gail Bailey

Telephone: 0117 414 9008

Dr Brathaban Rajayogeswaran trained at Kings College Hospital, London with a particular interest in Musculoskeletal Radiology and Trauma.

He undertook two international fellowships in Vancouver, to develop his strong interest in sarcoma, musculoskeletal intervention and emergency & trauma radiology.

GMC Number: 6069635

Year of first qualification: 1997, Belgrade University

Specialty: Diabetes & Endocrinology

Clinical interest: Type 1 diabetes

Secretary: Susan Trevascus

General Gynaecology covers many gynaecological problems including abnormal uterine bleeding, post-menopausal bleeding, ovarian cysts, and fibroids.

Clinics are Monday to Friday, in the morning and afternoon. The clinics take place at Southmead Hospital, Cossham Hospital, Clevedon Hospital, Yate West Gate Centre and Minor Injury Unit, and Thornbury Hospital. With an emphasis on a one-stop outpatient journey, there are facilities to perform pelvic ultrasound scans in clinic.  This enables a treatment plan to be drawn up immediately.

We offer a range of medical and surgical treatments which incorporates ambulatory, day case, and inpatient procedures. There is increasing focus on short stay and day case surgery, and the department has considerable expertise in laparoscopic surgery. Surgery is done at Southmead Hospital.

What to expect at your appointment?      

We offer face to face, and phone appointments. 

At face-to-face appointments we will discuss the problems you have been referred for and may do an examination. This could include feeling your abdomen, an internal examination, and an internal scan through the vagina. We may recommend taking a biopsy, smear, swab, or blood test. You may be given instructions to arrive with a full bladder if you need an ultrasound. A chaperone is always available. We will discuss any test results with you and any plans for treatment.

After your appointment we will send a letter to you and your GP with details of the consultation and any outstanding test results. 

© North Bristol NHS Trust. This edition published January 2025. Review due January 2027. NBT003770

MND Association

The Motor Neurone Disease Association (MNDA) is the only national charity in England, Wales and Northern Ireland focused on MND care, research and campaigning. They can provide information and support for people with MND, their families and carers. People with MND and their carers can join the MND Association without charge. There are several sources of information and support through the MND Association. 
Website: www.mndassociation.org

MND Connect

MND Connect is an advice line for people living with MND and their carers, as well as for health and social care professionals. MND connect offers advice, practical and emotional support including information on other services and agencies.
Telephone: 0808 8026262 (freephone from landline and mobiles)
Email: mndconnect@mndassociation.org

Regional Care Development Advisers

The MND Association Regional Care Development Advisers work with local health and social care staff to improve services for people with MND. They can provide information and advice to people with MND, their carers & families & professionals involved in your care, to ensure you receive the support you need.

MND Association Branches and Group

There is a network of Branches and Groups across the region which provide support to people living with MND and their families/carers. They raise money to support local people, fund research and raise awareness of the condition. The branches assist the team of Association Visitors locally who can provide regular support for you and your family through visits, telephone or email. They aim to ensure that you are given the right information at the right time.

The Bristol & Bath Group

This group runs regular support group meetings in Bristol and Bath and produces a regular newsletter. They also have a website:  http://mnd-bbww.org/

A  monthly  clinic  is  held  at  the  Bristol  Royal  Infirmary  (Sleep Unit),  University  Hospitals  Bristol  NHS  Foundation  Trust  for people  living  with  MND  who  experience  breathing  difficulties. 

Equipment to support breathing can be provided by the team at this clinic.

If you need more help with breathing the team has Respiratory Physiotherapists & Physiologists who can provide support at home.

The Consultant will have the referral letter from your GP, Neurologist or other doctor. They will ask you questions about your health, symptoms, your family history and any tests that have already been done. They will also conduct a physical examination.

Having made this assessment, and reviewed the results of any tests that have already been completed, the Consultant will give you information about the diagnosis and talk about the management options available. There will be an opportunity for you & your family/carers to ask any questions you/they may have.

Following the assessment you may be referred to another doctor or hospital for further tests. Some tests can be done on the same day but some tests will need to be done on another day. You will be sent an appointment letter(s) for this.

The MND care coordinator may also be present during your consultation. Other members of the multi-disciplinary team may also be in attendance in the clinic to offer advice and support. The MND care coordinator can refer you to other professionals within your local health and social care team:

• Physiotherapists will advise on exercises and stretches to keep you flexible and to prevent stiffness and pain caused by lack of mobility. They can also provide guidance on your posture and positioning. They will assess whether you need aids to support your walking. They can also show you how to do exercises to help your breathing and assist coughing.
• Occupational Therapists will assess your ability to perform tasks and give advice on techniques & equipment that might help you. They will also look at possible adaptations to your home that could make it easier for you to maintain your independence.
• Speech and Language Therapists will advise on how best to maintain and maximise your communication and swallowing. They can also suggest alternative forms of communication & can explore with you ways of accessing communication aids.
• Dietitians will offer advice on your nutritional status and can review your dietary intake. Diet, nutritional supplementation and alternative feeding requirements are assessed in conjunction with the Speech and Language therapist.
• The Palliative Medicine team offer expert advice on controlling symptoms, emotional advice and advance care planning. Referrals can be made to the Palliative Care Consultant and to your local hospice team. The hospice will be able to provide some support at home too.
• The Respiratory Medicine team will assess and monitor your breathing regularly if needed. If additional breathing support is being considered you will be referred to the joint MND and respiratory clinic at the Bristol Royal Infirmary (Sleep Unit) for advice and management. Respiratory equipment is provided by the team via this clinic.
• Neuropsychologists will provide assessment of your emotional and psychological state and provide strategies that may enable you to cope better with your illness
• The Primary Care Team (GP, Community Nurses and Community Matrons) assist in coordinating your everyday care at home.
• The Social Care Team can assess your practical care needs and negotiate the most appropriate way of meeting them for you. This will include supporting those who may already care for you.

Follow-up appointments

Follow-up appointments are offered on a regular basis, usually every 2 to 6 months. Your follow-up appointments will either be with your Consultant or the Neurology Specialist Registrar.

Referrals

You may be referred to the MND clinic by your Consultant or GP. If you live outside the region that we usually serve you are also very welcome to attend the clinic. You may be referred to the clinic by your local Neurologist or GP for a second opinion, or for your ongoing care.

Clinics

Clinics are held on Tuesday afternoons in Southmead Hospital, Brunel Building, Gate 36. 

It is advisable to bring someone with you to the appointment, even if they remain in the waiting area. It would also be useful to bring a list of your current medication.

We have a dedicated multi-disciplinary team with expertise in the management of MND.

This includes:

• an MND Care  Co-ordinator
• Consultants in Neurology, Respiratory & Palliative Care Medicine
• a Neurology Specialist Registrar
• Physiotherapists
• Occupational Therapists
• Speech & Language Therapists
• Dietitians
• a Counselling Psychologist
• MND Association Visitors.

MND Care Co-ordinator

Keri Vickery is the MND care co-ordinator and your main point of contact. Her role is to provide support and information. She will ensure that you receive the care you need at the right time by liaising with your local health and social care teams and voluntary organisations.

Keri attends the MND clinics but can also be contacted by telephone and e-mail in between clinic appointments. She is available for home visits if needed. If you are admitted to Southmead Hospital, Keri will help coordinate your inpatient admission. She will work closely with all those involved in your treatment to ensure the best possible care for you.

Consultant Neurologists

Dr Andria Merrison (Director of Bristol MND care centre) is a Consultant Neurologist with a specialist interest in neuromuscular disease including MND. You will be seen in clinic by a Consultant at your first clinic appointment. You will be seen by either your named Consultant or the Neurology Specialist Registrar for appointments thereafter.

Counselling Psychologist

Dr John Ashworth is a Counselling Psychologist with a specialist interest in working with people living with MND as well as other neurological conditions. He is available to provide you with emotional and psychological support from diagnosis onwards. If helpful, John can also work with your immediate family and/ or carer(s). He attends the MND clinic and can see you separate to, or following your appointment with one of our Consultant Neurologists.

A Caldicott Guardian is a senior person responsible for protecting the confidentiality of a patient and service-user information and enabling appropriate information-sharing.

North Bristol NHS Trust’s Caldicott Guardian is Mr Tim Whittlestone.

Organisations that access patient records are required to have a Caldicott Guardian; this was mandated for the NHS by the Health Service Circular: HSC 1999/012. The mandate includes acute trusts, ambulance trusts, mental health trusts, clinical commissioning groups (CCGs), special health authorities, commissioning support units and area teams.

The Guardian plays a key role in ensuring that NHS, Councils with Social Services Responsibilities and partner organisations satisfy the highest practical standards for handling patient identifiable information.

Acting as the 'conscience' of an organisation, the Guardian actively supports work to enable information sharing where it is appropriate to share, and advises on options for lawful and ethical processing of information.

For more information visit http://systems.hscic.gov.uk/infogov/caldicott