We offer dedicated multi-disciplinary clinics with physiotherapy and specialist nurses.

A well established number of patients are on Biologic Therapy

Find out more information about AS and different treatments.

NASS Bristol (National Ankylosing Spondylitis Society) has been running groups from Southmead Hospital since 1998. Since March 2020, we moved to online stretch sessions due to COVID-19.

We run physiotherapist-led online stretch sessions every Monday afternoon at 1pm and on Wednesday evening at 6:30pm.

If you’re interested in joining in, we ask you to email and we will send you a medical questionnaire for you to complete before starting the session.

Find out more on the Nass Bristol website. 

There are dedicated clinics at Southmead Hospital Bristol for new and follow up patients. The service is run by Dr Harsha Gunawardena, Dr Sam Patel and Dr John Pauling, supported by a specialist nurse and pharmacist.

We have experience in management of all autoimmune connective tissues diseases such as:

• SLE (systemic lupus erythematosus).
• Scleroderma (systemic sclerosis).
• Inflammatory muscle diseases (Myositis).
• Sjogren's Syndrome.
• Vasculitis.
• Behcet’s Disease.

We take referrals from GPs and other hospital doctors (tertiary referral) for the more complex cases requiring high level expertise, such as inflammatory muscle disease, systemic sclerosis, and vasculitis.

We prescribe advanced therapies only available at a specialist centre including cyclophosophamide and Rituximab on Medical Day Care. 

For more information on drug treatment in rheumatology please visit the Versus Arthritis website.

Combined clinics with other specialist centres and specialties including Respiratory medicine (interstitial lung disease) and Royal Free Scleroderma service for complex conditions.

Respiratory CTD Lung ILD Combined Clinic

Week 1 and 3: Dr Adamali and Dr Barratt and Dr Harsha Gunawardena for patients with lung disease secondary to autoimmune connective tissue disease or vasculitis.

Royal Free North Bristol systemic sclerosis outreach clinic

Held every 6 months with Professor Chris Denton and Dr Voon Ong of the Royal Free Hospital, London and Dr Harsha Gunawardena for patients with complicated systemic sclerosis (scleroderma).

Combined Rheumatology and Neurology neuromuscular metabolic bone disease clinic

Held every three months with Dr Emma Clark and Dr Andria Merrison

We hold a specialised osteoporosis and metabolic bone disease clinic at Southmead Hospital Bristol with Dr Emma Clark.

We have a DEXA scanner (to measure bone density) at Southmead Hospital Bristol. We often do an additional scan as part of standard DXA scans to look at the spine for vertebral fractures (VFA). We have good links with our radiology colleagues and can offer vertebroplasty if it is required.

We also have two dedicated osteoporosis specialist nurses.

Specialist therapies such as Denosumab injections are administered within the nurse clinic and Zoledronic acid infusions are administered on the medical day care unit.

The Royal Osteoporosis Society has up to date information on understanding osteoporosis, the treatments available, information on exercise diet and lifestyle, and local support in your area, please visit the Royal Osteoporosis Society website.

We have close ties with the physiotherapists, elderly care services and the falls services.

Our fracture liaison service is led by Dr Katherine Walsh and Dr Bailey, who are orthogeriatricians assisted by a fracture liaison nurse. The service is designed to identify new patients of 50 years and over who have sustained low trauma fractures injuries (equivalent to fall from head height or less). 

The nurse offers telephone follow up to patients with a high risk of future fracture to assess adherence and tolerability of bone protection medication. Where patients have not started treatment or there are medication issues they will be contacting patients to help resolve any issues.

Further information can be found on the Versus Arthritis Website.

We have a Rapid Access “Hot” Clinic for people suspected to have giant cell arteritis (GCA) with referrals from GPs and also within secondary care.

You will have an urgent appointment arranged and a temporal artery ultrasound carried out.  A further follow up will be planned if Giant Cell Arteritis is diagnosed.

Further information can be found on the Versus Arthritis Website.

This recipe makes a fruit cake with a lighter sponge and all the flavours of Christmas. It doesn’t need to mature like a traditional Christmas fruit cake.

Serves 16.

Ingredients

• 10oz/250g glace cherries, quartered
• 10oz/250g mixed peel
• 8 oz/200g tinned prunes, drained and chopped
• 5 eggs
• 2 dessert spoons of brandy/rum
• ½ teaspoon of almond essence (optional)
• 10oz/250g plain flour
• 1 teaspoon baking powder
• 7oz/175g soft brown sugar
• 10oz/250g unsalted butter, softened
• ½ teaspoon ground cinnamon
• 1 teaspoon ground mixed spice

Method

1. Place the cherries, mixed peel and prunes in a large bowl, add the brandy/rum and leave to soak overnight.
2. Grease a 7” (18cm) round cake tin, and double line with greaseproof paper. Preheat the oven to 140oC/120oC fan assisted.
3. Beat the butter, sugar, flour, eggs and spices in a large mixing bowl until well combined. Fold in the pre-soaked fruit and pour into the prepared cake tin.
4. Place a double layer of greaseproof paper loosely on top of the cake, and bake in the oven for 3 ½ to 4 hours. Remove greaseproof paper 15 minutes towards the end of cooking.
5. Leave to cool in the tin, and once cooled decorate with the icing of your choice. Store in an airtight container.

Ingredients

• 120g icing sugar
• 1tsp ground cinnamon
• 1tsp (5ml) water
• 2tsp (10ml) juice of an orange

Method

Sieve the icing sugar together with 1 tsp cinnamon, and mix with the water and juice of an orange. The icing should be thick enough to coat the back of the spoon. If it is too runny add a little extra sieved icing sugar, or if it is too thick then add a little more water.

Ingredients

• 8oz/200g plain flour
• 1 apple, grated
• 1 carrot, grated
• 4oz/100g sugar
• 4oz/100g mixed peel
• 3oz/75g glacé cherries
• 4oz/100g white breadcrumbs
• 3oz/75g tinned plums, drained and chopped
• 4oz/100g tinned prunes, drained and chopped
• 2 teaspoons mixed spice
• 1 egg
• 6 fl oz/150 ml milk
• 2 fl oz/50 ml brandy
• Caramel colouring
• 2 teaspoons lemon juice

Method

1. Mix together the flour, apple, carrot, sugar, mixed peel, cherries, breadcrumbs, plums, prunes and mixed spice.
2. Add the milk, brandy, egg, a little caramel colouring and lemon juice. Mix well.
3. Line a pudding bowl with a floured pudding cloth and place the mixture in the centre. Tie securely.
4. Put into a large pan half filled with hot water and boil the pudding for 4 hours. Cool and keep in the fridge.
5. Steam again for 4 hours before serving hot.

Foods to choose from

Turkey, chicken, duck, goose, beef, lamb, pork or fish.

Foods to choose from

Dishes made with tofu, Quorn, lentils, pumpkin,or squash. Cheese or brie and cranberry pastry parcels.

Foods high in potassium

Dishes made with nuts, courgette, mushrooms, spinach, sweet potato.

Foods to choose from

Boil potatoes first to make roast or mashed potatoes.

Foods high in potassium

Potatoes which have not been boiled.

2-3 portions

1 portion = 2-3 tablespoons

Foods to choose from

Boil vegetables. Choose those lower in potassium such as carrots, red cabbage and cauliflower. Limit Brussel
sprouts to 6.

Foods high in potassium

Vegetables such as mushrooms, parsnips, spinach, vegetable/tomato soup.

Foods to choose from

Yorkshire pudding, apple sauce, cranberry sauce, homemade bread sauce, mint sauce and horseradish.

Foods to choose from

Fruit pie or crumble (except for rhubarb, blackcurrant or apricot), artic roll, gateaux, ice cream, sorbet, pavlova,
profiteroles or trifle. Brandy/rum butter or double cream with puddings.

Foods high in potassium

Try to limit to 1 portion of either Christmas pudding or Christmas cake or 1 mince pie or 1 slice of Yule log.

Foods to choose from

Clementines, satsumas, apple, raspberries, tinned fruit.

Foods high in potassium

Fruits such as apricots, bananas, dried fruit and fruit juices.

Foods to choose from

Plain breadsticks, unsalted popcorn, corn, maize or wheat snacks (choose those without potassium chloride), pickled onions, cheese and biscuits. Carrot or cucumber sticks with cottage/cream cheese or sour cream or mayonnaise dips. Cranberries. Chestnuts (5)

Foods high in potassium

Potato crisps, Twiglets, guacamole, salsa, nuts and dried fruit.

Foods to choose from

Chicken or fish goujons, mini sausages, blinis or crispbreads with pate or salmon and cream cheese, prawns, arancini balls, mini quiches or vol au vents.

Foods to choose from

Sponge cake, gateaux, cream cakes, jam tarts, jam or cream swiss roll, brandy snaps, gingerbread or shortbread.

Foods high in potassium

Stollen, biscuits, cake containing dried fruit, nuts.

Foods to choose from

Jelly sweets, mint creams, marshmallows and Turkish delight.

Foods high in potassium

Liquorice, hot chocolate. Limit chocolate to 4 pieces / squares or 2 chocolate coated biscuits.

Foods to choose from

Liqueurs, port, sherry, spirits. 1 small beer/lager or 1 glass of wine/mulled wine or champagne.

Foods high in potassium

Cider and strong ales. Drinks/cocktails with fruit juice.

Disease of the small blood vessels in the brain (cerebral small vessel disease or SVD) causes a quarter of all strokes (lacunar stroke) and is the most common cause of vascular dementia. Despite its importance we understand relatively little about what causes this disease.  However we know genetic factors are important. If we can identify the responsible genes it will provide new insights into what causes SVD, and may help us identify new possible treatments.  

We are leading a worldwide collaboration to identify new genes for lacunar stroke. To identify new genes requires us to collect many thousands of cases of lacunar stroke, with the diagnosis confirmed on MRI. In a previous study, DNA lacunar 1, we collected 1000 cases. Using this data we have recently carried out an analysis which identified 11 new genes for SVD, and has provided completely new insights into what causes the disease. 

We are now extending this work aiming for a target of 5000 cases worldwide.

PI: Dr Sandeep Buddha

Planned End Date: 31/12/2025

Local ref: 5603

The “SPEEDY Trial” is a randomized controlled trial aimed at evaluating a new pre-hospital pathway designed to enhance access to thrombectomy treatment. Thrombectomy is a time-sensitive surgical procedure that can significantly improve outcomes for stroke patients. However, this treatment is currently only available in larger regional hospitals, limiting its accessibility.

In the trial, some patients will receive care according to the new “SPEEDY” pathway, while others will continue to receive standard care. Ambulance stations and teams will be randomly assigned to either implement the SPEEDY pathway or continue with the usual standard of care. The trial is currently open in the WMAS region and is expected to expand to NWAS, SWASFT, and NEAS in the coming months. Its primary aim is to assess whether this new approach can improve access to thrombectomy treatment for stroke patients.

PI: Dr Rose Bosnell

Planned End Date: 30/11/2025

Local ref: 5404

The objective is to assess the clinical effectiveness of tranexamic acid (TXA) after stroke versus usual care. With the primary objective being assess the effect of TXA on early deaths and the secondary objective to assess the effect of TXA on          dependency 6 months after Intracerebral Haemorrhage (ICH). The team are measuring the cost effectiveness of TXA versus usual care. Incremental cost effectiveness ratios (ICERs), net monetary benefit and cost effectiveness of usual care versus TXA. HE data collection will include Health Care Resource Use and the EQ5D-5L.

PI: Dr Sandeep Buddha

Planned End Date: 01/08/2027

Local reg: 4756

Key study findings:

• Majority of patients hospitalised with COVID-19 have not fully recovered after 5 months
• Those who experience more persistent symptoms tend to be middle-aged, white, female, with at least two ‘co-morbidities’, such as diabetes, lung or heart disease
• Cognitive impairment, also referred to as ‘brain fog’, occurs as a predominant symptom in a sub-set of patients who tend to be older and male
• A biological marker associated with inflammation, C-Reactive Protein (CRP), is elevated in all but the most mild of post-hospital cases

The majority of survivors who left hospital following COVID-19 did not fully recover five months after discharge and continued to experience negative impacts on their physical and mental health, as well as ability to work, according to results released by the PHOSP-COVID study today. Furthermore, one in five of the participant population reached the threshold for a new disability.

The UK-wide study, which is led by the National Institute for Health Research (NIHR) Leicester Biomedical Research Centre – a partnership between Leicester’s Hospitals, the University of Leicester and Loughborough University - and jointly funded by the NIHR and UK Research and Innovation, analysed 1077 patients who were discharged from hospital between March and November 2020 following an episode of COVID-19.

Researchers found that each participant had an average of nine persistent symptoms. The ten most common symptoms reported were: muscle pain, fatigue, physical slowing down, impaired sleep quality, joint pain or swelling, limb weakness, breathlessness, pain, short-term memory loss, and slowed thinking.

Patients were also assessed for mental health. The study reports that over 25 per cent of participants had clinically significant symptoms of anxiety and depression and 12 per cent had symptoms of post-traumatic stress disorder (PTSD) at their 5-month follow-up.

Of the 67.5 per cent of participants who were working before COVID, 17.8 per cent were no longer working, and nearly 20 per cent experienced a health-related change in their occupational status.

Professor Chris Brightling, a professor of respiratory medicine at the University of Leicester and the chief investigator for the PHOSP-COVID study, said:

“While the profile of patients being admitted to hospital with COVID-19 is disproportionately male and from an ethnic minority background, our study finds that those who have the most severe prolonged symptoms tend to be white women aged approximately 40 to 60 who have at least two long term health conditions, such as asthma or diabetes.”

The researchers were able to the classify types of recovery into four different groups or ‘clusters’ based on the participants’ mental and physical health impairments.

One cluster group in particular showed impaired cognitive function, or what has colloquially been called ‘brain fog’. Patients in this group tended to be older and male. Cognitive impairment was striking even when taking education levels into account, suggesting a different underlying mechanism compared to other symptoms.

Dr Rachael Evans, an associate professor at the University of Leicester and respiratory consultant at Leicester’s Hospitals, said:

“Our results show a large burden of symptoms, mental and physical health problems and evidence of organ damage five months after discharge with COVID-19. It is also clear that those who required mechanical ventilation and were admitted to intensive care take longer to recover. However, much of the wide variety of persistent problems was not explained by the severity of the acute illness - the latter largely driven by acute lung injury - indicating other, possibly more systemic, underlying mechanisms"

The pre-print, title, which is yet to be peer-reviewed, is now available to view on Med Archives.