Immunology, Clinical

Regular Off On Services & Referral

We run regular Adult Immunology/Immunodeficiency (and Allergy) clinics on Tuesday mornings, Thursday afternoons, and all-day Friday reviewing patients referred (see Patient Referral Pathways) to our service with suspected or confirmed immune deficiency. Criteria and advice for whom to refer can be found on the Remedy website.

Our service provides replacement antibody therapy (immunoglobulin) to patients with confirmed antibody deficiency. This can be given in the hospital (as a day case) or at home.

For patients with recurrent infections please try to confirm the nature of the infection before referral. For example, by sending relevant microbiological cultures, viral swab tests, taking the patient’s temperature, inflammatory markers, radiology etc.

 

Last updated: 25/11/2022

Clinical Immunology/Immunodeficiency

Allergy - For GPs

Regular Off On Services & Referral

We run regular Adult Allergy (and Immunology/Immunodeficiency) clinics on Tuesday mornings, Thursday afternoons, and all day Friday seeing patients referred (see Patient Referral Pathways) to our service with suspected or confirmed allergic disease. Criteria and advice for whom to refer can be found on the Remedy website.

Patient referrals are accepted via the NHS e-Referral Service (e-RS) and an Advice and Guidance service also operates via the same channel. Please ensure Adult Allergy is selected for both of these services (not Immunology).

We see patients in our Adult Allergy service with the following conditions:

  • Anaphylaxis
  • Allergic rhinoconjunctivitis
  • Bee or wasp venom allergy
  • Drug and anaesthetic allergy. Referral for anaesthetic allergy investigation will only be accepted from the relevant anaesthetic department – see below
  • Food allergy
  • Urticaria and/or angioedema
  • C1 esterase inhibitor deficiency (Hereditary Angioedema)

Please include as much detail about the clinical reaction/issue, relevant hospital discharge summaries, past medical history, past treatments (if relevant) and current medications. Referrals will not be accepted with inadequate information. For suspected General Anaesthetic Allergy Referrals please email allergy@nbt.nhs.uk  and a referral pro-forma will be supplied to you. 

We also offer a dedicated ‘Adult Allergy COVID-19 Vaccine Advice and Guidance’ service that can be accessed via eRS by General Practitioners. Patients who have had a suspected allergic reaction following their COVID-19 vaccination can be referred by their GP for advice. Please see Remedy for more information and please check the most up to date information about COVID19 vaccine reactions in the Green Book (chapter 14a) as well as the BSACI FAQ sheet before proceeding. For up to date information on COVID-19 vaccine allergy you can also visit the Anaphylaxis UK website. For suspected non-allergic reactions to this vaccine other specialties or the Southwest Immunization Regional Clinical Advice and Response Service may be better suited to offer advice.

Please note we do not see patients for:

  1. Patch testing (e.g. for eczema, contact hypersensitivity) – please refer to Dermatology instead.
  2. Lactose or food “intolerance” as we do not have expertise in these conditions.
  3. Myalgic encephalomyelitis (ME), chronic fatigue, or fibromyalgia as we do not have expertise in these conditions.
  4. Mast cell activation disorders as we do not have expertise in the management of these conditions.

Our service also performs:

  • Sublingual and subcutaneous desensitisation (COVID19 permitting)
  • Omalizumab injections for chronic spontaneous urticaria
  • Drug and food allergy challenges
  • Drug desensitisation

 

Last updated: 25/11/2022

Clinical Allergy

South West Maternal Medicine

Regular Off On Services & Referral

The South West Maternal Medicine Network co-ordinates and standardises care for pregnant women with pre-existing medical conditions or conditions that arise during pregnancy. The overriding aim of the Network is to ensure equitable access, excellent experience and optimal outcomes for women from all communities across the South West.

Governance

The network is overseen by the South West Maternal Medicine Network Steering Group, which consists of both clinical and operational representatives from each trust within the network footprint. The steering group is chaired by the Regional Chief Obstetrician Dr Judith Standing, and reports to its commissioner, NHS England, via the South West Regional Perinatal Quality and Safety Surveillance Group.

Education

For more information about managing acute medical problems in pregnancy, the Royal College of Physicians has a toolkit.

Referrals

There are different referral pathways depending on the condition, as outlined in these documents.

Cardiology referral pathway for South West Maternal Medicine Network.docx

South West Maternal Medicine: Your Pregnancy Journey

Regular Off Off A-Z of Services

Because you have a medical condition it is likely that you will have specialist team that monitor and manage your health, they may have even been involved in managing your condition in order to help stabilise your health prior to conception.

Some health conditions make pregnancy slightly more complex to manage and in turn pregnancy can make some health conditions more difficult to manage. When this is the case it is usual to have your pregnancy monitored by a consultant who specialises in medical conditions in pregnancy at your local tertiary hospital.

The South West Maternal Medicine Network allows the pool of knowledge about your condition to be larger. We have a team of specialist Doctors and midwives, who, as a group can look at your condition and pregnancy alongside each other and along with you and your family safely plan your pregnancy and birth.

Many conditions will continue to be managed at your local hospital and we can use virtual meetings to review your pregnancy.

Some conditions are more complex and you may need to attend a specialist hospital during your pregnancy and for the birth of your baby. You can see an example of the care plans used in the ‘care plan’ section of this website.

Stroke Patient Reported Experience Measures Survey 2022/23

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Help us to improve stroke care

Our Trust will soon be taking part in a national survey to find out what patients think about their stroke care.

All NHS stroke patients who received treatment and/or therapy between 16/05/22 and 16/09/22 will receive a copy of the survey. This is part of a national programme to improve stroke patients’ experiences.

The Stroke Patient Reported Experience Measures Survey (PREMS) will be the first of its kind, and will capture positive patient experiences, as well as letting us know where we need to make things better.

PREMS is a partnership project with the Stroke Association and NHS England.

Taking part is voluntary

The survey will be carried out by an independent company, under a signed agreement with NHS England in partnership with the Stroke Association.

Section 251 support has been recommended by the Secretary of State for Health and Social Care following advice from the Confidentiality Advisory Group (CAG), who are an independent advisory group which includes lay representation. This allows Trusts to share your details without your consent.

Regulation 5 of the 2002 Control of Patient Information Regulations provides a lawful basis for confidential patient information to be processed for medical purposes. If you have opted out via the National Data Opt Out, your information will not be disclosed by your Trust.

Why do we want your feedback?

We want to improve people’s experiences of stroke care by giving clear information, showing everyone respect and compassion and keeping patients safe and comfortable.

What happens to the information you give us?

Your NHS Trust will provide your name and address to Quality Health to send you the survey. Your answers will not be linked in any way to your personal contact details. We will keep your information secure and will not publish any information that can identify you.

We will use your answers to tell the people who treat patients what they’re good at and what they can improve.

Taking part

You will be sent a pack in early 2023 which will include:

  • The paper copy of the survey
  • A link to complete this online if you prefer
  • A Freephone number if you need help to complete this or require a translator.
  • Further information about the purpose of the survey and data confidentiality.

 

If you do not wish to take part, or have any questions about the survey, please contact us: alice.brown@nbt.nhs.uk 0117 414 4398.

 

For more information about the survey and how your information will be used, please visit www.stroke.org.uk/prems2022

Antimicrobial Reference Laboratory Resources

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Antimicrobial Reference Laboratory Contact Details

Antimicrobial Reference Laboratory
Level 2, Phase 1, Pathology Sciences Building
Southmead Hospital
Westbury-on-Trym
Bristol
BS10 5NB

For General Enquiries and Results:

Telephone: 0117 4146269 or 0117 4146220
For Clinical Advice: 07802 720900
Email: arlenquiries@nbt.nhs.uk

Laboratory Hours

Monday to Friday 09:00 - 17:15

Saturday 09:00 - 12:00

Test Information

Sample vials for testing

Includes details of sample types, volumes, special precautions, turnaround times & reference ranges.

Clinical Antimicrobial Assays

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BCARE hosts the Antimicrobial Reference Laboratory which provides a comprehensive antimicrobial assay service for the purposes of therapeutic monitoring and supporting consultative advice on technical aspects and clinical interpretation of antimicrobial assays. The laboratory receives referred samples from all over the UK and Ireland.

Please see the assay booklet below for full details.

Assays of serum drug concentrations are indicated in the following situations:

  • Drugs with a known or suspected relationship between concentrations in blood and toxicity
  • Drugs with a known or suspected relationship between concentrations in blood and efficacy
  • Where there is pharmacokinetic variation such that concentrations in blood cannot be predicted
  • To confirm oral absorption
  • To test compliance


The Antimicrobial Reference Laboratory routinely provides a wide range of antimicrobial assays. Some of these are routinely performed in large numbers and no advance warning is required if the sample is to arrive during a normal working day; others are performed less frequently and advance warning is essential if a same-day service is required.

In addition advice can be obtained on development of LS/MS assays, problems with immunoassays and patient-related issues.

Minimum inhibitory concentrations (MICs), minimum bactericidal concentrations (MBCs) and serum bactericidal titres (SBTs) can be performed on patients’ isolates and sera.

 

 

Analyte Information

Bcare (ARL) Contact Details

Antimicrobial Reference Laboratory
Level 2, Phase 1, Pathology Sciences Building
Southmead Hospital
Westbury-on-Trym
Bristol
BS10 5NB

Telephone: 0117 4146269 or 0117 4146220

Email: arlenquiries@nbt.nhs.uk

Clinical Antimicrobial Assays

General ultrasound - information for patients

Regular Off On Imaging Patient Information Ultrasound (general)

Welcome to the Imaging Department

The Imaging Department may also be called the X-ray or Radiology Department. It is the area of the hospital where examinations of patients are done like CT scans, MRI scans, and ultrasounds.

Radiologists are doctors specially trained to read the images and carry out more complex examinations. They work with radiographers and sonographers who are highly trained to do X-rays and other imaging procedures.

What is an ultrasound scan?

An ultrasound scan builds up a picture using sound waves that cannot be heard by the human ear. Ultrasound images are used for many different body parts. 

Are there any risks?

There are no known risks.

Do I need to prepare in advance?

Often you will need to prepare for a scan. For example, if your pelvis, kidneys, or bladder are being scanned, you may need to have a full bladder. For areas like the liver, you may need to not eat for several hours. If so, this will be explained in your appointment letter.

If you feel you may have difficulties preparing please contact our bookings team. The contact number is on your appointment letter.

Can I bring somebody with me?

Yes, you can bring a friend or relative with you. It may not always be possible for them to come with you into the scanning room. Please ask if you would like them to and we will try to accommodate your request.

What will happen when I arrive?

Please go to the reception desk. You will be shown where to wait until a member of staff comes to collect you. If you are coming to Southmead Hospital, please follow the check-in process outlined in your appointment letter.

There are toilets in the department. Please do not use the toilet until after the examination if you have been asked to fill your bladder.

Who will I see?

You will be seen by a radiologist or a sonographer depending on the type of scan you are having.

North Bristol NHS Trust is a teaching hospital; there may be a trainee present for some examinations. They will be introduced at the beginning of the examination. If you would prefer them not to be there, please tell the radiologist or sonographer.

Will I need to undress?

We will tell you if you need to remove any clothes before your examination. Private areas are available if you need to take off your outer clothes or put on a hospital gown.

What happens during the scan?

You will lie down on a couch, and we will dim the lights so that the images on the screen can be seen more clearly. We will put gel on your skin over the area to be scanned.

You may be asked to take deep breaths and to hold your breath for a few moments. For a scan of the bladder, it is sometimes not full enough for the examination and you may be asked to drink more fluid and wait while the bladder fills up.

The radiologist/sonographer will move the ultrasound probe over your skin while viewing the images on a screen. Some images will be saved so that they can be viewed later.

After the examination is finished, the gel will be wiped off and you will can get dressed.

Will it be uncomfortable?

Ultrasound itself does not cause discomfort and apart from the probe on your skin you should not feel anything.

Occasionally it may be necessary to push over an sore area to check what is causing the pain. This may cause discomfort for a short time.

If your bladder is uncomfortably full, please tell the radiologist/ sonographer so that this part of the examination can be done first. You can the leave the room to empty your bladder before returning to finish the examination.

Intimate examinations

If you are having an intimate examination the radiologist or sonographer will explain the procedure to you and ask for your permission to do the scan.

Please note: we have male and female staff performing these examinations. If you would prefer a male or female to do your examination, please contact our bookings team. The number is on your appointment letter, we will be more than happy to accommodate your request.

Female patients - for examinations of the womb or ovaries

Female patients: for examinations of the womb or ovaries. A “transvaginal” ultrasound means “through the vagina”.

You will be asked to empty your bladder before this scan is done. During the procedure, you will be asked to lie on your back with your knees bent.

A small ultrasound probe with a clean cover, not much wider than a finger, is then gently passed into the vagina and pictures of your organs are sent to a monitor.

Internal examinations may cause some discomfort, but don’t usually cause much pain and shouldn’t take very long.

If you have not been sexually active before, the internal scan can still be done, if you understand what it involves and agree to it. If you do not want an internal scan, that is completely fine. Please just make sure your bladder is full for the first part of the scan on top of your tummy If it is not, you may be rebooked.

In most intimate scans, a chaperone will be present and if there is not, you may request this if you wish. Please let the person doing your scan know when you arrive for your scan.

How long will it take?

The process of doing a scan usually takes around 10-20 minutes. Unless emergency patients delay your appointment, your total time should be less than an hour.

Are there any side effects?

No. You can drive afterwards, and return to work.

Can I eat and drink afterwards?

If no other tests are needed, you can eat and drink normally after your scan.

When will I get the results?

After the scan, we will review the pictures from the scan and prepare a report for the doctor on what we have seen. This may take time to reach the doctor who sent you, but is normally less than 14 days. You could ask the radiologist/sonographer how long it might take to get the results.

References

Ultrasound scan - NHS 

© North Bristol NHS Trust. This edition published July 2025. Review due July 2028. NBT002024.

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Vascular Testing Team

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Meet the Vascular Testing Team

Vascular Testing Team

 

We are part of the Bristol, Bath, and Weston Vascular Network, working alongside vascular consultants, interventional radiologists, podiatrists and vascular specialist nurses.

We provide a diagnostic scanning service for all inpatients at Southmead Hospital requiring specialist diagnostic vascular ultrasound as well as an outpatient service to the wider North Bristol Trust and local healthcare community.

As well as the vascular network, we work in collaboration with many departments including:

  • Stroke services
  • Cardiology
  • Renal
  • Emergency Department 

Our team comprises of six fully accredited vascular scientists (Society for Vascular Technology), two vascular scientists (National Scientific Training Programme) working towards full accreditation and one trainee vascular scientist on the Scientific Training Programme.

The wider team consists of two renal specialist nurses with a Postgraduate Diploma in Medical Ultrasound, two vascular technicians with an NVQ Level 3 diploma in abdominal aortic aneurysm screening and an administration team.