The Weight Management and Bariatric Service at North Bristol NHS trust consist of a supportive team of clinicians including dietitians.

There is a range of services available from the team including non-surgical weight management support and weight loss surgery.

Referral Criteria for Bariatric Service:

• BMI >40 kg/m2 or person with BMI 35-40 kg/m2 who has other significant disease that could be improved if they lost weight (e.g. type 2 diabetes, hypertension, dyslipidemia, obstructive sleep apnoea, Benign Intracranial Hypertension etc.).

For more information, please see the Bristol Weight Management and Bariatric Service (BWMBS).

Information on referring for clinicians. 

Useful links:

Dietary Support

NHS – Live Well https://www.nhs.uk/live-well/healthy-weight/start-losing-weight/

Change for Life https://www.nhs.uk/change4life

Diabetes UK www.diabetes.org.uk/Guide-to-diabetes/Managing-your-diabetes/Healthy-eating

British Heart Foundation Keep your heart healthy - BHF

The British Dietetic Association – Food Facts:

https://www.bda.uk.com/resource/weight-loss.html

https://www.bda.uk.com/resource/food-facts-food-and-mood.html

https://www.bda.uk.com/resource/detox-diets.html

https://www.bda.uk.com/resource/healthy-eating.html

Talking Therapies

Bristol, North Somerset and South Gloucestershire -  NHS Talking Therapies - North Somerset & South Gloucestershire (vitahealthgroup.co.uk)

Wiltshire Psychological Support  https://iapt-wilts.awp.nhs.uk/ 

Specialist Eating Disorder Service Eating disorders community team :: Avon and Wiltshire Mental Health Partnership NHS Trust (awp.nhs.uk)

Food Allergy & Intolerance

Allergic reactions can be triggered by food. They can be very severe reactions or cause delayed symptoms.

Diagnosis can be made with a combination of blood and skin tests, diet challenges and diet restrictions. Your GP may be able to diagnose your food allergy or you may be referred to an immunologist. The Dietitian can be involved in the diagnosis of food intolerances.

Food allergies and intolerances are managed by dietary manipulation through the exclusion of the food which is causing the reaction. The dietitian helps in diagnosing, educating and supporting the patient:

• In following food restrictions
• Identifying and treating possible nutritional deficiencies
• Providing a link between the patient and their GP
• Providing information on external specialist agencies

Find out more about the North Bristol Trust Allergy, Immunology & Immunogenetics. 

If you feel you would benefit from seeing a dietitian, please ask your GP or Immunology consultant to refer to us.

Information on referring for clinicians. 

Please note this service is for adults only. See the Paediatric Nutrition & Dietetic for information on children & allergies.

Useful links:

Allergy UK

Food Allergy and Food Intolerance

Food Allergy and Food Intolerance Testing

HIV (Human Immunodeficiency Virus)

HIV is a virus that affects the immune system.

It can be diagnosed through a blood test by your GP, local specialist services, sexual health clinics or local support charities.

If you have been diagnosed with HIV you will be referred to specialist services.

Within this service a Dietitian helps educate and support by:

•  Providing nutritional support with eating and drinking
• Providing long term lifestyle change support
• Identifying and treating possible nutritional deficiencies

Contact the Terrence Higgins Trust for more information about HIV.

 Useful links

Information on HIV & AIDS: https://www.aidsmap.com/

Information on heart health: https://www.heartuk.org.uk/; https://www.bhf.org.uk/; https://www.bda.uk.com/resource/heart-health.html

Weight loss information: https://www.bda.uk.com/resource/weight-loss.html

Type 2 Diabetes information: https://www.bda.uk.com/resource/diabetes-type-2.html

Cholesterol information: https://www.bda.uk.com/resource/cholesterol.html

North Bristol Trust predominantly provides dietetic services to adults only but we do have a Neonatal Intensive Care Unit (NICU) within our Women’s and Children’s directorate.  We currently provide specialist neonatal dietetic services to the inpatients on our NICU. The Neonatal dietitian only takes referrals from the specialist Neonatal team. Parents of preterm infants and Health Care Professionals working with ex-premature infants are welcome to seek nutritional advice for their infant.

If you think your child (from birth to 18 years old) would benefit from seeing a Paediatric dietitian you should first speak to your GP or hospital consultant. They will refer you to the Bristol Children’s Hospital Paediatric Dietitians department who will then contact you to arrange an appointment. They provide outpatient services at Bristol Children’s hospital.

Where can I find other information?

• For babies born prematurely http://www.bliss.org.uk/
• For enquiries about breast milk donation http://www.ukamb.org/
• South West Neonatal Network Milk Bank milk.bank@nbt.nhs.uk
• South West Neonatal Network www.swneonatalnetwork.co.uk/parent-family-area

The dietitians at North Bristol NHS Trust provide a neurology clinic at Southmead Hospital twice per month on Thursday mornings. 

Patients who attend this clinic are likely to have been diagnosed with one of the following neurological conditions:

• Parkinson’s Disease
• Huntington’s Disease
• Motor Neurone Disease
• Multiple Sclerosis
• Progressive Supranuclear Palsy (PSP)
• Duchenne’s Muscular Dystrophy

The dietitian’s role is to assess, educate and support. 
When you attend your appointment the specialist neurology dietitian will:

• Ask you about your medical condition, medications, investigations and symptoms
• Assess your weight and monitor weight changes
• Assess your current diet and fluid intake, ensuring that any nutritional deficiencies are identified
• Advise on methods of promoting/reducing weight or reducing symptoms
• Recommend nutritional supplementation as appropriate
• Provide information on alternative methods of feeding such as via a gastrostomy (PEG/RIG) tube
• Provide a link between you, your GP, allied health professional and consultant

Other conditions where you may be seen by a neurology dietitian include:

• Chronic Fatigue Syndrome
• Myalgic Encephalomyelitis

If you have one of these conditions and you feel you would benefit from seeing a dietitian, please ask your GP or Neurology consultant to refer to us.

Information on referring for clinicians. 

Useful links:

Chronic Fatigue Syndrome and Diet

Eating and Drinking with MS

Eating and Drinking with MND

Diet and Parkinsons Disease

At North Bristol Trust, the diabetic service consists of a multi-disciplinary team including two dietitians.

NBT diabetes dietitians see patients which require input from the entire diabetes team. If dietetic input is required, but input from the whole diabetic team is not necessary, consider community services.

If you are a clinician looking to refer a patient, please see indications for referral to North Bristol Trust’s Multi-disciplinary Diabetes Clinics.

For more info see the Diabetes & Endocrinology page.

Useful links:

Diabetes UK

Type 2 Diabetes and Diet

Type 1 Diabetes and Diet

Gestational Diabetes

13 Consultant Neurosurgeons cover all aspects of Neurosurgical practice.

The team also consists of 11 Specialist Registrars, 6-8 Senior House Officer Grade doctors, 9 Neurosurgical Nurse Practitioners and 2 Neuro-oncology Specialist Nurse Practitioners.

Dedicated trained nursing staff and invaluable Allied Health Professionals working alongside the team ensure that the care received by all Neurosurgical patients is of the highest standard.

At North Bristol Trust, we supervise Plymouth University dietetic students for A, B and C placements, as well as overseeing placements for MSc Dietetics students from Birmingham City University.

We aim to offer our students a varied experience when they are on placement with us. Areas which students typically gain experience in include:

• ICU
• Stroke and Neurosurgery (inpatient)
• Outpatient Bariatric Services
• Renal disease (inpatient and outpatient)
• Gastroenterology (inpatient and outpatient)
• Complex care (inpatient)
• Surgery (inpatient)
• Respiratory (inpatient)
• Burns & plastics (inpatient)
• Diabetes (outpatient)
• Metabolic disease (outpatient & learning)

We offer students a combination of home learning, face-to-face patient contact and virtual clinic experience. The home learning often comprises of case studies and tutorials to support learning in each speciality.

The dietetic team here comprises of approximately 30 dietitians. Each student will be assigned a key worker and mentor but will likely spend some time with most of the dietitians over the course of the placements.

Dietitians are uniquely qualified to translate scientific information about nutrition and food into practical dietary advice. As well as providing impartial advice about nutrition and health, dietitians also advise about food related problems and treat disease and ill health.

Many dietitians work in the National Health Service (NHS) and may work in one or more specialist areas e.g. diabetes, children's health, cancer, renal, public health. Others work with people in the community, sometimes visiting them in their own homes. They are a key part of the healthcare team and have an important role training other Allied Health Professional’s (AHP’s) and the public about nutritional issues.

Dietitians have the only legally recognised graduate qualification in nutrition and dietetics that is registered with the Health Professions Council (HPC). This is a national regulatory body, which was created following the Health Professions Order, 2001. Dietitians are one of 13 healthcare professions regulated by the HPC, which ensures rigorously maintained standards of training, professional skills, behaviour and client safety. The title Dietitian/Dietician can only be used if the individual is appropriately qualified and registered with the HPC. Verification can be achieved by checking the Dietitians Register on the HPC website www.hpc-uk.org.

How does a dietitian differ from a nutritionist?

The title ‘nutritionist’ is not protected. Some may have attended degree level courses in nutrition, and upon qualification, many register as nutritionists (RNutr) or as public health nutritionists (RPHNutr) with The Nutrition Society. However, there are many who will not have a recognised qualification. Nutritionists work in government, industry, sports, education, media and for charities, supporting the collection and communication of information about food and health. Some nutritionists provide general guidance about eating to support good health, however, as they are not regulated by a governing body, information given does not have to comply with scientifically based evidence.

Want to become a dietitian?

There are two types of programme available to qualify as a dietitian:

• Full-time undergraduate BSc (Hons) programme - these are either three or four years in length.

• Full-time postgraduate programme - these are two years in length and can either lead to a Postgraduate Diploma (PgDip) in dietetics or a Masters (MSc) qualification in dietetics.

Find out more on The Association of UK Dietitians website.

Shadowing a dietitian

At North Bristol NHS Trust, we don’t routinely offer opportunities to shadow dietitians. Instead, we run virtual allied health professional events. This will give you the opportunity to find out more about what working as a dietitian in a hospital is like.

To find out more about when our next event is, follow us on Twitter @nbt_dietitians or email dieteticenquiries@nbt.nhs.uk

Dietitians at North Bristol NHS Trust (NBT) provide both an inpatient and outpatient service.

Inpatient services

Our inpatient team is made up of dietitians who work within North Bristol NHS Trust providing a dietetic service to all wards.

The service is available between 8:30am - 4:30pm Monday to Friday.

• If you are an inpatient and your care team thinks you would benefit from seeing a dietitian, they will refer you directly.
• If you are an NBT health care professional and want to refer an inpatient to the nutrition and dietetic service, please do so via ICE.

Malnutrition is common in hospital patients and it’s important that it’s identified and treated early to reduce recovery time and complications. Each patient should be screened for malnutrition risk on admission to hospital and weekly throughout their stay. At NBT, we use the BAPEN Malnutrition Universal Screening Tool (MUST).

We use a range of assessment techniques to devise and review nutritional plans for patients. The aims of treatment are to improve nutritional status or symptoms to aid recovery.

Outpatient Services

Outpatient clinics are run at Southmead Hospital Bristol and Cossham Hospital where adult patients can be treated for conditions under a range of different specialties including:

• Gastroenterology
• Neurology
• Diabetes
• Bristol Bariatric Service
• Inherited Metabolic Conditions
• Renal
• Diet and Cancer

For more information click on the relevant specialty above to find out more.

If you are a clinician and want to refer a patient to a specialist outpatient clinic please view Nutrition & Dietetics – For Clinicians.

Community Services

• Patients who continue to need support to increase nutritional intake following discharge from hospital will be referred to the Community Nutrition and Dietetic team if appropriate. Read more information about their services.
• Patients who are being fed through a feeding tube (enteral feeding) will be referred to the Home Management Service (HMS). HMS will make arrangements to deliver feed products at home and to monitor progress. This service covers all of Bristol, South Gloucestershire and North Somerset.
• If a patient requires specialist dietetic input, the ward dietitian will arrange follow up through the GP or book directly into clinic.
• If you have never seen a dietitian and think that you need to, you can ask your GP, practice nurse or hospital consultant to refer you depending on the nature of your condition.
• If you have seen a dietitian at North Bristol Trust in the past, you can telephone the dietetics department directly and ask if you would need a referral.

Patient Handover for Clinicians

Inpatient handovers

If you are a dietitian and your patient has been transferred to NBT, please ring the department on 0117 4145428 to hand over.

Please note that University Hospitals Bristol also provide inpatient care to patients in the Bristol area.

Community handovers

If a patient has been discharged to the Bristol community, please contact the community team to handover.

If the patient has been discharged to the Bristol community and is receiving enteral nutrition, please contact the Home Management Service to handover.

The North Bristol NHS Trust Adult Neurosurgery Department, Brunel building, Southmead Hospital (previously located at Frenchay Hospital) is a tertiary referral centre providing Adult Neurosurgical care for Gloucestershire, Somerset and Wiltshire and the city of Bristol.

The Neurosurgical team includes 13 consultants, who are world-leading experts in their specialities, carrying out more than 3,500 individual procedures each year, of which 50% are operations for emergency admissions.

The service at Southmead Hospital is supported by three state-of-the-art Neurosurgical theatres including one theatre dedicated to emergency procedures.

The Neurosurgery wards, Gate 7, Level 3, Brunel building, Southmead Hospital provides patients with a high level of nursing care in a modern and spacious environment. 

The service provides all aspects of Neurosurgical practice, including:

• Cranial & Spinal Trauma
• Neuro-Oncology
• Complex Skull Base Surgery
• Complex Cerebro-Vascular Surgery
• Epilepsy Surgery
• Pituitary Surgery
• Spinal Surgery Including Spinal Tumors
• Neuro-modulation For Pain
• Neuro-modulation For Movement Disorders Including Parkinson’s Disease
• Surgery For Trigeminal Neuralgia
• Paediatric Neurosurgery
• Surgery For Hydrocephalus
• Neuro-Endoscopy