Prostate Transperineal Biopsy Training Workshop

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Next course date TBC

The Bristol Urological Institute run this 1 day course with BXTAccelyon using the PrecisionPoint Transperineal Access System for biopsies in prostate cancer diagnostics. The techniques taught in the course are endorsed by the prostate steering group of the Southwest cancer alliances as a means of improved patient care and minimising cancer pathway delays.

This course is aimed at urologists, oncologists, radiologists, trainees and Allied health professionals.  The one day workshop will teach the principles of freehand local anaesthetic transperineal targeted and systematic prostate biopsies.

It will be an exciting and comprehensive day comprising of presentations and Q&A sessions. Taught by experienced faculty who are BXTAcceylon Ltd approved trainers.

Course Directors: Stefanos Bolomytis and Raj Persad, Consultant Urological  Surgeons

 

For further information please email buicourses@nbt.nhs.uk

Prostate Transperineal Biospy

Dr Fleur Talbot - Diabetes & Endocrinology

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GMC Number: 6129715

Year of first qualification: 2005, University College London

Specialty: Diabetes & Endocrinology

Clinical interest: Adrenal disease, obesity, pituitary and thyroid disease. 

Secretary: Sue Trevascus

Telephone:  0117 414 6422

Dr Fleur Talbot completed a PhD at the University of Cambridge, looking at hypothalamic function and its control of appetite and energy expenditure. She joined the trust in 2019 and practices general diabetes, endocrinology and general medicine. 

Talbot

Virtual Flexible Cystoscopy Course

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Wednesday 25 May 2022

This one day virtual Flexible Cystoscopy Course aims to enhance the safe and effective use of Narrow Band Imaging and products during flexible cystoscopy.   

Local Course Faculty: Helena Burden and Kate Warren, Consultant Urological  Surgeons, Bristol Urological Institute.

This course is being offered by Olympus

Further details about the event and how to secure a place are available at https://learn-emea.olympus-europa.com/learn/course/external/view/classroom/1167/flexible-cystoscopy-course

 

Flexible Cystoscopy

SWNODN Events for Professionals

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SWNODN Events for Clinicians and Allied Healthcare Professionals

South West Interest in Muscles (SWIM) Conference

The SW Neuromuscular ODN deliver a SWIM Conference twice a year.  The Conference is open to clinicians and allied healthcare professionals who have an interest in neuromuscular conditions.  It's a great opportunity to network with colleagues in other specialties and organisations in the South West.  The conference is usually themed around neuromuscular conditions or focusing on points in the patients care pathway across other related specialties.  

If you would like to be notified of details of future SWIM conferences, please contact the SWNODN Neuromuscular Office by email (swneuromuscularodn@nbt.nhs.uk) and request to be added to our mailing list.

 

Past SWIM Themes

Below is a list of some of the past SWIM Themes.  If you would like further information, please contact the SW Neuromuscular office on 0117 4141184 or e-mail swneuromuscularodn@nbt.nhs.uk.

  • 29 June 2023 - Peripheral Neuropathies with an emphasis on CMT
  • 16 June 2022 - Spinal Muscular Atrophy: Progression with treatments
  • 21 November 2019 - Duchenne Muscular Dystrophy
  • 20 June 2019 - Anterior Horn Cell disorders - including MND and SMA
  • 29 November 2018 - Moaning Muscles and Miserable Mitochondria - The Metabolic Myopathies
  • 21 June 2018 - Myasthenia Gravis and related disorders
  • 23 November 2017 - Neuropathies
  • 8 June 2017 - Respiratory and Neuromuscular Disease
  • 1 December 2016 - The New Genetics: Transforming Research in Neuromuscular Disease
  • 19 May 2016 - Psychology related to Neuromuscular conditions / Transition from paediatric to adult neurology services
  • 19 November 2015 - Neuromuscular disorders and Scoliosis Surgery / Orthopaedic considerations in Neuromuscular conditions
  • 23 April 2015 - Neuromuscular disorders and their impact on child, family and society / Neuromuscular disorders and the heart
  • 20 November 2014 - Transition and Genetics
  • 8 May 2014 - Muscles and Mitochondria in Neuromuscular disorders / Metabolic conditions
  • 21 November 2013 - Bones in Neuromuscular disorders
  • 23 May 2013 - Respiratory issues in Neuromuscular disorders - paediatric and adults
  • 22 November 2012 - Palliative Care
  • 14 May 2012 - Neuromuscular disorders and the heart
  • 1 December 2012 - Myasthenic and Myotonic conditions
  • 5 May 2011 - Bone health and neuropathy
  • 18 March 2010 - Cardiac, Physiotherapy, Spinal Complications and Respiratory care

 

SWNODN SWIM audience 1.jpg

Stroke Thrombectomy Service - For Clinicians

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Flow diagram made of different boxes, setting out what is needed for a referral, with arrows pointing to the next points in a patient's journey through thrombectomy and then returning to their referring hospital

The service is open 24 hours a day, seven days a week to patients referred from: 

Gloucestershire Hospitals Foundation Trust

Great Western Hospitals Foundation Trust

North Bristol NHS Trust

Royal United Hospitals Bath

Taunton & Somerset NHS Foundation Trust

University Hospitals Bristol and Weston NHS Foundation Trust Bristol

Yeovil District Hospital NHS Foundation Trust

We also provide a service to the south and western regions of Wales 7 days a week from 6am and patients must be at the hospital by 10pm.

Please use the following process to refer a patient to our service.

Stroke Thrombectomy Service - For Clinicians

Stroke Thrombectomy Service

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Thrombectomy is a revolutionary treatment that can be used to treat strokes that are caused by a blockage of the largest arteries of the brain by blood clots; this is around 1 in 8 strokes. In 2019-20 North Bristol Trust, based at Southmead Hospital, performed the third highest number of thrombectomies for strokes of any stroke centre in England. We currently take referrals for thrombectomy 7 days a week.

We provide a thrombectomy service to the following hospitals 24 hours a day:

Gloucestershire Hospitals Foundation Trust

Great Western Hospitals Foundation Trust

North Bristol NHS Trust

Royal United Hospitals Bath

Taunton & Somerset NHS Foundation Trust

University Hospitals Bristol and Weston NHS Foundation Trust Bristol

Yeovil District Hospital NHS Foundation Trust

Thrombectomy at Southmead Hospital is carried out by interventional neuroradiologists, supported by stroke specialist consultants, advanced nurse practitioners, anaesthetists and a large team of other professionals using state of the art equipment.

We also provide a service to the south and western regions of Wales 7 days a week from 6am. Patients must be at the hospital by 10pm.

HKAT - Development of a speech analysis algorithm

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Background to the project:

Speech sound disorder (SSD) is one of the common problems that children face in their childhoods.  According to research, between 2% and 25% of children aged 5 and 7 years old have SSD (Law et al, 2000). When children learn to say new words, most children make some speech errors, which should diminish as they get older. SSD occurs when these errors continue beyond the age when we expect a child to have mastered specific speech sounds.  Most speech errors occur when the speech sounds are substituted, omitted or distorted.  The errors may affect how well a child is understood and can potentially limit his/her interactions with other people and negatively impact on the child's social and emotional development.

SSD is usually diagnosed by speech and language therapists using formal articulation tests and oral mechanism assessments.  As children make age-appropriate and age-inappropriate mistakes during their development, it can be difficult for parents or teachers to identify if there is a problem. Therefore, a request may be made for a formal assessment by a speech and language therapist to determine if a problem with speech exists.  This can lead to delays in accessing intervention.

Not all children need a formal articulation assessment. Some can be assessed using a screening tool which can be used to identify those children who need a more complete and thorough assessment from those who need advice only. The purpose of a screening tool is to quickly identify those children whose speech is within normal limits and those who may have SSD. People identified as falling outside normal limits can be seen or referred for complete formal evaluation in a timely fashion.

In recent years, computerised digital sound analysers have started to be widely used in speech sound analysis in detecting voice disorders, speech and audio-signal processing, etc.  Ms Ng Wing Yee (Chief investigator of this study) has recently developed a Cantonese speech sound analyser in order to make speech screening more accessible to parents and teachers in Hong Kong.  The speech sound analyser is a computer algorithm which carries out acoustic analysis of speech sounds. Now this analyser has been developed in Cantonese, we want to assess its application in an English speaking population.

Thus, the primary purpose of this study is to determine:
1) If a test which has been developed to screen children’s speech is accurate enough to be used as a screening tool to identify children with speech sound disorder.
2) How accurate the algorithm which has been developed to analyse speech sounds is when compared to a speech and language therapist.

Data collection is under way. The research team at the Bristol Speech and Language Therapy Research Unit (BSLTRU) are phonetically transcribing the speech of 200 native English speaking children aged 3 to 6 years old. At the end of the data collection, the transcriptions and audio recordings will be sent to the Chinese University of Hong Kong for analysis in order to answer the research questions above.

Within this study, there is also a unique opportunity to investigate how intelligibility varies in children with typically developing and impaired speech and how it might be perceived differently by parents and teachers. Intelligibility is often the reason for referral to speech and language therapy services and there is sometimes a mismatch between what parents and teachers consider reason for concern. The ‘Intelligibility in Context Scale’ is a seven-item parent reported measure which has been validated and provides information on how frequently a child is perceived to be understood by a range of communicative partners. In this study, we will also be collecting and comparing data on the Intelligibility in Context Scale when completed by teachers and parents. 

An additional concern with regards to speech development in children today is the anecdotal evidence from teachers that children are starting school with weaker speech and language skills than twenty years ago, and that this is having an impact on their developing literacy skills. The data collected in this study will also be compared with that collected in a previous community population study and will enable us to investigate whether this is indeed the case. We will therefore need to explore:

3) How parent report of children’s intelligibility compares to that of teachers’ for children aged 3 years to 6 years, 11 months.
4) How parents and teachers reports of intelligibility correlate with measures of speech production collected during assessment by a speech and language therapist.
5) What patterns of speech production are observed in a sample of children aged 3 years to 6 years, 11 months today and how this compares with the speech of child participants in the Avon Longitudinal Study of Parents and Children (ALSPAC) in the 1990s.

 

 

 

Pregnancy Scans

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Ultrasound scans are very important during your pregnancy and can tell us a lot of information about your baby.  Ultrasound is used to check that your baby is growing and developing as expected.  Having a scan can be very exciting; if everything is OK you get to see your baby!  But it’s not just for fun it is a medical screening test.

Please note"NBT is no longer able to accept cash payments. We continue to accept all bank and credit cards. 

If you have a specific reason why you are unable to pay via a card, then please let the Antenatal Team know at your appointment so that alternative arrangements can be made. 

We apologise for any inconvenience. "

What is an ultrasound scan?

Scans are performed by specially trained staff in ultrasound known as sonographers.  The sonographer usually puts some gel on your tummy and moves a small, hand-held probe (a transducer) over your skin to get views of your baby.  High frequency sound waves are used to transmit images of your baby onto a computer screen.

Why can it be difficult to scan some women with a raised BMI?

The sonographer likes to be able to see all of your baby’s organs and physical structure.  Scanning the unborn baby of a woman with a BMI over 25 can be more difficult as some of the power of the ultrasound waves can be absorbed by the mother’s tummy before they reach the baby. The quality of these images may therefore be poor and so the sonographer has a reduced ability to detect problems and there is a greater chance that an abnormality can be missed.  This means that not all abnormalities may be seen by scanning, especially at the 20 weeks scan.

Additional scans may also be necessary later on in your pregnancy to check your baby’s growth or position as increased fatty tissue can reduce the ability to see that the baby is growing as expected.

We understand that some patients may find it difficult or embarrassing to talk about their weight.  Please be reassured that all health professionals will be sensitive towards you and your own situation.

How is the ultrasound scan done?

The first scan is usually best performed with a comfortably full bladder but the anomaly and any scans afterwards would you’re your bladder to be empty but the sonographer may need to press on your tummy to get the best views of the baby.  Sometimes the sonographer will have to apply a firm pressure in order to improve the quality of the ultrasound beam to be able to visualise our baby clearly.  This may be more so when there is excess tummy fat.  If you find this uncomfortable, let the sonographer know.

The quality of the image produced will also affect the quality of any photos of our baby which you want to purchase.  Therefore please bear this in mind if you choose to purchase any scan photos of your baby.

When can I find out the sex of my baby?

We are unable to tell the baby’s gender at the dating (first) scan.  However, if you wish to know your baby’s sex at the 20 week scan please ask the sonographer at the start of this scan.  Please note that the sex of your baby is not always correctly identified and is not  guaranteed, therefore is not recorded or written down.

Can I bring someone into the scanning room with me?

The sonographer will need to concentrate on your baby during the scan.  Therefore we advise that you do not bring more than one person with you or your children to this scan. Your scan is an important medical examination and it is essential that our sonographers are allowed to concentrate fully without the distraction of filming or noise within the room.  The use of mobile phone cameras, videos and other photographic equipment is not allowed during your ultrasound scan.  Thank you for your co-operation and understanding.

If there are any complications after the scan what should I do?

The sonographer will inform you at the end of the scan of any problems they may have detected or concerns they may have although they may not be able to explain what this will mean going forward.  If this is the case, you will be given the opportunity to ask any questions and have further follow up by a consultant obstetrician who will discuss any further testing required.

Cell Salvage

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Cell salvage is a method of collecting blood that you may lose during an operation. The blood collected is filtered and washed to remove contaminants. If needed, it can be given back to you through a small tube into a vein. Your blood will only ever be given to you and cannot be used for someone else.

Cell salvage is a technique that is well established in many types of surgery and is used regularly at Southmead Hospital.

Why might I need a blood transfusion?

It is normal when having a caesarean section, to lose some blood during the procedure. Most of the time, the blood lost can be replaced with other fluids. Your body will make new red blood cells over the next few weeks.

However, it may be necessary to replace the blood by giving a blood transfusion. Blood used for these transfusions can be:

  • A supply of donor blood from volunteers
  • Your own blood using the cell salvage method
  • Both donor blood and your own blood

What are the benefits of cell salvage?

The use of cell salvage can reduce the need for a blood transfusion of donor blood.

Although risks associated with receiving a blood transfusion from a donor are low, there are still very small risks of infection being passed on. Having your own blood returned to you removes these risks and may decrease your length of hospital stay.

Donor blood is stored before transfusion and this can affects its properties: for instance, stored blood does not carry oxygen as well. Having your own blood returned to you straight away eliminates these problems.

The cell salvage technique is sometimes seen as an acceptable alternative for those who will not accept a transfusion using donated blood as cell salvage is a continuous circuit.

What are the risks of cell salvage and how can they be prevented?

1. Amniotic Fluid Embolism

There is a theoretical risk that the fluid that surrounds the baby, amniotic fluid, could be returned to the mother. This could potentially cause a condition called amniotic fluid embolism that can cause harm through an allergic reaction.

However, the washing and filtering mechanisms of the machine are very effective in removing amniotic fluid. Cell salvage has been used in caesarean section for many years and there is no evidence of this happening.

2. Antibody formation

There is a risk that the baby’s blood can get into your bloodstream. This may cause antibodies to develop that can harm the baby in future pregnancies. The most common blood group where this happens is if you are RhD negative and your baby is RhD positive.

There is always risk of mixing mother and baby’s blood during a caesarean section or delivery, even when cell salvage is not used. Therefore, to prevent antibodies forming, all mothers who have Rhesus negative blood group have a blood test after the operation. A drug called Anti-D Immunoglobulin is given to mothers whose baby has Rhesus positive blood group to prevent problems in future pregnancies. This is given irrespective of whether cell salvage has been used and can be given up to 72 hours after the operation.

What does this mean for you?

This information will help you make an informed decision on receiving your own blood back (cell salvage) during surgery. If you have any questions about cell salvage, which are not answered by the leaflet, please discuss them with your Anaesthetist.

Further information

For further information about cell salvage visit: www.transfusionguidelines.org

The use of cell salvage in caesarean sections has been endorsed by: 

  • National Institute for Health and Clinical Excellence (NICE)
  • Confidential Enquiry into Maternal and Child Health (CEMACH)
  • Obstetric Anaesthetists Association (OAA)
  • Association of Anaesthetists of Great Britain and Ireland (AAGBI)

Pain Management Who we are

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Pain Management Who we are 

Pain has an impact on many areas of life including how you move, what you do, your finances, your mood and sleep, your relationships, and your thought processes. 

These areas of life also have an impact on how people manage their pain. This is why the pain management service has different specialists working together to look at the impact of your pain. 

Psychologists

Pain can have a significant effect on the way you think, feel, connect to others, and sleep. It can affect your self-esteem and confidence, and make you feel stuck.

Some patients worry that psychologists might think pain is “all in the mind.” We know that your pain is real, the longer pain goes on, the more areas of your life it can affect. 

Our priority as psychologists is to help you:

  • Understand the impact of your pain.
  • Make meaningful changes to manage pain.
  • Improve your quality of life.

Psychologists

  • Hazel O’Dowd (Head of Department)
  • Julia Cordey
  • Kelly Paull
  • Lindsey Hume
  • Nicholas Ambler
  • Oonagh Koppel
  • Sebastian Eisenberg
  • Vicky Williams

Physiotherapists

We specialise in supporting people with long term, persistent pain. We may work differently to physiotherapists you have worked with before. Pain can make it harder to move, and over time this may make the pain worse. 

As pain management physiotherapists, we focus on the whole person looking at ways to improvement and activity based on your goals. By helping people get stronger and manage their symptoms, this can help lower stress and give you more control of your life.

Physiotherapists

  • Crispin Barker
  • Hazel Stevens
  • Irene Campagnolo Maschio
  • Melanie Berry 

Occupational therapists

Occupational therapy helps you do the things you need and want to, at home or anywhere else. 
An occupation is any activity you do to take care of yourself like washing or eating, to be productive like working or studying, or fun like hobbies and socialising. Occupations give life purpose and connect us to others.
When pain makes it hard to do these things, occupational therapy can help you adjust to have the best quality of life.  

Occupational therapists

  • Caroline King
  • Leanne Nabosi

Patient volunteers

We are lucky to have help from past patients who know what it is like to live with pain. They help in many ways:

  • Volunteers help run our self-management programmes with one of the team. They also give advice and support to new patients, and share their experiences.
  • Volunteers join meetings to help plan our future services, review our paperwork, and help with how we run our groups. 

© North Bristol NHS Trust. This edition published May 2025. Review due May 2028. NBT003600.