North Bristol NHS Trust is the main centre for elective (planned) orthopaedic surgery for Bristol and its surrounding areas and we offer a comprehensive service. This includes rehabilitation following complex joint reconstruction, oncology resection, primary and revision joint surgery and Joint stabilising surgery.

North Bristol NHS Trust is the regional centre for renal care and we offer a dedicated renal physiotherapy service.

• We have an excellent dedicated inpatient amputee service with close links to the Disablement Services Centre.
• We are a specialist site for all medical respiratory services in North Bristol.
• We have well-equipped inpatient gyms.
• We offer a specialised cardiology physiotherapy service.
• We offer specialist lecturing to undergraduates on amputee rehabilitation and orthopaedics and trauma.
• We deliver a specialised stroke rehabilitation service that is led by a clinical specialist physiotherapist.

Extended scope practitioners are physiotherapy clinical specialists, with an extended scope of practice. This means that they can undertake duties such as ordering investigations like X-rays or blood tests and can refer to other health care professionals.

At North Bristol NHS Trust we have 11 Extended Scope Practitioners working alongside our rheumatology and orthopaedic consultants, with additional staff employed in neurosciences and accident and emergency.

We also have several staff working as advanced practitioners and clinical specialists in different areas e.g. stroke.

North Bristol NHS Trust Physiotherapy provides a skilled and dynamic service with a commitment to delivering high quality, evidence based care. We maintain our excellent standards by having a commitment to training and development, ensuring that all staff are highly skilled.

We have excellent facilities and deliver our services in variety of different areas including: 

• Medical Rehabilitation including stroke and neurological problems
• Head Injury 
• Surgical Rehabilitation including vascular surgery
• Intensive Care and Respiratory
• Burns and Plastics
• Hands
• Pain Services
• Major Trauma
• Acute and Community paediatrics
• Musculoskeletal outpatients
• Elective orthopaedic surgery e.g. hip replacements Rheumatology
• Women’s health.

AAC WEST is one of 15 Augmentative and Alternative Communication (AAC) specialised services in England. We assess children and adults in the South West of England. 

Who Can Refer? 

• New assessments: Only speech therapists funded by the health, education, or social care can refer. If you don’t have a speech therapist, ask your GP to refer you to your local NHS SLT service. (Private therapists can’t refer directly, but can support the referral by working with the NHS therapist. See Private Therapists page for more info [LINK to new page]). 
• Mounting referrals: Anyone can send these (e.g. family, carers, teachers). 
• Repairs: No referral needed. If your AAC WEST device or mount needs fixing, email aacwesttech@nbt.nhs.uk. Visit the Support Guide Page [LINK] for more help.  

How to refer 

All referrals must be filled in electronically (no handwritten forms). Please include: 

• NHS number 
• GP details 
• Ethnicity (unless declined) 
• A short video 
• Current reports 
• Consent to share information. (See Consent Symbols [DOCUMENT] for supporting this conversation). 

All referral forms should be emailed to aacwestadmin@nbt.nhs.uk  

Funding and criteria 

We check if the person meets NHS Specialised Services criteria when they are referred. We also review this during the assessment.  If they meet the criteria, AAC WEST will fund the AAC. If not, they might still find AAC helpful, but it should be funded by local services. 

These NHS national documents explain the referral criteria and how the local and specialised services work. 

• Guidance for commissioning AAC services and equipment  - Information about the remit and specification of the local and specialised AAC services
• Specialised AAC Services Eligibility Criteria (full document with additional guidance) 2025(PDF) 
• Specialised AAC Services Eligibility Criteria (shorter version) 2025 (PDF)
• Flow chart - Decision Tree 2025 (PDF)

Visit the Communication Matters website (Communication Matters) for more details. 

If you're unsure whether the individual meets the NHS Specialised Services criteria, we're always happy to discuss the referral with you before you complete the form. 

Please feel free to call the AAC WEST Service Lead on 0117 414 5850 to discuss. 

The hospital specialist palliative care team works alongside ward doctors, nurses and other health care professionals in supporting people with life-limiting illnesses (cancer and non-cancer) and their families. We can discuss illnesses and treatments that may be offered in as much or as little detail as our patients wish and we will support and listen to any concerns.

We can offer advice about managing symptoms and provide support for psychological, spiritual, social and practical concerns. Where appropriate we work closely with our colleagues in the local community palliative care team and hospice and with other specialists involved in your care. Our aim is to achieve the best possible quality of life for patients with life-limiting illness and their families.

The team work Monday to Saturday and some bank holidays 8.30 am to 4.30 pm. The team can be contacted by hospital teams outside of these hours for advice and support to ensure the best care for patients.

Consultants

Dr Anitia Brigham - Clinical Lead

Dr Laura Bernstein 

Dr Maggie Presswood

Dr Natasha Lovell

Specialist Doctors

Dr Katie Markkanen

Dr Jennifer Gardiner 

Clinical Nurse Specialists

Shona Mcintosh and Lisa Thomas Trust End of Life and Palliative Care Lead Nurses

Carol Cappell

Amanda Herman

Alice Monument

Lucy Rolt

Kate Allchorne

Elaine Walsh

Emma-Claire Breen

Administrator: Hannah Hopewell

Telephone: 0117 4140519

Email: palliativecare@nbt.nhs.uk

We will respond to all messages as soon as we are able but please note this may not be until the next working day. 

Conditions Treated:

• Colorectal diseases
• Colon and rectal cancer
• Inflammatory bowel disease (colitis and Crohns disease)
• Diverticular disease
• Colostomies and ileostomies
• Anorectal disorders (haemorrhoids, fissure, fistula, rectal prolapse, faecal incontinence)
• Hernias

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.