COVID-19 CCP-Cancer Study

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Currently, there is extremely limited information regarding the risks posed by SARS-CoV-2 virus responsible for COVID-19 to patients with cancer.

This study aims to understand the presentation, management and outcomes of cancer patients with COVID19. The influence of cancer type and treatment will be explored as well as comparing cancer patients with non-cancer patients.

This study will provide valuable information that would educate as well as help inform practice for future possible outbreaks. The information may also inform the development of guidelines with regard to the care and management of cancer patients with viruses such as COVID19 and similar infectious diseases.

Cancer is immunosuppressive, the nature of the immunosuppression seems to be influenced by the microbiota, in addition pulmonary infections are also influenced by the host microbiota, therefore it is important to understand this impact in cancer patients. Analysis of samples from cancer patients with COVID19 offer the opportunity to learn more of these interactions.

The purpose of CCP-CANCER UK study is to obtain additional data from patients with cancer who were/are recruited into the Principal CCP-UK study which is the key national protocol for characterising COVID19 in the UK population. This study is designed to supplement, not replace, the Principal CCP-UK protocol.

This study will be open to research sites who are currently participating in the Principal CCP-UK study.

The CCP-Cancer UK study will run for two years. An additional specific cancer data set will be collected from participant's existing medical records. This cancer specific information when combined with the rich data set related to the COVID-19 episode (derived from CCP-UK) will enable a full understanding of COVID-19 in patients with cancer as well as enable a comparison with non-cancer patients.

Take Part in Research

Patient & Doctor viewing an x-ray

Become one of the thousands of people taking part in research every day within the NHS.

Contact Research

Research & Development
North Bristol NHS Trust
Level 3, Learning & Research building
Southmead Hospital
Westbury-on-Trym
Bristol, BS10 5NB

Telephone: 0117 4149330
Email: research@nbt.nhs.uk

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Urology Research Team

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The Urology Research Team at NBT is a multidisciplinary team of healthcare professionals, academics and members of the public working across both functional urology and oncology.

Our research is supported by the Department of Health and the Bristol Urological Institute. We conduct research across a variety of settings, including laboratory based work and clinical work.

We work on a range of commercial and non-commercial, qualitative and quantitative research and collaborate with colleagues locally, nationally and internationally in order to improve outcomes for patients suffering from various urological conditions, including but not limited to:

  • Cancers such as prostate, bladder, kidney, penile and testicular
  • Male and female incontinence
  • Kidney disease including stone problems
  • Uretic disease
  • Benign prostate disease

We have close links with the University of Bristol and University of the West of England (UWE). We also work with patient groups such as Prospect.

Meet the team:

Becky Cousins - Lead Research Nurse

Lead Research Nurse

Becky currently works as the Lead Research Nurse for Urology at Southmead Hospital, managing a team of 6 highly competent research practitioners. Prior to her training, she completed her degree in Biomedical Sciences and Masters of Research at Cardiff University. Having qualified as an adult nurse from City University in 2013, she began working on a complex older adult ward at Whipps Cross Hospital, London. Whilst working in a clinical role she became focused on making an impact on quality of life through her job and keen to identify ways she could use her skills in research. After seeing an advert for the Huntington’s Disease (HD) research team at Cardiff University, she headed back to Wales in 2014 taking on a full-time role as a research nurse. She led on drug trials, longitudinal and academic studies, for which she gained a deep interest and passion. She joined North Bristol NHS Trust in 2019 as a research nurse with the ReMemBr group, focussing her passion for dementia research. Recently, she took a new path and joined the Urology Research team as the team lead, focusing on expanding the research portfolio and delivering a first in human catheter study. Becky has a keen interest in quality of life research, focussing on how we value people living in residential care. She is driven to see her team succeed; pursue their own research ideas and become highly qualified health-care professionals.

Marta Cobos-Arrivabene - Research Nurse

Research Nurse

Marta joined the Urology Research team in May 2021 and works primarily in functional urology. She qualified as a Registered Nurse in 2018 at the University of the West of England. Previously she worked as a recovery nurse in Medirooms at NBT where she covered different surgical specialities including urology. Her interest in research started during her student days when she had a placement with the research team. Since then, her passion about finding out about the latest treatment options for her patients and further understanding patient diagnoses and disease prevention has grown.

Victoria Garner - Research Nurse

Research Nurse

Victoria is the newest member of the Urology research team, having joined in June 2021. She has a degree in Medical Physiology from the University of Leicester, and in Adult Nursing from the University of Birmingham, and qualified as a nurse in 2014. Victoria has worked mostly in London, initially in Intensive Care at Kings College Hospital, before moving to Neonatal Intensive Care at St Georges Hospital. While this is the first role Victoria has had in research, it has been an area of great interest to her for many years, and she is passionate about pursuing a role in developing and improving the care available to people. Victoria works primarily in functional urology, on the PriMUS and PURSUIT trials.

Kathryn Jones - Research Administrator

Research Administrator

Katie joined the Urology Research team in April 2021 as a research administrator. Her role involves assisting the team with the daily administrative elements of running clinical research studies, helping with diary management, data entry and queries, document management and archiving, study finances and liaising with external sponsors. Having completed a psychology degree in 2019, Katie has developed a keen interest in psychological health and wellbeing research and is currently studying for a Master’s in Neuropsychology.

Take Part in Research

Patient & Doctor viewing an x-ray

Become one of the thousands of people taking part in research every day within the NHS.

About Research & Development

NBT Researcher

Find out more about our research and how we're working to improve patient care.

Contact Research

Research & Development
North Bristol NHS Trust
Level 3, Learning & Research building
Southmead Hospital
Westbury-on-Trym
Bristol, BS10 5NB

Telephone: 0117 4149330
Email: research@nbt.nhs.uk

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Nutrition & Dietetics Nutrition Support

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Malnutrition is a serious condition that happens when your diet does not contain the right amount of nutrients. Signs of malnutrition include weight loss, increased tiredness and poor wound healing.

If you or someone you know is at risk of malnutrition it is important to recognise and treat early.

Calculate the risk of malnutrition for you or someone you know.

There are many causes of malnutrition including loss of appetite, difficulty swallowing and changes to taste and smell. If left untreated, malnutrition can cause loss of muscle strength, increased risk of infection and low mood.

If you are in the community and are worried that you or someone you know is at risk of malnutrition, take a look at the following resources. If weight loss continues or you have already lost a lot of weight without meaning to, please speak with your GP and they may refer you to a community dietitian.

For ways to increase energy and protein intake at home, click on the below links:

For ways to increase variety in your diet, click on the below links:

If you or someone you know is in hospital take a look at the following resources.

For ways to increase energy and protein intake in hospital:

Additional information

For information on nutrition and COVID 19: Malnutrition Pathway COVID-19 Leaflets

For information on malnutrition and specific conditions: www.malnutritionpathway.co.uk/specific-resources 

For information on diet and specific conditions:

 www.bda.uk.com/food-health/food-facts.html

www.bda.uk.com/resource/pressure-ulcers-pressure-sores-diet.html

 

Contact Nutrition & Dietetics

Kendon House
Kendon Way
Southmead Hospital
Bristol

Telephone:  0117 414 5428 or 0117 414 5429

FIT Testing for Patients

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Information for Patients

Faecal Immunochemical Test (qFIT) for Occult Blood in Faecal Samples

What is being tested?

The faecal immunochemical test (qFIT) checks for blood in your faeces. Normally, only a very small amount of blood is lost in the stomach or intestines. This is less than you can see in your faeces and is not enough to be detected with a FIT test.

A positive FIT test will tell your doctor that you have bleeding occurring somewhere in your gastrointestinal tract. This blood loss could be due to ulcers, bulges, polyps, inflammatory bowel disease, haemorrhoids (piles), swallowed blood from bleeding gums or nosebleeds, or it could be due to early bowel cancer. Anything that sticks out into the intestine, like a polyp or tumour, and is rubbed against by the faeces as it passes through, has the potential to bleed now and again. Often this small amount of blood is the first, and sometimes the only, symptom of early bowel cancer.

Which patients are eligible for FIT?

The main use for the FIT test is as to find early bowel cancer. Blood in the stool may be the only symptom of early cancer. If the cancer is detected before it spreads to other areas, there is a greater chance it will be cured. The signs and symptoms of bowel cancer are not always easy to see. In some patients, with an abdominal or rectal mass, rectal bleeding, anal ulceration or if they are age >60 y with iron deficiency anaemia. Your GP will request you are seen by the hospital urgently as a “two week wait patient” and you will not be offered a FIT test. In other patients where the signs and symptoms are less clear your GP may think you could have bowel cancer but wants to be more certain that this is the case. In these circumstances a FIT test will help them decide.

You also need to meet some other criteria to be offered the test; these criteria have been developed by the National Institute for Clinical Excellence and local cancer services after reviewing all the evidence. 

  • •    Weight loss, abdominal pain, change in bowel habit (age >40 years)
    •    Iron deficiency anaemia (age <60 years) or a non-iron deficiency anaemia (age >60 years)
    •    Change in bowel habit or other symptoms that could be caused by colorectal cancer but are low risk (age >18 years)

How do you get tested?

Your GP will give you a pack containing all the information and equipment you need to collect your faecal sample and send it directly to the laboratory or return it to the GP practice to forward to the laboratory

Outer packaging for sending FIT test sample to laboratory
Outer packaging for sending FIT test sample to GP surgery

 

Inside the pack you will find the 
•    Collection device
•    Request form (for return to GP pack this will be generated by the practice)
•    Instruction sheet
•    Return envelope

Contents of FIT testing pack to send back to laboratory
Contents of FIT testing pack to send back to GP surgery

 

Your GP should have completed the request form, if this has not been done then please ask the practice to do this for you.

Request form for FIT testing

 

Read the instructions carefully

Instructions for collecting sample for FIT test and sending back to laboratory
Instructions for collecting sample for FIT test and returning to GP surgery

 

Click here to see a full sized version of the instructions:

 

When you have collected your sample

Overview of collection of FIT sample to return via mail or GP

 

 

 

 

 

How soon can I expect the results?

GP’s will receive the results of the analysis within 7 working days from the date the test is sent to the laboratory.  Your GP may then need to decide what is the next best step for you but if you have not heard within 10-14 days please contact the practice.

What do the results mean?

If the Faecal occult blood test is negative:  If your result is negative (Faecal occult blood (FIT) <10 μg Hb/g faeces) it is very unlikely you have bowel cancer. You therefore do not need referral for suspected bowel cancer.  If your GP is concerned that worrying symptoms persist they may do further tests or refer you for specialist advice.  This will be done in line with local arrangements.

If the Faecal occult blood test is positive:  If your result is positive (Faecal occult blood (FIT) >10 μg Hb/g faeces), this does not necessarily 'prove' that you have cancer. There are other possible causes of bleeding and other follow-up procedures will need to be done to find the source of the bleeding.  Your GP is likely to refer you for further investigations and this may be done urgently
 

Where can I access further information and support?

•    For more information about FIT the following website might be of interest: www.faecal-immunochemical-test.co.uk/
•    For more general information about laboratory tests: https://labtestsonline.org.uk/

Lab Tests Online Logo

 

 

To contact the laboratory who are going to process your sample?

Please email the laboratory on nbn-tr.nbtfit@nhs.net

 

Page updated 28/09/21

Test Information

Sample vials for testing

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

FIT Testing for Patients

Clinical Immunology/Immunodeficiency - Information for Patients

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This page is for patients with an immunodeficiency. It has information about when to contact us and how to get further information about living with an immunodeficiency. 

General information

ID UK (Immunodeficiency UK) is a patient organisation that has produced useful information for patients with primary and secondary immunodeficiency: Immunodeficiency UK | Home 

If you are on immunoglobulin replacement or if your consultant has recommended this then you can find more information about this treatment here: Use of immunoglobulin (IgG) in antibody deficiency | North Bristol NHS Trust (nbt.nhs.uk)

COVID-19

We advise our patients to follow government guidelines in terms of protecting themselves from COVID-19. These are updated regularly and can be found here: COVID-19: guidance and support - GOV.UK (www.gov.uk)

ID UK also produces expert guidance for patients with immunodeficiency in relation to COVID-19: COVID-19 - Immunodeficiency UK

COVID-19 vaccines

Useful information with regards to COVID-19 vaccines can be found on the government website and the ID UK website. Household contacts of people who have weakened immune systems are also eligible for COVID-19 vaccinations.  

Further support and information

If you are under the care of the Immunology team for an immunodeficiency and are admitted to hospital for an infection:

  • Let us know by phoning 0117 414 3456.
  • Tell the team looking after you that you have an immunodeficiency.

You should also let us know if:

  • You have regular immunoglobulin infusions and develop an infection that is being treated in hospital.

© North Bristol NHS Trust. This edition published April 2024. Review due April 2027. NBT003618.

Clinical Immunology/Immunodeficiency

Breast Care Research Team

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The Breast Care Research Team

Our team is a dedicated group of nurses, administrators, and surgeons, conducting Breast Care studies.

Our research is supported by the Department of Health with our research projects encompassing a wide breadth of both laboratory-based and clinical work, to improve patient health, wellbeing and care.

We work on a range of commercial and non-commercial, qualitative and quantitative projects and collaborate with colleagues locally, nationally and internationally in order to improve outcomes for patients suffering from various conditions. 

Our work benefits patients not only here in the NHS, but also increases care standards globally.

The team has a wealth of experience conducting research studies and trials, and improving training, guidelines, and patient outcomes.

Our staff work in close collaboration with a number of partners, primarily linked with the University of Bristol and University of the West of England (UWE) as well as a number of other NHS Trusts.

We also work closely with Bristol’s Haematology and Oncology Centre (BHOC) and operate a shared care research pathway between us so patients can receive the highest standard of care whilst taking part in a research study

Meet the Team:

Sasirekha Govindarajulu

Consultant Breast Care Surgeon

Miss Sasirekha Govindarajulu has worked in the Breast Unit at Southmead Hospital Bristol for the past 12 years and maintained the highest possible standard of care for patients, always seeking to improve the experience of patients.

With continuing interest in research, publications and lecture tours maintained high standards of care for patients: Faculty of the national ultrasound course, Faculty of the National vacuum assisted mammotomy training course, National peer review panel, Faculty National Survivorship Programme Patient User and information lead for ASWCS network.

As an Audit Lead of the breast unit, Miss Govindarajulu is always passionate about standards and excellence of care.

Her clinical interests are diagnosis and treatment of breast cancer, including surgery for breast cancer and reconstructive surgery, sentinel node biopsy for breast cancer assessment, diagnosis and management of all benign problems including breast pain. Miss Govindarajulu is also experienced in performing diagnostic breast and axillary ultrasound, diagnostic and therapeutic ultrasound guided interventional procedures, ultrasound guided minimally invasive procedures for therapeutic excision of benign lumps using vacuum assisted procedure and radio frequency ablation, and localising small lesions with ultrasound. 

Her clinical interests also include latissimus dorsi breast reconstruction, all implant-based reconstructions including use of acellular dermal matrix, breast reduction and augmentation, and symmetrisation procedures and other onco-plastic procedures.

Anjum Mahatma

Consultant Breast Care Radiologist

  • FRCR
  • Consultant Radiologist with subspecialty interest in Breast Radiology
  • Clinical Governance lead of Breast Care Unit
  • Principal Investigator of Mammo-50 Trial
  • Educational Supervisor

Alexandra Valencia

Consultant Breast Care Radiologist

Alexandra was appointed as a Consultant Radiologist at the Bristol Royal Infirmary and Avon Breast Screening in 2006, and was Director of Screening from 2012-2019, co-leading on the centralisation of breast services in Bristol. She was Clinical Lead for the Bristol Breast Care Centre from 2018-2020, and has been a Professional Clinical Advisor for PHE since 2014. Alexandra is currently a member of the Breast Screening Clinical Professional Group and the Clinical Advisory Group. Her main interests are Breast MR and breast interventional procedures as well as Quality Assurance in the NHSBSP and increasing the efficiency of breast screening and symptomatic pathways.

Michelle Mullan

Oncoplastic Breast Consultant

Michelle qualified from the University of Bristol in 1995 and underwent her surgical training in Bristol and the West Midlands. She has always been interested in breast disease and undertook research at The Royal Surrey County Hospital in sentinel lymph node biopsy, as part of the Medical Research Council ALMANAC Trial. Michelle has been appointed as a Trustee for the Association of Breast Surgery and sits on the Clinical Practices and Standards Committee.

Her advanced surgical training in Oncoplastic Breast Surgery was in the UK and the United States, practising at the University of Michigan, Ann Arbor, and the Henry Ford Institute in Detroit. She was admitted as a Fellow of the Royal College of Surgeons of England in 2006. In 2008 Miss Mullan won the European Society of Surgical Oncology Travelling Scholarship and spent her time at the Nottingham Breast Institute. Her first consultant appointment was in Worcestershire in 2008, where she was Lead Cancer Clinician for the county. She was appointed to her current position as an Oncoplastic Breast Consultant at North Bristol NHS Trust in 2019.

Her clinical interests include breast cancer surgery using oncoplastic techniques (surgery with minimal scarring), sentinel lymph node biopsy, lipofilling of breast defects (Colman fat transfer), breast reconstruction, nipple reconstruction and nipple tattooing.

Emily Allam

Breast Care Senior Research Nurse

Linda Bourton

Breast Care Research Nurse

Shinu Jackson

Breast Care Research Nurse

Alison Markham

Breast Care Research Nurse

Alexander Rose

Breast Care Research Admin

Take Part in Research

Patient & Doctor viewing an x-ray

Become one of the thousands of people taking part in research every day within the NHS.

About Research & Development

NBT Researcher

Find out more about our research and how we're working to improve patient care.

Contact Research

Research & Development
North Bristol NHS Trust
Level 3, Learning & Research building
Southmead Hospital
Westbury-on-Trym
Bristol, BS10 5NB

Telephone: 0117 4149330
Email: research@nbt.nhs.uk

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Women & Children's Public Involvement Group

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We value Public Involvement to help us to improve the care we provide

Our team does not just involve patients as Research/Trial participants. We are also committed to involving the public in every stage of a research project’s journey. From the development of an idea, through to the sharing of a project’s findings, we feel strongly that consistent involvement and engagement with our public partners in our research will result in high quality projects that are focussed on patients, and with outcomes that are important to them. We want to address real world healthcare challenges and improve care, but we can only do this by understanding and listening to a wide range of opinions and by ensuring we have a culture that encourages patient driven ideas.

We are always keen to expand our Public Involvement Group and have new members join us!

Who is this opportunity for?

Patients with experience of Obstetrics/Gynaecology/Maternity services or members of the public with an interest in improving Women & Children’s Health and Care through research. We also have project-specific groups whose members may have a particular condition or experience – please contact us and we can keep you up to date with any relevant projects.

How you can be involved.

The Research Unit will host face-to-face meetings, video chats or can discuss projects via phone or email, if you prefer. We like to encourage discussions with researchers about their project ideas and research approaches; we ask for help reviewing research summaries and other research documentation; and also want to hear your  general “lived experience” perspective to advise our research staff and clinicians on how best to deliver our projects. We can provide training to support your involvement in our projects, as required.

When?

The dates and times of all the meetings/activities will be agreed in advance and we will endeavour to give as much notice as we can. Timings will be varied and flexible to accommodate the group.

Where?

Face-to-face meetings are sometimes held in the Learning & Research centre at Southmead Hospital. However, we also like to choose the most suitable venue for the group that is meeting – these can be less formal and, for example, more child-friendly, if required.

If you are interested in being involved in our general and/or or a specific project’s Public Involvement Group, would like to register your interest, or would just like some more information please email us via wchresearch@nbt.nhs.uk.

Take Part in Research

Patient & Doctor viewing an x-ray

Become one of the thousands of people taking part in research every day within the NHS.

About Research & Development

NBT Researcher

Find out more about our research and how we're working to improve patient care.

Contact Research

Research & Development
North Bristol NHS Trust
Level 3, Learning & Research building
Southmead Hospital
Westbury-on-Trym
Bristol, BS10 5NB

Telephone: 0117 4149330
Email: research@nbt.nhs.uk

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Women & Children's Research Team

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The Women & Children’s Health Research Unit (WCHRU) is a multidisciplinary team of healthcare professionals, members of the public and academics. They conduct research across many areas of Women’s Health: from Reproductive Health and Gynaecology, through Antenatal care to childbirth; and also the follow on care of mothers and new born babies.

Our research is supported by the Department of Health and a range of charities, with our research projects encompassing a wide breadth of both laboratory-based and clinical work, to improve health, wellbeing and patient care.

We collaborate with colleagues nationally and internationally to develop and deliver ground-breaking, high-quality research and care, which benefits our patients here in the NHS but also increases care standards globally.

The Women & Children’s Health Research Unit is led by a multi-professional senior research team with support from North Bristol NHS Trust, the University of Bristol and the Prompt Maternity Foundation.

The team has a wealth of experience conducting research studies and trials, and improving training, guidelines and patient outcomes.

Our key areas of interest and expertise include:

  • Multi-professional Obstetric Training
  • Maternal & Foetal medicine
  • Bereavement care following baby loss
  • Improving antenatal care
  • Improving education
  • Simulation training
  • Operative vaginal births
  • Infertility
  • Core Outcome Sets
  • Global obstetrics

Our staff work in close collaboration with University partners, as well as a number of other NHS Trusts. We also have fundamental links with organisations such as the Royal College of Obstetricians and Gynaecologists, the Clinical Research Network, the National Simulation Network, International Stillbirth Alliance, and many more.

Meet the team:

Mary Alvarez

Senior Research Midwife

Mary qualified as a midwife in 1991 and has worked at NBT since qualifying. Marys research career began in January 2015 when she was given the lead midwife role on the IMox study; she was subsequently promoted to the role of senior research midwife in 2017. Mary is also a faculty member of PROMPT maternity Foundation, a research champion for the West of England and is an alumni of the NIHR’s Advanced Leadership Programme. Mary aims to create a research culture at NBT where research is seen as ‘everyone’s daily business’ and where all women will have an opportunity to engage with world class research. Mary recently completed an MScR award with the University of Bristol. Using qualitative data from the women and midwives who participated in the ASSIST II study integrated qualitative study, Mary produced and will publish a framework to ensure that recruitment to intrapartum research is a whole pregnancy process, is fair and woman centred.

Nichola Bale

Senior Research Midwife

Nicky was a clinical midwife for 16 years before entering research in 2016, to lead on a large intrapartum study at the Great Western Hospital, Swindon.  From this, she developed a keen interest in research processes and the difference research can make to both current and future patients.  Keen to pursue this as a new career pathway, Nicky took a fixed term research contract at North Bristol NHS Trust, which was made permanent in October 2019.  From March 2019 Nicky has been substantively employed as a Senior Research Midwife, jointly leading the Womens’ and Childrens’ research team of nurses and midwives.  The growing portfolio covers studies in maternity, gynaecology and NICU and is successfully expanding in breadth and depth.  Nicky is also a Midwifery Research Champion working with a national network of midwives and nurses representing all Clinical Research Network regions and the devolved nations. 

Elizabeth 'Annie' Deacon

Research Midwife

Annie has worked in research delivery across multiple studies for over seven years and witnessed first-hand how research improves the health and wellbeing of women and children in maternity services. She acknowledges that women need to be given the highest quality evidence to make decisions about their care and this can only be achieved through an NHS trust that is research active with motivated staff. She feels privileged to work in such an environment.

With 38 years of nursing and midwifery experience prior to entering the world of research, I have had the opportunity to use my clinical knowledge to support women considering and participating in research to make an informed choice when they become involved in the research process.

Naomi Mallinson

Research Midwife

Naomi joined the Women and Children’s Health research team in 2016 and brought with her a wealth of clinical midwifery
experience. She qualified as a midwife in 2002 focussing on mainly providing care to families within the labour ward and
antenatal settings. 

Naomi is a core member of the W&C research team and has engaged families in a wide range of maternity, gynaecology,
reproductive health and more recently, neonatal research studies. Naomi helps provide a link between the community and hospital settings by regularly attending NBT’s antenatal classes, giving families the opportunity to learn more about research much earlier in their pregnancies. 

She is keen to share the positive impact research can have on health care and recognises the wide range of benefits that 
taking part in research offers to patients, staff and NBT.

Katie Mettam

Research Midwife

Katie qualified as a Midwife in 2016 after studying for her midwifery degree at the University of the West of England. Since then she worked as a rotational Midwife at the Great Western Hospital in Swindon and completed two secondments to the Midwife led birth unit there. Katie joined the Women and Children’s research department on secondment in October 2019 to work on the AKID study, investigating Acute Kidney Injury and Diabetes in pregnancy. Katie is passionate about evidence based practice and the positive impact research can have on improving patient care.

Anne Glover

Research Midwife

Anne is a midwife with extensive clinical experience particularly in intrapartum care. She is passionate about research and has previously been involved in Women and Children’s studies as a series of secondments before being welcomed to the team in a permanent role in 2021. Joining at an exciting time of expansion for Maternity Research at NBT, Anne particularly enjoys building relationships with the women and their families who are so enthusiastic about participating in studies. She is looking forward to the team continuing to expand their research portfolio and striving to lead pioneering research and improve care for generations to come.

Rachel Hobbs

Research Midwife

Rachel has enjoyed a varied midwifery career since 2016, working in different midwifery roles at King’s College Hospital NHS Foundation Trust and Great Western Hospitals NHS Foundation Trust. She qualified as an International Board Certified Lactation Consultant (IBCLC) in 2021. This process furthered her interest in women and children’s research. Rachel joined NBT in 2023. She is keen to ensure that the research process is available and accessible for all families with a baby in NICU. Rachel is enthusiastic about the impact research can have on health outcomes and in ensuring the highest quality, evidence-based compassionate care experience for families and those providing care.

Paula Brock

Research Midwife

Paula is a Registered Nurse who also qualified as a midwife many years ago, and then developed a career in Neonatal Nursing.  She  joined the  Research Team with a wealth of clinical experience  to deliver Neonatal studies in 2021. Paula is passionate about expanding neonatal research, to ensure the care of  sick babies is evidence based  and of the highest quality.  She believes that every baby and every family have the right to take part in research.

Since joining the team 6 new national and international studies have opened, with the majority of parents willing to take part. The rapid expansion of projects has an impact on the workload  large neonatal clinical team and Paula is keen to train and motivate professionals, increasing awareness and knowledge to support the delivery of studies.

Michelle Maggs

Research Midwife

Since qualifying as a Midwife in 2003, Michelle gained a wealth of experience in many clinical settings including Antenatal and Postnatal wards, Community and Central Delivery suite within United Hospitals Bristol and Weston NHS Trust. Michelle is passionate about the provision of high quality, evidence based care and recognises the fundamental role research plays in achieving this.  In 2022, Michelle decided to explore a more active role the world of NHS research and joined the Women's and Children's research department at North Bristol Trust.  Since joining, Michelle has worked on a variety of studies covering fertility and maternity care.  Michelle is enthusiastic about the promotion of embedding research into every day clinical care, ensuring opportunities are available to all women and their families.

Ashleigh Promnitz

Research Nurse

Ashleigh joined the Women and Children’s health research team in 2021. She is a qualified nurse with over 10 years of experience, she started her career in surgical admissions and went onto working in the Emergency department at Southmead Hospital. More recently Ashleigh started working in the fertility sector which led her to working in the Women and Children’s research team.

From personal and professional experience, Ashleigh is very passionate about fertility and women’s health research. When she first started working in research, she worked on the BRIST-IVF study, a study that looked to improve outcomes for couples undergoing IVF. Ashleigh now works with Katie on the Gynaecology research portfolio alongside the Gynaecology team on Cotswold Ward at Southmead Hospital.

Sally Hall

Research Administrator

Sally joined North Bristol Trust in 2008 with an extensive secretarial and administrative background. She began working within the respiratory department and then transferred to the maternity Unit where she worked on Quantock Ward and Day Assessment Unit for 9 years as Ward Clerk. Sally joined the research department in 2017 as Trial Administrator for studies including Imox, Mifemiso, Parrot and ASSIST and ASSIST II. Her increasing knowledge of the Women & Children’s department and passion for research helps support and facilitate correct governance for studies within the maternity research department.

Claudia Sepulveda Hurtado

Research Midwife

Claudia is a Midwife that qualified in Chile in 2019, and has been in the UK since 2022. She has mainly worked in a central delivery suite setting and has recently joined the research team in November 2024. She is committed to improving maternal and neonatal outcomes by addressing disparities in care and reducing health inequalities through research and evidence-based practice.  

Laura Caddell

 Research Midwife

After graduating from The University of Nottingham in 2015, Laura worked as a midwife at United Lincolnshire Hospitals NHS Trust before moving to NBT in 2016.  She has worked in all areas of clinical midwifery, both in the UK and abroad, with a particular focus on providing woman-centred intrapartum care in midwife-led settings. She has been a part of the Mendip Birth Centre and homebirth teams at NBT since 2018 and joined the Women’s and Children’s research team in 2024. She is passionate about women and their families receiving both evidence-based and individualised maternity care, and loves being able to support families who want to contribute to our knowledge and understanding of pregnancy and childbirth by participating in maternity research studies.

Kody Lagrimas

Research Administrator

Kody has been with the trust since 2023, utilizing their strong administrative and interpersonal skills to support the Urology department, where they assisted with clinic utilization, booked surgeries, and provided patient support. In late 2024, Kody transitioned to the Women's and Children's department as a research administrator, motivated by the significant impact research has as well as the trust's extensive research initiatives. Since joining, they have been actively involved in the DIVO, GENERATIONS, and PIONEER studies, and is looking forward to contributing to the department's ongoing research efforts.

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About Research & Development

NBT Researcher

Find out more about our research and how we're working to improve patient care.

Contact Research

Research & Development
North Bristol NHS Trust
Level 3, Learning & Research building
Southmead Hospital
Westbury-on-Trym
Bristol, BS10 5NB

Telephone: 0117 4149330
Email: research@nbt.nhs.uk

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Patient activated monitoring

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What is a patient activated monitor?

The monitor is a small patch that will monitor your heart rate and heart rhythm. It will be fitted on upper left side of your chest, and you wear it as the referring doctor requested. This could be from 72 hours up to 14 days.

Why do I need to have this test?

Your doctor has requested that you have this simple non-invasive test in order to monitor your heartbeat for the required time.

Preparing for the test

What should I wear when I attend my test?

It is helpful to wear clothing that makes it easy to access your chest. A t-shirt, shirt, or blouse would be best.

What happens during the test?

You will receive instructions on how to use the monitor, how to log in your symptoms, and how to return the monitor from the technician during your appointment. You should carry out normal daily activities while wearing the patch. 

For the first 24 hours the patch is not waterproof. After the first 24 hour period you can have showers.

Will I experience any discomfort or side effects?

On rare occasions patients can experience an allergic reaction to the patch. If this happened, the patch can be removed. 

After the test

What happens after the test?

After the designated time you will remove the patch by yourself as instructed, and post it with the diary logbook in the prepaid box for the analysis. Make sure that the box is well sealed. The technician will show you how to do this at your appointment.  

When/how will I receive the results of the test?

The results will be passed onto the doctor who requested the test. You are usually told the results at your next clinic appointment or a letter may be sent to your GP.

What will happen if I do not want to have this test?

If you do not have this test we will not be able to pass important diagnostic information to the doctors. This may affect the medical treatment that you receive.

© North Bristol NHS Trust. This edition published June 2024. Review due June 2027. NBT002241.

Pacemakers

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This page is a general guide for patients and their families who want to learn more about pacemakers. Please ask any questions at your pre-op assessment appointment or next follow-up check.

The heart

The heart's main job is to pump blood and oxygen throughout your body. It has four parts: two on the top called the right and left atria, and two on the bottom known as the right and left ventricles.

The electrical system of the heart

The conduction system sends electrical signals through your heart, making it beat. It makes sure these signals reach every part of your heart at the right time so your heartbeats are organised and happen at a healthy speed. 

Why do I need a pacemaker?

There are several reasons, but pacemakers are mostly implanted because of an issue in the conduction system of the heart. This can make the heart beat too fast, slow, or irregularly. These can causes symptoms like dizziness, shortness of breath, extreme fatigue, or may just be discovered in a routine check-up or pre-op assessment.

These changes in rhythm can have many causes including:

  • Hereditary defects - conditions passed down through family).
  • Certain illnesses.
  • Some cardiac medications.
  • Secondary to heart attacks (after a heart attack).
  • The aging process.
  • An unknown cause.

You will be told why you need a pacemaker and what type has been/will be implanted. The type you have is dependent on your heart condition.

Pacemaker system

A pacemaker is made up of two main parts, the generator and lead. The generator is a tiny, sealed box containing the electric circuit and a battery. The battery in most pacemakers will last 7-10 years. (There are several factors that affect battery life but none that you can control yourself). The lead is a flexible, insulated wire. One end is attached to the generator and the other end is passed through a vein into your heart. You may have one, two, or three leads depending on the type of pacemaker.

What are the different types of pacemaker? 

  • Single chamber pacemaker - this will pace the right atrium or right ventricle. It has one lead.
  • Dual chamber pacemaker - this will pace the right atrium and the right ventricle. This has two leads.
  • Bi-ventricular pacemaker - in some cases you may benefit from both ventricles being paced. This improves the ability of the heart to pump. This has three leads.
  • Single pass VDD pacemaker - this is a special type that has only one lead, but can sense in the top chamber and pace in the bottom chamber.

Preparing for the procedure

Eating and drinking

If your procedure is in the morning you can have an early, light breakfast before 06:30. You must not eat any solid food after 06:30. You can keep drinking water if you are thirsty, If your procedure is in the afternoon you need to eat no solid food from 10:00. You can have water after this if you are thirsty. You can eat and drink as normal after the procedure.

Medication

Before your procedure, you will have a pre-op assessment with a cardiology nurse. They will talk to you about your medications at that appointment. Please keep taking all your medications until then. If you need to stop any of them before your procedure, the nurse will tell you.

The procedure

The procedure and risks are explained below, and you will be asked to sign a consent form to confirm you understand them.

  • In the procedure lab you will lie relatively flat on a narrow X-ray table.
  • In most cases the pacemaker will be placed on the side opposite the hand you write with. You may be shaved in the upper chest area.
  • The doctor will clean your skin with some antiseptic solution. You will be covered with sterile drapes. It is important to keep your hands by your side to avoid contamination.
  • The procedure is normally done using local anaesthetic. You will be awake but the area will be numb. You won’t feel pain but may feel a bit of pushing. If you feel any pain, tell a member of the team.
  • If you are anxious about the procedure, you may be given a mild sedative to help you relax.
  • A small cut is made, and a pocket formed for the pacemaker to sit in.
  • A lead will be passed along the vein into your heart using X-ray imaging to help, a the lead will be connected to the generator (pacemaker).
  • The would is stitched with dissolvable stitches and covered with a dressing.
  • You will be taken to the recovery area for a short while, and then moved to a ward or go back to the ward you were on before.
  • The procedure can take between 40 minutes to 2 hours depending on the number of pacing leads and how easy it is to access.

After the procedure

Looking after the wound 

Your wound might feel sore and look bruised for a couple of weeks which is normal. If you have pain, you can take painkillers. Keep the wound clean and dry for about 7-10 days, after this you can take off the dressing. Allow the paper stiches to fall of on their own. 

Using your arm

It is important to be gentle with the arm on the same side as the pacemaker. Use it normally, but avoid raising it above your shoulder or lifting heavy objects. This is because over time new tissue will grow around the lead in your heart, helping to hold it in place. Until that tissue forms there is a slight chance that the lead could move out of position (this would mean we need to reopen the wound to fix it).

If you have any questions about how to use your arm, please ask for help.

Before you leave hospital you will have the pacemaker checked and a chest X-ray of the pacemaker and leads. You will be given a pacemaker ID information sheet. This identifies you as a patient with a pacemaker and has information about your pacemaker and lead(s), and information about your cardiologist and GP. Keep this information sheet with you at all times.

Risks

Every medical procedure has some risks, including having a pacemaker fitted. You can discuss these in more detail with your doctor. The most common risks are: 

  • Infection - you will be given antibiotics to reduce this risk.
  • Lead displacement - there is a very slight risk that the wire moves from its original position (becomes displaced).
  • Pneumothorax - very rarely the lung is perforated (punctured) during the implant. This causes air to leak from the lungs into the chest. The follow-up chest X-ray after your implant would show this.
  • Pain/discomfort/bruising - some bruising can happen as the skin is stretched to fit the pacemaker. You may also have some discomfort around the wound site.

Follow-up

Once the wound has completely healed you can mostly return to normal life. The pacemaker is checked every so often to make sure it is working as it should.

The follow-up for pacemakers usually involves checking it 24 hours after implant, and again at six weeks - this also includes a wound check. You will have checks every year, six months, or three months depending on the age of the pacemaker.

The checks take about 15-20 minutes. These are separate from other appointments with the cardiologist and are only to check the pacemaker.

When you come for a check-up your heart rate will be monitored. The pacemaker will be scanned with an external device that the physiologist will place over your chest.

If you have had any symptoms since your last check, tell the physiologist. During the check you may feel your heart beat slightly differently - faster or slower. If you become uncomfortable tell the physiologist. The pacemaker may be adjusted to get the best performance.

At the end of the check you will be told if there are any problems and when your next appointment is. Please make a note of the date and time.

Dos and don’ts

Do 

  • Tell all medical staff you have a pacemaker. Some hospital equipment may interfere with pacemakers, and some procedures like an MRI (magnetic resonance imaging scan) may not be suitable. Some medical procedures may need to use antibiotics if you have a pacemaker. These can be discussed with your doctor.
  • Carry your pacemaker ID information sheet with you at all times and show it at hospital appointments.
  • Tell the DVLA and your car insurance company (if you drive) that you have a pacemaker. This is a legal requirement. It should not affect your premium costs. You can access the DVLA guidelines at Check if a health condition affects your driving: Overview - GOV.UK
  • Tell your GP or pacing clinic if the wound site becomes red and inflamed, if you feel unwell with a fever, or if you have oozing from the site.
  • Hold your mobile phone to the ear on the opposite side of your pacemaker when making phone calls.
  • Tell airport security you have a pacemaker if travelling abroad.
  • Keep all follow-up appointments. If you cannot go to an appointment please phone us so we can rearrange.
  • Contact you GP as normal if you feel unwell. They will be able to help you and will contact us if they suspect a problem with your pacemaker.
  • Contact your GP if your symptoms return once you have a pacemaker fitted.
  • Avoid any strenuous activity for about six weeks after the pacemaker has been fitted. After that you can continue most sports and activities.

Don’t

  • Don’t drive until you have had your pacemaker checked at the 6-week appointment. If this is a problem speak to the cardiac physiologist at your 24-hour check.
  • Don’t lift your pacemaker side arm above shoulder height or six weeks.
  • Don’t carry your mobile phone in a shirt pocket over your device.
  • Don’t do arc welding.
  • Avoid going near strong magnets.
  • Avoid certain massage chairs.
  • If you have any queries about what to avoid or can do, please phone the pacing clinic on 0117 414 0791

Living with a pacemaker and lifestyle considerations

Regular exercise is beneficial for most people. You are advised not to exercise (including golf and swimming) until you 6-week check, after this you can begin gradually.

Modern pacemakers are designed with modern life in mind and are usually not affected by electrical items such as hairdryers, washing machines, and TVs. Modern microwaves are fine to use as long as they are in a good state of repair.

© North Bristol NHS Trust. This edition published January 2025. Review due January 2028. NBT002323