What you can do to practically care for someone who is in their last days and hours of life

The Helix Centre website offers some practical advice to those caring for someone in their last days to hours of life. Please visit there website for more information. 

Financial Support 

Managing finances can be a major problem for patients and families, due to loss of income because of the inability to work. Additional expenditure can arise from the cost of travel, disrupted routine, cost of equipment, aids or additional household appliances, special dietary requirements, child care and increased household bills.

The Palliative Care Team can support patients and their families to understand what is available and how to apply for non-means tested benefits such as Attendance Allowance or Personal Independence Payment (PIP). 

The Citizens Advice Bureau can be contacted for advice. Contact number: 08444 994718 www.citizensadvice.org.uk 

For guidance and claim forms for benefits visit the DWP website www.gov.uk/browse/benefits/disability
Freephone: 0800 882 200

Macmillan Cancer Support 

The Macmillan Cancer Support Helpline provides practical, medical, emotional and financial support. Contact 0808 808 0000.
Macmillan also produces a booklet called ‘Help With the Cost of Cancer: a guide to benefits and financial help for people affected by cancer. Macmillan Benefit Advisers are based at Southmead Hospital on certain days. They can advise patients who have a cancer diagnosis about eligibility for any benefits or grants.

Some people may be eligible for a Macmillan grant which is a one-off payment for adults, young people or children with cancer, to cover a wide range of practical needs. This can include things such as heating bills, extra clothing, or for a much-needed break. Find out more information by visiting the Macmillan website. at www.macmillan.org.uk

Age UK provides information and fact sheets for older people on topics such as benefits, community care and housing. Information line freephone: 0800 009966 or 0800 1696565 or visit the Age UK website. 

Carers UK offers advice and support for carers throughout the UK, including help with benefits and finances. Carersline freephone: 0808 808 7777 or visit the Carers UK website.

Carers Information 

A carer is someone who regularly provides a lot of help for, or looks after a partner, relative or friend to support them in returning to and remaining at home. We recognise that caring for someone with palliative or end of life needs can be difficult. The local authority has a duty to assess the needs of carers. Find out more about carers information.

In the first few days after a death it is often the responsibility of the closest relative or friend to make necessary practical arrangements. The staff at North Bristol NHS Trust will aim to help in every way possible. For the most up today information please see the attached leaflet below.

These are the referral criteria for the Bristol M.E. Service, previously known as  the "Bristol CFS/ME Service". We are a regional multidisciplinary service covering  Bristol, North Somerset, and all of Gloucestershire. The team consists of Psychologists, Occupational Therapists and Physiotherapists. We are specialists in supporting patients with post-infective fatigue syndromes and ME/CFS, which was previously known as CFS/ME until the publication of the NICE Guideline NG206 in October 2021.

Referrals from Primary Care will only be accepted via the NHS e-referral system. 

Referrals from Primary Care in Bristol should use the BNSSG referral management system 
https://remedy.bnssgccg.nhs.uk/adults/pain-management-and-mecfs/mecfs/

Severn Pathology have introduced a streamlined screening request system that is available on ICE as a profile called CFS/ME. Using this profile will ensure all the blood tests required by the NICE guideline are done.

General Practitioners referring to the Service can download the referral criteria and referral checklist below.

When sending referrals from outside the BNSSG, please print out copies of the blood tests and results for our files. 

We are able to reply to queries from General Practitioners via email BristolME@nbt.nhs.uk

The British Association of Clinicians in ME/CFS (BACME) is a multidisciplinary organisation which exists to promote and support the delivery of evidenced based treatment for children, young people and adults with ME/CFS throughout the UK. Bristol M.E. Team members are active within BACME and have contributed to the BACME guides. The BACME ME/CFS Guide to Symptom Management is written for healthcare practitioners, and includes guidance about the use of medication and is available here: https://bacme.info/wp-content/uploads/2022/08/BACME-Guide-to-Symptom-Management-Sept2022.pdf 

As a specialty we routinely achieve the national government targets of referral to treatment in 18 weeks.

We also work to a 13 week referral to treatment target.

For Clincians referring to the Network

We deliver specialist vascular surgery; this includes the inpatient management of arterial and venous disease, including abdominal aortic aneurysm, carotid artery disease and peripheral vascular disease in the Major Arterial Centre (MAC) in the Brunel building, Southmead Hospital, Bristol.

The MAC brings together all inpatient elective and emergency arterial surgery for the Bristol Bath Weston Vascular Network. 

The MAC provides 24 hours a day 7 days a week access to a specialist vascular multi-disciplinary team including vascular surgeons, interventional radiologists and specialist nurses. The MAC also includes the provision of a ‘hybrid’ operating theatre and provides complex aortic endovascular treatments for the whole of the South West.

Outpatient clinics

Outpatient clinic locations are available in the local hospitals, attended by the vascular consultants who patients currently see.

The clinic locations include:

• Southmead Hospital
• Bristol Royal Infirmary
• Royal United Hospital Bath
• Weston General Hospital
• Cossham Community Hospital
• Melksham Community Hospital

There is a ‘hot clinic’ Monday to Friday mornings at the MAC (Southmead Hospital) for patients requiring urgent review but not necessarily admission.

Referring to the vascular service

Referrals should be made via NHS eReferrals where possible, or alternatively by email to nbn-tr.bbwvascularnetwork@nhs.net or fax 0117 414 9378.

Urgent referrals

Urgent patients can be referred via the vascular network office telephone 0117 414 0798 or by discussion with either the General Surgery/Vascular Surgery Registrar on call or the Vascular Consultant on call – both can be contacted via our  switchboard on 0117 9505050.

Booking team for Outpatients

Please refer via NHS eReferrals.

Booking team for Inpatients

Elizabeth Hedges, telephone: 0117 4140847

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Soft tissue sarcomas referral

All suspected soft tissue sarcomas should be referred to the BSS for investigation and management. This can be done via the two-week cancer wait system directly to the plastic surgical team at Southmead Hospital Bristol. Otherwise, cases can be referred directly to the MDM for discussion.

Download: [attachments]

Soft-tissue sarcoma should be suspected if:

• Any soft tissue mass >5cm diameter
• Any deep, hard or fixed mass
• Any enlarging or painful soft tissue mass

Bone sarcomas referral

Suspected primary bone tumours should be referred directly to the Oxford Bone Tumour Service

If you are in doubt about how to proceed the cases can be discussed at the BSS MDM first if requested.

Did you know that the long-term effects of head injury affect one family in 300?
The physical difficulties can be obvious, but many problems - emotional, communication and cognitive - are often hidden.
The Head Injury Therapy Unit is a specialist rehabilitation outpatient service for people who have sustained a brain injury.
The team comprises of:
•  Physiotherapy
• Occupational Therapy
• Speech & Language Therapy
• Clinical Neuropsychology
• Rehabilitation Support Workers
A structured goal-orientated approach is used which is tailored to your needs and we work closely with families and carers to support carry over of rehabilitation at home and in the community.

North Bristol NHS Trust provides a comprehensive rheumatology service for common inflammatory disorders such as rheumatoid arthritis as well as specialised services like complex osteoporosis, connective tissue diseases and transition services for young people.

We have a specialised multidisciplinary team and care pathways based on evidence for best practice and built around patients needs.

General rheumatology referrals

Appointments can be done through NHS eReferrals or by faxing a referral to us.

All referrals are triaged by the consultants. We endeavour to see cases suspected to be early inflammatory arthritis within 3 weeks. If you feel that a sooner appointment is needed contact us directly.

For urgent referrals please contact the rheumatology registrar or the on call rheumatology consultant via switchboard 0117 9505050.

Our multidisciplinary team consists of 7 consultant rheumatologists, SpRs, a junior doctor, specialist nurses, physiotherapists, occupational therapists, orthotics and a clinical psychologist.

We provide services for a wide range of rheumatological conditions in adults including:

• Inflammatory arthritis
• Connective tissue disease and vasculitis
• Widespread pain if an inflammatory condition needs to be excluded
• Complex osteoporosis or metabolic bone disease

Conditions we treat:

• Rheumatoid arthritis
• Psoriatic arthritis
• Ankylosing spondylitis
• Reactive arthritis
• Adults with Junvenile Idiopathic Arthritis and transition services
• Other inflammatory arthritis
• Connective tissue diseases including SLE, scleroderma, Sjogrens, mixed connective tissue diseases.
• Myositis
• Behcet's syndrome
• Vasculitis
• Giant cell arteritis
• Polymyalgia rheumatica
• Osteoporosis and metabolic bone disease
• Crystal arthritis (e.g. gout and pseudogout)