Some patients require intravenous or subcutaneous treatment for osteoporosis with Zoledronate or Denosumab. Zoledronate is given once a year and Denosumab every six months.

We have a day case facility for administering this drug at Southmead Hospital Bristol.

If you are to be given this treatment, you will need a couple of blood tests to check you are suitable, which will be arranged by the doctor who sees you in clinic.

Dr Emma Clark runs an osteoporosis clinic every fortnight, for patients with more complicated or severe forms of osteoporosis who require investigations or treatment beyond the scope of the GP.

For patients who are being seen in this clinic and have not yet had a DXA scan, we run a one-stop service in which patients have the DXA scan on the same day as being seen in the clinic. Patients with other bone disorders, such as Paget’s disease, are also seen in this clinic.

Osteoporosis & Metabolic Bone Disease

This service assesses patients with severe/complex osteoporosis and offers advice on alternative treatment for patients intolerant to oral bisphosphonates. 

We accept referrals for patients with other metabolic bone problems such as Paget's disease, primary hyperparathyroidism and osteomalacia.

North Bristol NHS Trust’s neuropsychiatry service is based at The Rosa Burden Centre, Southmead Hospital.

The neuropsychiatry team is a mix of professionals from different disciplines including:

• Doctors in psychiatry and neurology.
• Nurse therapists trained in physical and mental health.
• Physiotherapy.
• Occupational therapy.

We work with patients who have a mixture of different problems including:

• Mental illness associated with neurological diseases.
• Epilepsy and non-epileptic attacks.
• Functional neurological symptoms.
• Neurological sleep disorders.

We aim to provide high quality specialist assessment and treatment plans that incorporate expertise in both physical and mental health.

Being a part of the neuroscience department, we work closely with our colleagues in neurology and neurosurgery. We also provide neuropsychiatry support for the mental health liaison team for inpatients in other wards at Southmead Hospital.

Our outpatient clinics take referrals from across the south west from general practitioners, neurologists, neurosurgeons and psychiatrists.

Our inpatient service is situated within the Rosa Burden Centre. We have two inpatient beds for patients with neuropsychiatric conditions, and two inpatient beds for assessment of sleep disorders.

Osteoporosis is the term used to describe bones when they become ‘porous’, when the struts which make up the mesh-like structure within bone start to disappear. This leads to a reduction in bone strength and an increased risk of fracture after injuries such as a low impact fall.

These broken bones or ‘fragility fractures’ can occur in different parts of the body, although the wrist, hip and spine are most commonly affected. Osteoporotic bones don’t cause any other symptoms such as pain.

Osteoporosis is thought to affect 1 in 3 women and 1 in 7 men during their lifetime. It is critical that the bone mineral density (BMD) of those at risk is measured in order to find out if you have osteoporosis or at risk of developing it.

The North Bristol NHS Trust Osteoporosis Service at Southmead Hospital Bristol provides a bone densitometry DXA scanning service for patients who have had a fragility fracture or are at risk of osteoporosis for other reasons.

We perform DXA scans using a Hologic Horizon bone densitometer, which uses a very low dose of X-ray in order to quickly and accurately work out your bone density. A DXA report, including recommendations for treatment, will then be sent to doctor.

According to the result, this may also include an assessment of your risk of breaking a bone over the next ten years, using the FRAX tool, which can be helpful in deciding about whether you need treatment. For more information about the FRAX tool, visit  www.fraxplus.org.

Your GP can refer you for a DXA:

• If you are a postmenopausal woman over 50 with a low trauma fracture (defined as a limb fracture after a fall from standing height or less while stationary or walking, or a vertebral fracture of the spine)
• Or, if you are a woman or man over 50 with a FRAX score in the intermediate or high risk zone

To make a referral, your GP needs to complete a NBT DXA request form on the ‘ICE’ system.

In other circumstances, your GP may want to contact us first to establish eligibility. If you are ineligible for a scan under the NHS, we also offer this service self-funded at a cost of £200. Please note, we still require a referral for private scans.

Alternatively, it may be that you are referred for a DXA scan by a hospital consultant looking after you for a condition such as breast cancer or celiac disease.

Dr Shalini Janagan is the DXA service lead. Prof Emma Clark leads on the vertebral fracture assessment.

Neurophysiology Head of Specialty
Peter Walsh
Peter.walsh@nbt.nhs.uk

Neurophysiology Medical Consultants
Dr Nick Kane
Dr Agepong Oware
Dr Sabine Klepsch

Neurophysiology Medical Registrar
Dr Luke Canham

Healthcare Scientists
Peter Walsh (Service Manager)
Hayley Marriott
Nadine Harris
Portia Chorlton
Kelly Macey
Adam Pearson
Hollie Morris
Lealah Nouri
Georgina Hazelwood
Steve Chaffey (Trainee)
Claire Johnson (Adult Epilepsy Surgery Program)
Abigail Parks Galton (Adult Epilepsy Surgery Program)
Abby Warren (Adult Epilepsy Surgery Program)
Eibhin Goulding (Adult Epilepsy Surgery Program)

Neurophysiology, located at Gate 36, Level 1, Brunel building, Southmead Hospital, provides diagnostic and ‘functional monitoring’ services covering a wide range of conditions affecting both the central and peripheral nervous system.

Tests include:

• EEG
• NCS/EMG
• Ambulatory EEG monitoring Video
• Video/EEG monitoring for Epilepsy Surgery
• Evoked responses (Brainstem Auditory, Visual, Somatosensory and Motor pathways)

We support the Adult Epilepsy Surgery Programs, the Sleep Service, and the Neurosurgical and Spinal Surgeons with Intra-Operative Monitoring.

The Surgical Neuro-oncology at North Bristol NHS Trust provides continuity of care for patients with Primary and Secondary brain tumours and their families from first diagnosis, ensuring a smooth transition of care from initial surgery, through radiotherapy and/or chemotherapy and into the community.

All patients are discussed at a weekly multidisciplinary meeting before additional treatment is planned, which is delivered locally closer to the patient’s home.

Please visit www.nbt.nhs.uk/bnog for more information about services offered and referring a patient with a suspected or proven Brain or spine tumour to the Neuro-Oncology multidisciplinary team meeting.

It is important you take time to understand the costs and benefits for surgery to make a fully informed choice. The links below will take you to decision aids that can help guide you through this process and help you decide on the appropriate course of treatment.

Knee replacement
http://www.healthwise.net/cochranedecisionaid/Content/StdDocument.aspx?DOCHWID=uh1514&SECHWID=zx3678

ACL surgery
http://www.healthwise.net/cochranedecisionaid/Content/StdDocument.aspx?DOCHWID=aa54360

Meniscus tear
http://www.healthwise.net/cochranedecisionaid/Content/StdDocument.aspx?DOCHWID=te7366

Dr Hilary Archer                                                              
Secretary: Helen Oaten                                                        
Telephone: 0117 414 7296                                                       

Dr Luke Bennetto                                                              
Secretary: Katie Brunton                                                  
Telephone: 0117 414 6696

Dr Michaela Boca
Secretary: Tracy Chiddy
Telephone: 0117 414 4437

Dr Rose Bosnell
Secretary: Janette Duggan
Telephone: 0117 414 6698

Dr Sandeep Buddha
Secretary: Janette Duggan
Telephone: 0117 414 6698

Dr Philip Clatworthy                                                                           
Secretary:  Janette Duggan                                 
Telephone: 0117 414 6698

Dr Mark Cossburn
Secretary: Rebecca Hale
Telephone: 0117 414 6683

Dr David Cottrell                                                                
Secretary: Rebecca Legg
Telephone: 0117 414 6683

Dr Elizabeth Coulthard                                                      
Secretary: Helen Selman
Telephone: 0117 414 6691

Dr Hugo De Oliveira 
Secretary: Canis Ho
Telephone: 0117 414 0525

Dr Howard Faulkner                                                                             
Secretary: Eileen Faulkner           
Telephone: 0117 414 6687

Dr Barnaby Fiddes
Secretary: Rebecca Legg
Telephone: 0117 414 6693

Dr Ben Grimshaw
Secretary: Janette Duggan
Telephone: 0117 414 6698

Dr Kiran Gurung
Secretary: Janette Duggan
Telephone: 0117 414 6698

Dr Sabine Klepsch
Secretary: Tracey Gore    
Telephone: 0117 414 6692

Dr Stela Lefter
Secretary: Stephanie Burke
Telephone: 0117 414 7718

Dr Gauhar Malik
Secretary: Janette Duggan
Telephone: 0117 414 6698

Dr Elizabeth Mallam
Secretary: Helen Selman
Telephone: 0117 414 6691

Dr Mark Manford
Secretary: Janette Duggan
Telephone: 0117 414 6698

Dr Andria Merrison    
Secretary: Claire Edwards
Telephone: 0117 414 6688

Dr Chinedu Nkole
Secretary: Janette Duggan
Telephone: 0117 414 6698

Dr Steven Novak
Secretary: Tracey Gore
Telephone: 0117 414 6692

Dr Justin Pearson
Secretary: Janette Duggan
Telephone: 0117 414 6698

Dr Madhu Ramamoorthi
Secretary: Paula Davies  
Telephone: 0117 414 6685

Dr Claire Rice
Secretary: Samantha Yildirim
Telephone: 0117 414 6695

Dr Natalie Robinson
Secretary: Janette Duggan
Telephone: 0117 414 6698

Dr Kanch Sharma
Secretary: Janette Duggan
Telephone: 0117 414 6698

Dr Kasia Sieradzan     
Secretary: Katherine White       
Telephone: 0117 414 6686

Dr Matthew Smith
Secretary: Tracey Gore
Telephone: 0117 414 6692 

Dr James Stevens
Secretary: Denise Gould  
Telephone: 0117 414 6710

Dr Konrad Szewczyk-Krolikowski
Secretary: Laura Martin 
Telephone: 0117 414 6690

Dr Alan Whone
Secretary: Laura Martin    
Telephone: 0117 414 6690

Dr Alastair Wilkins
Secretary: Samantha Yildirim
Telephone: 0117 414 6695

Dr Clare Wood-Allum
Secretary: Holly Yockney
Telephone: 0117 414 1751

Specialist Nurse Contact Details

Epilepsy Specialist Nurses: Helen Hodgson & Anna Davis
Epilepsy Surgery Nurses: Samantha Travis & Geri Watson
Secretary: Kerry Holloway
Telephone: 0117 414 6456 / 07710 916 916

MS Specialist Nurse Helpline: 0117 414 8288