A 'sputum induction' test is a simple test that involves producing a fresh sample of sputum to be analysed.
Why do I need to have this test?
The doctor has requested that you have this test to analyse your sputum for different cells found in your lungs.
What happens during the test?
Before the test starts the Physiologist will explain the test to you in detail and will answer any questions that you may have. The sputum induction test is a painless procedure.
Preparing for the test
What should I do before the test?
Please inform the clinic coordinator (phone number on your appointment letter) if any of the following apply to you:
You have coughed up any blood in the last 2 months.
You have been told you have a collapsed lung.
You have used your GTN spray in the last few months for chest pain.
You have been told you have a blood clot.
You have had a heart attack in the last 2 months.
You currently or have had recently had a chest infection requiring antibiotic treatment.
You have had any surgery in the last 2 months (including eye surgery).
If you feel unwell on the day of the test.
Please follow these important instructions:
Do not smoke for 4 hours before the test.
Do not drink alcohol for 4 hours before the test.
Do not do any vigorous exercise 30 minutes before the test.
Do not eat a substantial meal 2 hours before the test.
Do not wear lipstick or nail varnish to the appointment.
What should I wear to my test?
You should wear normal comfortable clothing.
Will I experience any discomfort or side effects?
The saline used can cause narrowing in your airways. To prevent this you will be given a medication (salbutamol) to open up the airways at the start of the test.
There are no long term side effects of performing the test. You may however find it tiring because of the repeated coughing, and it can irritate the throat. You will be given time to recover between tests.
After the test
What happens after the test?
If we are able to produce a sample, it will be sent for analysis.
When/how will I receive the results of the test?
You are usually told your results at your next clinic appointment or a letter may be sent to the healthcare professional who referred you for the test.
What happens if I don’t want the test?
It is your decision but if you do not attend, we will not be able to pass important diagnostic information to your clinical team. This may affect the medical treatment you receive.
Is there a different test I could have?
There are no other simple tests that provide the same information.
References
Pavord, I. D. et al. The use of induced sputum to investigate airway inflammation. Thorax 1997; 52:498-501.
Pizzichini, E. et al. Safety of sputum induction. European Respiratory Journal 2002; 20:9-18.
This information is for anyone who has been referred for tests by their GP with a suspicion of cancer.
It explains what you might expect in the days after your referral, and how you can get further support and advice.
Many people we see will not have cancer. It is important that we find out either way as quickly as possible, so you have been referred to us on a Fast Track pathway.
If you require this information in a different format please contact pals@nbt.nhs.uk.
Healthy changes start with little changes. Whether you want to lose weight, drink less alcohol, get active, or quit smoking you have access to lots of free tools and support. Better Health - NHS (www.nhs.uk)
All relevant activities are licensed by the Human Tissue Authority, license 12413.
The Neuropathology Department takes part in the following External Quality Assessment (EQA) schemes:
UKNEQAS for Cellular Pathology Technique: Neuropathology
UKNEQAS for Cellular Pathology Technique: Muscle Histochemistry
UKNEQAS ICC: Neuropathology
UKNEQAS Bolt-on Scheme: Frozen Sections and Mega Blocks
We hope that you never have reason to feel concerned about any of our services. However, if you do have an issue, the best thing to do is speak with a senior member of team (Neuropathology Team | North Bristol NHS Trust (nbt.nhs.uk). If you do this as soon as possible we can hopefully resolve the matter immediately.
The Gynae Oncology team at North Bristol NHS Trust (NBT) are a team who are experienced in providing comprehensive, specialist services of individuals who are either undergoing investigations for suspected gynaecological cancers or those who have been diagnosed with a cancer of the ovary, cervix, womb, vulva, vagina, and some rare gynaecological cancers.
We understand that waiting for test results and appointments can be a worrying time. We are available to support you from the moment of referral, until you are either discharged from our service or your care has been taken over by the gynaecological cancer team at St Michaels Hospital, UHBW and/or the Bristol Haematology and Oncology Centre.
As NBT is not the main cancer treatment centre for Bristol, there will be different people involved in your care and we therefore act as a ‘link’ to improve communication between them, you and the wider cancer team. We are here to answer any queries or concerns and provide support and information for you, your family, and carers.
Meet The Team
Amy Slater – Miss Amy Slater, MBChB, MRCOG.
"I am a Consultant Gynaecologist, and lead for the Gynaecological Cancer Services at NBT.
"You may meet me or one of my other colleagues at North Bristol NHS Trust, but I am often involved in co-ordinating your care behind the scenes. We know that undergoing investigation for suspected cancer and treatment for cancer is stressful and worrying but my team of professional and caring colleagues and I are here to support you through this challenging time and ensure you receive the highest standards of care."
Clinical Nurse Specialist Team (CNS) – Our role is to provide support and information to you if you are undergoing investigations for suspected gynaecological cancers or have been diagnosed with a cancer of the ovary, cervix, womb, vulva, vagina and some rare gynaecological cancers. We will act as your keyworker until you are either discharged from our services or your care has been taken over by the gynaecological CNS team at St Michaels Hospital, UHBW and/or the Bristol Haematology & Oncology Centre.
Leanne Hopkins – Lead Gynae-Oncology Nurse Specialist
When you come to see the team at NBT(North Bristol NHS Trust) or UHBW (University Hospital's Bristol and Weston NHS Trust), you may have a lot of questions. It is not uncommon to find it difficult to remember things at the time of and/or after your appointment so here are some tips to help you. These ‘Questions to Ask’ may be accessible in a language of your convenience. Please contact the Gynae-Oncology CNS team if this is needed.
Before your appointment
Write down your most important questions.
List or bring all your medicines and pills – including vitamins and supplements.
Write down details of your symptoms, including when they started and what makes them better or worse.
Ask your CNS team for an interpreter or communication support if needed.
Ask a friend or family member to come with you, if you like.
During your appointment
Don't be afraid to ask if you don't understand. For example, 'Can you say that again? I still don't understand.'?
If you don't understand any words, ask for them to be written down and explained.
Write things down, or ask a family member or friend to take notes.
After your appointment, don't forget the following
Write down what you discussed and what happens next.
Keep your notes.
Ideas of questions to ask at the time of your appointment
'what's happening if I'm not sent my appointment details,' and 'can I have the results of any tests?'
If you don't get the results when you expect – ask for them.
Ask what the results mean.
Tests, such as blood tests or scans
What are the tests for?
How and when will I get the results?
Who do I contact if I don’t get the results?
What next
What happens next?
Do I need to come back and see you?
Who do I contact if things get worse?
Do you have any written information?
Where can I go for more information?
Is there a support group or any other source of help?
Here are some useful organisations and websites that we feel you may find helpful. If you've come across any other useful resources not listed here that you think could benefit others, please inform us.
You may be offered one or more of the following options after your initial assessment appointment with us. In our experience, most people coming into our service benefit from a group approach, although when appropriate we may offer some individual input. We will do our best to make sure that whatever you are offered is accessible to you. We offer sessions online, at Southmead, Cossham, and Central Health Clinic.
Pain Management Programme (PMP)
PMP aims to develop a broad set of strategies for managing the impact of the pain on your physical, emotional, and social wellbeing. The course will explore your personal values to support you in making changes to improve your quality of life.
It is a group programme delivered by a team including a physiotherapist, occupational therapist, and psychologist.
You will meet once a week for 12 weeks, either in person or online.
Self-Management Programme (SMP)
SMP sessions build on your current knowledge of pain management focusing on activity management, managing difficult thoughts and emotions, relaxation, communication, and flare-up management.
It is a group programme delivered a member of the pain management team, and a trained volunteer who has personal experience of persistent pain.
You will meet once a week for eight weeks, either in person or online, with other people who are challenged by persistent pain.
Backpack
Backpack supports people who are functioning well but struggling with variable levels of pain and flare-up episodes. This may be impacting on family life, work, social and leisure activities. By developing a set of strategies, we aim to improve activity and functioning whilst minimising the impact of worse days and flare-ups.
It is a group programme run by a by a physiotherapist and psychologist.
You will meet once a week for 6 weeks, either in person, or online.
You can be referred by your GP, physiotherapist, local MATS (musculoskeletal assessment and treatment service), spinal surgery services, and the pain service.
Sleep course
This is for people with persistent pain who also struggle with insomnia, to help you explore the science behind, and the various factors that affect sleep. We aim to tailor this information to the individual challenges you have, and to help you build strategies for improving the quality and duration of your sleep.
It is a group programme facilitated by our assistant psychologist and a trained patient volunteer.
It is a five-week course, online or in person.
Carers group
This group offers support to adults (over 18) who support our patients. It aims to discuss challenges, support each other, and look after ourselves.
It is facilitated by staff.
This is a rolling group that takes place online once a month.
Employment workshop
This workshop is for people who are managing pain whilst in work but may also be helpful as a first step for those who are keen to move towards returning to employment.
You will be introduced to the legislation (laws) about employment and long-term health conditions such as persistent pain. You will then discuss ideas about how to use self-management skills in the workplace, and how best to communicate your needs effectively to employers and colleagues.
It is a one-off group meeting online.
Mindfulness programme
Mindfulness is a form of meditation that is recognised worldwide, particularly in relation to health and stress. It involves learning a number of techniques that are practiced throughout the day and have been shown in numerous studies to improve your ability to cope.
The techniques are based on simple meditation techniques. These are linked with being more able to actively manage health conditions which cause pain and fatigue.
Compassion in pain and fatigue group
The programme aims to give you a deeper understanding of biological systems involved in the persistent pain experience, and to directly link this understanding to gaining tools for managing pain, primarily through helping you develop a more compassionate stance towards yourself and your pain.
The course will help you understand what ‘compassion’ is, how to build self-compassion, and why this is important and helpful in the management of persistent pain.
It is a group programme led by a psychologist from the pain service, and a psychologist from the ME/CFS service.
It is held once a fortnight for eight weeks online.
Exercise and compassion group
This programme aims to help identify patterns in relation to activity and exercise and support you to work towards your activity goals in a flexible and sustainable way.
There are strategies to support self-compassion and self-care throughout the programme.
This is an eight-week online programme led by a physiotherapist.
Movement class
This course is based on the Neuro Development Sequence – the movement patterns we go through as babies when learning to walk. We revisit these movement skills as adults to help improve our function and confidence with movement now. The course also includes other fundamentals of movement. These include (where possible) regaining symmetry in movement patters, the role of breathing in movement, mobility and stability exercises, and looking at the neural pathways as a key component of successful movement.
It is run by the physiotherapist from the pain management and ME/CFS service.
It takes place online (on Zoom) for 6 weeks on a Thursday at 13:30-14:15. You may have the option to join some follow-up movement sessions held periodically though the year.
Pelvic Pain Management Programme (PPMP)
This is for people with persistent pelvic pain. It covers some of the same topics as the generic PMP such as understanding pain mechanisms in the body, flare-up management, stress, relationships, and sleep. It also covers specific pelvic pain topics such as bladder and bowel function, pelvic floor exercise, hormones, and psychosexual health.
It is a group course run by the gynaecology and pelvic health physiotherapy services. You will also have one individual appointment with the pelvic health physiotherapist.
The sessions last two and a half hours and are once a week for 12 weeks.
Please note that we are not a crisis service and we may not be able to answer your call but you are more than welcome to leave us a voice message and we will get back to you within 2-3 working days.
If you need urgent medical support or advice you will need to contact your GP, or phone 111 or 999.
If you feel you need emotional support urgently, please contact your GP, or phone 111.
If you wish to speak to to the Pain Clinic, please visit the Pain Clinic page.
The pain management centre is linked to the Pain Clinic at North Bristol NHS Trust and provides a service for people suffering with chronic (or persistent) pain. We offer assessments at Southmead Hospital and Cossham Hospital, as well as online and by phone. This service is delivered together with UHBW NHS Foundation Trust and some of our groups take place there in the Central Health Clinic.
The clinical team includes:
Psychologists.
Physiotherapists.
Occupational Therapists.
Clincal Nurse Specialists.
Assistants.
What does the Pain Management Centre do?
Here at pain management our focus is about managing your pain rather than getting rid of it. Whilst it may feel like the pain is controlling your life, we will help you find ways to gain a sense of control and develop a sense that you do have a choice in what you do.
We will do this by sharing different ways to manage the many consequences that can happen when you live with pain such as effects on mood, sleep, work, movement, relationships with your family, coping with flare ups and other aspects so that you can regain a sense of wellbeing.
Pain Management Information Meeting
For most people, the first step is to come to a pain management information meeting to help you find out more about our service. It is a group meeting at either Southmead Hospital, Cossham Hospital, or Central Health Clinic.
The meeting is led by two members of the team, and a volunteer who has been through the service in the past. It will last about an hour, and we try to keep it as informal as possible. There are usually 12-20 people there.
There are plenty of opportunities to ask questions, but you are welcome to just listen. You are welcome to bring one member of your family or a close friend to the meeting as long as they are over 18.
By the end of the meeting, you will know more about what we do.
What happens after the information meeting?
If after the meeting you decide to be seen by our service you can choose to have an individual appointment with a member of the team. This assessment appointment will take a much broader look at your current coping strategies including the impact of the pain on your mood.
We can also discuss aspects of the service we offer including group and individual work and a plan will be made with you.
If you decide that our service is not for you, you will have the opportunity to talk to a member of staff about other options.
In the past you may have been asked to undergo a physical examination or to demonstrate how the pain is affected by affecting your movement and posture. You will not be asked to do this at your assessment session here.
What do people who have seen us before say?
“Living with pain that doesn’t go away can be hard and make you feel miserable. The support written about in this leaflet can really help you find ways of coping and make your life easier. It’s up to you, but after doing the course you’ll have lots of tools to help give you a better quality of life. Can you afford not to go for it? Come and find out more about how you can make simple changes that will help make life easier!” (Sandra)
“When I was offered a place on the Self Management Programme I was unsure whether I would find it helpful. I went along and found the course leaders very welcoming and friendly. I knew the sessions would not stop my chronic pain, but I hoped I would gain some advice or strategies to help me cope. I was surprised by how interesting and helpful I found the programme. It has given me lots of ways to help cope, including lifestyle changes, helpful thinking and relaxation techniques. I enjoyed learning with a group of people which helped me realise others have the same problems as I have.” (Diane)
These are quotes from two of our patients who both attended one of the pain management groups. Not all of our patients attend these courses, and other approaches are available.
What should I do if I can’t attend my appointment?
Please contact the service administrator for the Pain Management Service on 0117 414 7357 who will be happy to help you.
Please note that we are not a crisis service and we may not be able to answer your call but you are more than welcome to leave us a voice message and we will get back to you within 2-3 working days.
If you need urgent medical support or advice you will need to contact your GP, or phone 111 or 999.
If you feel you need emotional support urgently, please contact your GP, or phone 111.
If you wish to speak to to the Pain Clinic, please visit the Pain Clinic page.
Information for patients who've been advised to take phosphate binders.
Why do I need to take phosphate binders?
Phosphate binders are tablets to help keep the phosphate level in your blood within the normal range. You may not have any symptoms of a high phosphate but taking your phosphate binders may prevent problems with your bones, blood vessels and heart. The normal range for blood phosphate is between 0.8mmol/l and 1.5mmol/l.
How do phosphate binders work?
They work by binding to the phosphate in your food, allowing it to pass out in your stool. You may also be advised to reduce your intake of phosphate containing foods. Your renal dietitian can provide you with information if this is needed.
How do I take my phosphate binders?
To work properly phosphate binders will either need to be chewed or swallowed whole either before, during or immediately after any meals, snacks or drinks containing phosphate. Your renal dietitian can guide you based on the phosphate binders you have been prescribed by the doctor. See the information below. Take your prescribed dose daily and spread your tablets throughout the day when you eat. Your renal dietitian can guide you on how to take these tablets with your usual meal pattern and food choices. See the information on page 4. You do not need to take your phosphate binders if you miss a meal. If you forget to take your binders with a meal try to remember to take the next dose at your following meal.
Practical tips
Keep a container of binders in each of the places you eat.
Keep a container of binders in your bag/pocket/in the car ready for when you eat out.
Set an alert on your mobile phone to remind you to take your binders when you eat.
Phosphate binders and other medication
Phosphate binders and some tablets should not be taken at the same time. Some tablets will need to be taken 1 to 3 hours before or after taking your phosphate binders. Check the patient information leaflet provided with your phosphate binders for information. You can also ask your pharmacist or doctor or dietitian.
Things you should write down:
The name and daily dose of your phosphate binder.
When to take your phosphate binders: meals/snacks, the binder, and the recommended dose.
The timing of your phosphate binders with meals/snacks: before, during, or after.
How to take your phosphate binders: chew well or swallow whole.
Managing your fluid intake is an important part of your treatment
Drinking less can:
Help you breathe more easily.
Prevent your ankles swelling.
Help you keep your blood pressure stable.
Help prevent faintness or cramp on dialysis.
It is also very difficult to control your fluid intake if you eat a lot of salt. Try not to add salt to cooking or at the table. Speak to your dietitian for more information on how to eat less salt. Your doctor nurse or dietitian can advise you how much fluid to have.
Write down the amount of fluid you have been advised to have.
Useful measurements
Standard cup = 150ml.
Standard mug = 250ml.
Standard tumbler = 250ml.
Standard wine glass = 125ml.
Other helpful amounts
600ml = 1 pint.
1000ml = 1 3/4 pints.
Remember liquid foods could as part of your food allowance
Some typical servings
Item
Quantity
ml
Custard/jelly/yoghurt
1 typical pot
100
Ice cream
1 typical scoop
50
Milk pudding
1 serving
200
Ice cube
1 standard
30
Soup
1 serving (1/2 can)
200
Milk on cereal
1 serving
125
If you are feeling thirsty, try one of these first
Slice of lemon or orange.
Frozen grapes or pineapple cubes.
Boiled sweets or sugar free mints.
Chewing gum.
Try this to help space your drinks through the day
Pour water into a jug in the morning that is the same as the amount of fluid you can have daily.
Every time you have a drink such as squash, tea, coffee, milk, pour away the same amount of water from the jug.
This will help you keep track of the amount you are drinking and how much fluid you have left in your allowance for that day.
Helpful tips
Use a small cup or glass for drinks. This should be about 150mls (5½fl.oz).
Keep a record of your fluid intake to help you see how much you are consuming.
Spread your fluids through the day and have smaller drinks.
Remember spicy foods can make you feel thirsty. Try to reduce these foods.
Use plastic ice cubes in drinks to save on fluid.
Brushing your teeth or rinsing your mouth with water or mouthwash can help to freshen your mouth.
If you have a dry mouth, artificial saliva sprays such as Glandosane (available on prescription) can help.
Try swallowing tablets with food instead of fluid.
If you drink less on one day, save some of your fluid allowance for the next day.
You can drink sociably, but choose smaller drinks and try to drink less before or afterwards.
Modern slavery is the removal of personal freedoms in order to exploit human beings for financial or personal gains. It can take many forms including forced labour, human trafficking and sexual exploitation. It is a complex issue with a global reach. There were an estimated 50 million people in modern slavery in 20211 and these numbers are increasing. We recognise that modern slavery will exist in our supply chain, and we are committed to do all we can to identify and manage the risks that our business and purchasing activities pose.
Our Statement
This Modern Slavery and Human Trafficking statement is for the financial year ending 31 March 2023. It outlines the shared commitment and actions that have been carried out by Bristol and Weston NHS Purchasing Consortium (B&WPC), North Bristol NHS Trust (NBT) and University Hospitals Bristol and Weston NHS Foundation Trust (UHBW) over this time period. In the statement, terms such as ‘our’ and ‘we’ refer to all three organisations. This is the first modern slavery statement that we have produced. It covers the following areas of our business activities;
The recruitment of both temporary and permanent employees.
The working conditions and practices for our employees.
The procurement of goods and services.
Organisation Structure and Supply Chains
Bristol and Weston Purchasing Consortium B&WPC provide a comprehensive range of purchasing services to support local Trust and Healthcare Providers.
B&WPC staff are NHS employees, hosted by North Bristol NHS Trust and the services provided include all aspects of clinical and non-clinical purchasing and supply chain management. B&WPC’s main clients include both NBT and UHBW and cover an annual spend of approximately £750m. B&WPC work closely with both Trusts to support compliance with all purchase-to-pay procedures and deliver improved efficiencies.
North Bristol NHS Trust
NBT has over 12,000 staff delivering healthcare across main sites at Southmead Hospital Bristol, Cossham Hospital and Bristol Centre for Enablement and within the local community of Bristol, North Somerset and South Gloucestershire. NBT is a regional centre for neurosciences, plastics, burns, orthopaedics and renal services. NBT’s aim is to deliver an outstanding patient experience and its values of caring, ambitious, respectful and supportive underpin everything that we do.
University Hospitals Bristol and Weston NHS Foundation Trust
UHBW has a workforce of over 13,000 staff, delivering over 100 different clinical services across 10 different sites serving a core population of more than 500,000 people locally and from across the southwest.
With services from the neonatal intensive care unit to care of the elderly, UHBW provides care to the people of Bristol, Weston and the southwest from the very beginning of life to its later stages.
Our Supply Chain
Our supply chain is large, multi-tiered, global and complex. We procure a wide range of clinical and non-clinical goods, services and works. This includes medical equipment, personal protective equipment and uniforms, dressings, mattresses and bed linen, laptops, software, furniture and mechanical and electrical services to name but a few.
Many of our purchases are from sectors that are known to be high risk for modern slavery. Our approach to identifying and managing modern slavery risks must be embedded into any new procurement activity and within our existing contracts to be effective.
We let contracts over a range of timescales from medium to long term relationships to oneoff purchases. As part of our procurement policy, we actively seek to utilise frameworks provided by public sector organisations such as NHS Supply Chain and Crown Commercial Services. We have over 2,500 tier 1 suppliers and over 1,000 active contracts in place.
Policies in relation to slavery and human trafficking A number of national regulations and mandates have been set over the past 12 months that allow for modern slavery to be prioritised as a topic for consideration in the purchases that we make.
The Health and Care Act 2022 allow for regulations to be set to eradicate modern slavery and human trafficking in NHS supply chains. NHS England has also adopted the mandatory inclusion of Net Zero and Social Value criteria in the evaluation of all tenders. This is also mandated for all NHS Trust procurements. Modern slavery can be a topic addressed under social value where it is proportionate and relevant to the contract.
We have created two policies that build on this national level focus to address to this issue. The B&WPC procurement strategy 2022-25 is published online and is publicly available having been signed off and approved by the Trust Boards of both NBT and UHBW.
B&WPC Procurement Strategy 2022-25. This document sets out our values and outlines the areas of focus for B&WPC to ensure that we are maximising the value obtained from our external spend. There are 4 objectives within the strategy. The Anchor in the Community objective includes a clear commitment to remove modern slavery for our supply chain and to use our market leverage to drive an ethical supply chain. The aim is to ensure that our supply chains and procurement processes are ethical, free from worker abuse and exploitation and provide safe working conditions. An away day was held with all B&WPC staff to engage with and explore the strategy and what its aims mean in the short, medium and long term to the team.
Joint Ethical Procurement Strategy. This document will reflect our joint vision and aims to support the delivery of exceptional healthcare services in a sustainable manner. Included within the definition of ‘sustainable’ is ethical conduct and social value. We will document a specific commitment to ensure that our supply chain and procurement processes are ethical, free from worker abuse and exploitation and provide safe working conditions. This policy will be approved and be available publicly during 23/24.
Our existing recruitment policies set out the processes that cover the recruitment of both our temporary and permanent employees. The overall approach is governed by compliance with legislative and regulatory requirements and the maintenance and development of good practice in the fields of employment.
Our recruitment processes are robust and adhere to safe recruitment principles. We have a range of policies and procedures to protect staff from poor treatment and/or exploitation which comply with all respective laws and regulations. This includes policies on recruitment, pay and equality, diversity and inclusion.
In addition to this, we have clear systems and polices in place to encourage the reporting of concerns, speaking up and the protection of whistleblowers Our policies such as Safeguarding Adults and Children, Dignity at Work, Grievance procedure and Freedom to Speak Up policy provide additional platforms for our employees to raise concerns about poor and inappropriate working practices. We have a number of dedicated Freedom to Speak Up Guardians and Executive and Non-Executive Director leads for Freedom to Speak Up. Whilst these are not exclusively for the purpose of raising concerns for modern slavery and human trafficking, their remit covers any issues linked to this.
Risk Assessment and Management
A category level environmental, social and governance risk assessment has been carried out for our spend profile. This assessment included the identification of modern slavery risks across the lifecycle of goods and services purchased on criteria including the risk of forced labour, child labour, working conditions and discrimination. The following purchasing categories were identified as high risk:
Construction.
Information Technology (IT).
Food and Catering.
Medical Equipment.
Textiles (clothing, bed linen etc).
Waste Management.
Temporary Staff and Recruitment Services.
Due Diligence Process
Our robust recruitment processes are in line with relevant employment legislation and adhere to safe recruitment principles. We follow strict pre-employment checks on all directly employed staff, Bank Workers and others undertaking work within our organisation. These include identification, right to work, qualification, registration and reference checks. Our pre- employment checks are in line with the NHS employment check standards and our Resourcing functions oversee fair and equitable recruitment and selection practices.
We align to nationally negotiated NHS pay rates and terms and conditions of employment. We consult and negotiate with recognised Trade Unions on proposed changes to working arrangements, policies and contractual terms and conditions.
Only approved frameworks are used for the recruitment of temporary agency staff. All providers are audited to provide assurance that pre-employment clearance has been obtained in line with the NHS Employment Check Standards.
We also provide access to learning and development opportunities and provide a comprehensive staff benefits and health and wellbeing offer.
As part of our standard checks within our procurement process, bidders are checked (where relevant) for their compliance with the Modern Slavery Act (2015).
We have been engaging with our category leads and main suppliers within our IT category to raise awareness and understand the maturity levels of work across the sector in this area. We aim to replicate this approach for other high-risk categories.
We will use this to inform the due diligence processes we need to implement. We recognise that our current due diligence processes are not adjusted to reflect the risk associated with the purchase involved. We will develop our process over the coming year to ensure that our due diligence processes are proportionate to the risk posed by the purchase in question.
KPIs to measure effectiveness of steps being taken
We have a robust governance mechanism for monitoring the delivery of the commitments set out in our policies. The Sustainable Procurement Workstream as part of the ICS Green Plan Implementation Group is made up of representatives from all three organisations. It is responsible for driving the delivery of the commitments and reporting on their progress to the Green Plan Steering Group that sits above this and feeds into Executive and Board level activities at each organisation.
Training on Modern Slavery and Human Trafficking
We provide advice, training and support about modern slavery and human trafficking to all staff through our safeguarding children and adults mandatory training, our safeguarding policies and procedures and our safeguarding teams.
We also ensure that all staff receive a comprehensive induction programme which includes information on, and guidance regarding modern slavery and human trafficking.
Specifically within our procurement function, B&WPC has been developing a capability framework for all procurement job roles. This framework will be completed in the next financial year and will include modern slavery and social value.
A list of available training resources, including those on modern slavery, has been complied and is available for B&WPC staff to access.
UHBW and NBT plan to develop education resources and make them available to their staff and, over the coming year, map the key stakeholders who are involved in the procurement and contract management process to focus engagement efforts and further drive our shared commitment to eradicate modern slavery and human trafficking from our supply chains.
Information for patients who have been advised to have a CT scan.
Introduction
You have been advised by your doctor to have a Computerised Tomography investigation which is more commonly referred to as a CT scan. This leaflet will explain what CT is, the benefits and risks, as well as what the examination involves. If you have any further questions please speak to your doctor, nurse or radiographer looking after you.
CT scans take place in the Imaging department which can also be known as the Radiology or X-ray department. This is the facility within a hospital that carries out radiological examinations such as X-rays, CT scans, Magnetic Resonance Imaging (MRI) scans, Ultrasound scans along with other types of radiological investigations.
Radiologists are doctors specially trained to interpret the images and carry out more complex examinations. They are supported by highly trained operators, known as radiographers, that carry out X-rays and other imaging procedures.
What is a CT scan?
A Computerised Tomography (CT) scanner is a machine that uses ionising radiation (X-rays) and a computer to produce very detailed cross-sectional images of any part of the body. The information is then built up into a series of pictures for the radiologist to view.
What are the risks and benefits of having a CT scan?
A CT scan involves the use of ionising radiation (X-rays); we are all exposed to natural background radiation every day from radioactivity in the air, food that we eat and even from space. Exposure to ionising radiation from a CT scan carries a small risk, however, the main benefit of having the scan is to get an accurate diagnosis so that you can get the right treatment for you. A specialist will have agreed that the benefit of the scan outweighs the risk of the ionising radiation, and we can assure you that all safeguarding to minimise ionising radiation exposure is taken.
If you are between the age of 12 and 55 years of age and there is any chance that you could be pregnant then please contact the Imaging department before you attend for your appointment. The contact details will be on your appointment letter.
Patients should ideally be scanned within the first 10 days of their menstrual cycle. If you are between the age of 12 and 55 and your appointment does not lie within this timeframe, or you are or may be pregnant please contact the Imaging department before you attend. The contact details can be found on your appointment letter.
Some patients will require an injection of contrast medium, also described as X-ray dye, for their scan which increases the amount of information seen on the scan. There is a small chance of an allergic reaction to the injection of contrast medium, however, the Imaging team are trained to deal with any complication, and the risk is very small.
The Imaging team will make sure you are feeling alright and have recovered before letting you leave the department.
Is there anything I need to do before my CT scan?
Please read your appointment letter as this will give you specific details of how to prepare before your CT scan.
If your appointment letter asks you to drink water before your scan please do so, slowly, over one hour prior to your appointment time. This will keep you hydrated and will also highlight the bowel if we are imaging your abdomen and pelvis. You do not require a full bladder for your CT scan.
If you are taking any medication prescribed from your doctor, please continue to take these as normal, unless told otherwise by your doctor.
If you are asthmatic please bring your inhaler with you to your appointment.
It is recommended that you attend your appointment in clothing that doesn’t contain any metal fastenings, zips or decoration as they show up on the CT scan. If this is not possible, we may require you to change into a hospital gown which will be provided.
Please be punctual to your appointment time. We are a busy department and if you are late for your appointment, we may not be able to fit you in. If you are running late on the day of your appointment, then please let us know by contacting our booking office on 0117 414 8989. If we know you may be delayed, then we may be able to rearrange things to fit you in.
What happens during my CT scan?
From the reception waiting area you will be escorted through to the CT waiting area. From this point onwards you will be cared for by a small team of radiographers, image support workers and possibly a radiologist. The radiographer will be the professional carrying out your CT scan.
In the CT waiting area a member of the CT team will begin to get you ready for your scan. If necessary, you will be asked to change into a hospital gown or to remove any metallic items from the area being scanned.
The radiographer will take you through to the CT scan room and, if necessary, assist you onto the CT scan couch. The radiographer will then raise the couch up and move it into the CT scanner until the part of the body we need to scan is in the centre of the hole in the middle of the CT scanner.
Once you are in the correct position the radiographer will leave the room to perform your scan in an adjacent room. The radiographers can always see and hear you throughout your CT scan and can communicate with you through an intercom if required.
You will be required to keep still throughout your CT scan to avoid blurry images being produced. You might also be asked to follow breathing instructions given by the CT scanner which the radiographer will explain to you before they leave the scan room.
If an injection of contrast medium or X-ray dye is required, a cannula will be placed into a vein in your arm. The radiographer will connect this to a machine called an injector pump that will administer the dye during the scan. When the contrast is injected, it is common for some patients to feel a sensation of warmth around their body, a metallic taste in the mouth or throat and the sensation of peeing. These feelings are normal and are just sensations, they usually pass within the first 30 seconds. Please be assured that the feeling of peeing is just a feeling and not actually happening. Not all patients will experience these feelings.
How long will my CT scan take?
If you have been given an injection of contrast media as part of your CT scan, then you will be required to stay in the department for an extra 15 minutes after your scan has finished. This is so that we can ensure that you have not had an allergic reaction.
If you have not received an injection of contrast media, then in most cases, you will be able to leave the department immediately after your CT scan has been completed. You can eat and drink as normal after your scan.
If you experience any problems after your CT scan, then please contact your GP or 111.
How will I get the results of my CT scan?
After your appointment, your CT scan images will be reviewed by a radiologist. The radiologist will write a report which is then sent to the doctor who requested a scan for you. The doctor who requested your scan will inform you of the results.
