COVID-19 ReMap CAP Study

Regular Off Off

The purpose of the ReMap CAP study is to compare a combination of antibiotics for patients who have been admitted to ICU. This is in order to determine which combination is the best at improving survival and recovery for patients with pneumonia.

ReMap CAP is part of the international effort to fight COVID-19, currently running in 13 countries worldwide. In the UK specifically, over 30,000 people are taking part in a range of NIHR-supported COVID-19 research studies, including ReMap CAP.

Dr Matt Thomas talks about the ReMap CAP study at North Bristol NHS Trust:

Video Transcript

Hello, Matt Thomas is my name and I'm a Consultant in Intensive Care here at Southmead Hospital, and I'm the Principal Investigator for the ReMap CAP study, which is currently recruiting patients in the Intensive Care Unit.

ReMap CAP is a really exciting study that's now running in 13 countries worldwide, from North America, through Europe, down into Australia and New Zealand. And the reason it's exciting for us is the trial design is very new. It's called an adaptive trial and that means that we can test multiple different interventions simultaneously, and retain a lot of flexibility about the interventions that are available for patients here at Southmead, and those that they might be able to benefit from.

So the study is designed so that the interventions that look beneficial are selected out and patients have a greater chance of receiving them, and interventions that are maybe not so beneficial tend to be lost from the study early.

So we have a number running here. We have antiviral interventions, we have those that modify the immune system, we have anticoagulation and we have steroids. And one that is coming in the UK, but we are not participating in, is the immunoglobulin domain.

So as of today we have ten patients recruited and I think that's a reflection of the very hard work that the COVID research team are doing, communicating with patients and their families to make sure we get as many patients recruited as possible to this important work.

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

R&I ReMap CAP.png

Mindfulness 4

Regular On Off

This page contains all of the course materials you need to support you once you have attended Session Four of the North Bristol NHS Trust Mindfulness course.

Course materials

Session 4 recordings to practice at home:

This week we suggest you continue alternating what you do each day: aim to do a movement practice of your choice (see week 3) one day and the “sitting” breath awareness practice the other.  Remember you can do this in sitting, lying or standing. It can be worth experimenting with how you do it.

25 minute “Sitting” practice – can be done in lying or standing as well as sitting:

https://soundcloud.com/fiona-mckechnie108681984/sitting-practice-25-mins/s-DgF59SMNVHe

We suggest you also practice a 3 step pause or breathing space, regularly and also when you feel you need it:

https://soundcloud.com/fiona-mckechnie108681984/3-minute-pause/s-T9yMnZ8Cq2d

You can click on the links below to download the written materials which support the course. We have made each handout available as a Word document or a pdf. The Word document is likely to be more useful if you want to write comments on your own handout and store them on your own computer.

 

Session 4 workbook 2020.pdf Session 4 workbook 2020.docx Session 4 handout 2020.pdf Session 4 handout 2020.docx

Mindfulness 3

Regular On Off

This page contains all of the course materials you need to support you once you have attended Session Three of the North Bristol NHS Trust Mindfulness course.

Course materials

Session 3 recordings to practice at home:

A typical mindfulness course yoga-based movement practice. Do listen to this and make sure you are happy with it before going ahead: https://soundcloud.com/mindful-health/sets/mindful-yoga-with-taravajara

Fiona has made a lying sequence that is less strenuous: 

Mindful walking can also be an option: https://www.bangor.ac.uk/mindfulness/audio/cd1/04Track04.mp3

There is also a video Pete has made to guide you through some mindful movements:

Workbooks and handouts

You can click on the links to download the written materials which support the course. We have made each one available as a Word document or a pdf as we know that some people prefer one or another. The Word document is likely to be more useful if you want to write comments on your own copy and store them on your own computer.

Workbooks outline the practice and other activities for the week and have the option of recording and reflecting on what you are learning (you will need to use this one).

Handouts explain more about the background theory (this one is optional).

 

 

Mindfulness
Session 3 workbook 2020.pdf Session 3 workbook 2020.docx Session 3 handout 2020.pdf Session 3 handout 2020.docx

Mindfulness 2

Regular On Off

This page contains all of the course materials you need to support you once you have attended Session Two of the North Bristol NHS Trust Mindfulness course. Each week of the course has it's own page where  you will find the specific practice recordings for that week plus some additional written and sometimes video information.

Course materials

Session 2 recordings to practice at home:

15 minute body scan: https://soundcloud.com/fiona-mckechnie108681984/15-min-body-scan-fiona-wright/s-OcfX3

30 minute body scan: https://soundcloud.com/fiona-mckechnie108681984/half-hour-body-scan-fiona-wright/s-1NJPz

Landing/anchoring 10 minutes: https://soundcloud.com/fiona-mckechnie108681984/arrivallanding-practice-10-mins/s-hW1hz8wClD4
 

Workbooks and handouts

You can click on the links to download the written materials which support the course. We have made each one available as a Word document or a pdf as we know that some people prefer one or another. The Word document is likely to be more useful if you want to write comments on your own copy and store them on your own computer.

Workbooks outline the practice and other activities for the week and have the option of recording and reflecting on what you are learning (you will need to use this one).

Handouts explain more about the background theory (this one is optional).

Mindfulness
Session 2 workbook 2020.pdf Session 2 workbook 2020.docx Session 2 handout 2020.pdf Session 2 handout 2020.docx

Repeat Samples & Limitations of Testing

Regular Off Off

Updated on 20/10/21

Key factors which are known to affect performance of the screening tests.

Working in conjunction with midwives and other health professionals we aim to reduce the number of 'avoidable repeats' as far as possible. Patient safety is our utmost concern, and if we request a repeat sample, it is to ensure we get the correct result, on the right baby, so each baby who has one of the diseases we screen for, can access appropriate treatment in a timely manner.

Avoidable repeats: Key factors known to affect performance of the screening tests.

1. Problems arising before sample collection:

  • Baby too young (e.g. day 4)
  • Expired card
  • Details missing or inaccurate:
    • No NHS number / Date of birth / Date of sample

TIP: Ask the parents to check the card (if necessary make amendments to the label and/or card).

 

2. Problems arising during sample collection:

  • Insufficient - blood spots too small
  • Insufficient - Inappropriate application of blood e.g. not soaked through, applied both sides or multi-spotted.
  • Compression of sample
  • Contamination of sample (e.g. with faeces).
 

TIPS:

You can ask for the baby to be held in a different position to make it easier for you to take a good quality sample.
Prick the heel and wait for the blood to flow.

Fill each circle on the card with a single drop of blood - check the blood has soaked through to the back of the card.

Take your time - If the baby is not bleeding it may be necessary to prick the heel again. Do not squeeze.
 

3. Problems arising after sample collection:

  • Sample contamination (e.g. with faeces)
  • Water damage
  • Arrival in laboratory >14 days after collection
  • Analytical problem / Unsatisfactory analysis.
 

TIP: Samples sent by courier arrive in the lab more quickly.

 

Resources

 

Unavoidable repeats

Occasionally, we will contact the midwife and ask for a repeat sample for one of the following reasons. In these cases, the original sample was collected correctly, but the results for one or more of the tests was borderline or inconclusive.

  • Slightly raised TSH result - Repeat should be collected 7 -10 days after the initial sample.
  • Inconclusive CF screen - Repeat should be collected between 21 - 24 days of age.
 

Other factors known to affect the reliability of the screening tests

  • Thalassaemia trait is not excluded.
  • The Sickle Cell Screen is only valid if baby not transfused.
  • IRT is not always abnormal in CF patients with meconium ileus; therefore the screening result may be falsely normal.
  • IRT is an unreliable indicator of CF in babies >8 weeks of age. Therefore the test will not be performed in samples collected in this age group.
  • Some babies with MCADD, MSUD or IVA may become symptomatic in the first few days of life, before the screening test has been carried out. In this case the clinician looking after the baby should send clinical samples to their usual diagnostic laboratory. 
  • CHT screening tests for raised TSH only; therefore if hypothyroidism occurs secondary to pituitary disease, the screening result may be falsely normal.
  • Newborn bloodspot screening is only offered to babies up to 1 year of age. In older babies, other tests are available to doctors through clinical pathways for babies/children with suggestive symptoms.

This list is not exhaustive and it is important to remember that these tests are screening tests; no screening test is 100% reliable. Further information about the limitations of newborn screening tests can be found in the following laboratory handbooks:

 

Updated 23/04/2020

Contact Newborn Screening

Newborn Screening Laboratory (Bristol)
PO Box 407
Bristol
BS9 0EA

Email: newbornscreening@nbt.nhs.uk
Telephone: 0117 414 8412
 

Opening times: 9am - 5pm Monday - Friday excluding bank holidays.

Clinical advice & interpretation is available during working hours.

Access the NHS Blood Spot Screening Programme Centre

Repeat Samples & Limitations of Testing

Introduction to Pain Management

Regular On Off

We normally invite patients to attend the Introduction to Pain Management Meeting at Southmead or Cossham hospital. This would be a group meeting,  to provide you with enough information to make an informed choice about how to proceed with your Pain Management referral.


We are currently unable to offer groups because of the Covid-19 restrictions, so we have made this presentation available online. We would encourage you to listen to this in your own time and then contact us if you wish to proceed with your Pain Management referral by email or phone:


Email: painmanagementcentre@nbt.nhs.uk
Telephone: 0117 4147357


We will then be able to offer you an assessment appointment, at a mutually convenient time. At present, because of the Covid-19 restrictions we are offering telephone assessments.

Pain management information video 

 

Contact Pain Management Service

For all appointment enquiries, please contact:

Pain Management
Gloucester House
Southmead Hospital
Telephone: 0117 414 7357
email: painmanagementcentre@nbt.nhs.uk

Please note that we are not a crisis service and we may not be able to answer your call but you are more than welcome to leave us a voice message and we will get back to you within 2-3 working days. 

If you need urgent medical support or advice you will need to contact your GP, or phone 111 or 999

If you feel you need emotional support urgently, please contact your GP, or phone 111.

If you wish to speak to to the Pain Clinic, please visit the Pain Clinic page

Pain Management

Mindfulness 1

Regular On Off

This page contains all of the course materials you need to support you once you have attended Session One of the North Bristol NHS Trust Mindfulness course. Each week of the course has it's own page where  you will find the specific practice recordings for that week plus some additional written and sometimes video information. This course has been adapted for people who are living with fatigue and pain, and we are grateful for the time and care which our patients have offered to improve this course.

Course materials

Session 1 recordings to practice at home:

15 minute body scan: https://soundcloud.com/fiona-mckechnie108681984/15-min-body-scan-fiona-wright/s-OcfX3

30 minute body scan: https://soundcloud.com/fiona-mckechnie108681984/half-hour-body-scan-fiona-wright/s-1NJPz

Workbooks and handouts

You can click on the links to download the written materials which support the course. We have made each one available as a Word document or a pdf as we know that some people prefer one or another. The Word document is likely to be more useful if you want to write comments on your own copy and store them on your own computer.

Workbooks outline the practice and other activities for the week and have the option of recording and reflecting on what you are learning (you will need to use this one).

Handouts explain more about the background theory (this one is optional).

Mindfulness
Session 1 workbook 2020.pdf Session 1 workbook 2020.docx Session 1 handout 2020.pdf Session 1 handout 2020.docx

Pain Management: Helpful resources

Regular Off Off

Pain Management: Helpful resources

We have added several resources in sections below. Just click on each section and it will open up to show the different resources.

Financial and social care advice

The Pain Management Service recognises the impact that pain can have on people’s ability to work and therefore on their finances.  We cannot advise you directly about finances and accessing benefits as this is a specialised area, but we may be able to support you if you are applying for benefits such as:

Specialist support

We advise you to contact specialist support to find out  which benefits you can apply for. These organisations may be able to give you some help to complete the application forms. Here are some of the places that can offer this support:

  • Citizens Advice Bureau
  • North Bristol Advice Centre
  • Bristol Law Centre
    • Bristol Law Centre provides skilled assessment, triage, and signposting for social welfare legal issues. They may be able to offer free legal advice and casework, depending on capacity, funding, and your circumstances. If they can’t help you, they will always give you information on your options if you live in Bristol and surrounding areas. The Centre can help with housing issues, welfare benefits, discrimination and other disputes at work, mental health tribunals and Court of Protection, immigration and asylum, family disputes and tribunal appeals. 

Employment

The Equality Act aims to prevent employers from discriminating on the grounds of long-term ill health or disability and to make reasonable adjustments to support people in work: What is the Equality Act? | EHRC

Access to Work provides advice to employees and employers, assessing for equipment, environmental adaptations and support.

If you require additional advice with your employer you can contact:

  • The Advisory, Conciliation and Arbitration Service ACAS on 0300 123 1100.
  • Your trade union, if you are a member. 

If you need support in getting  a job, you can find information here: 

Support can also be accessed through the following organisations:

Social care and adaptive equiment

You will need to contact the social services department you live in, which is provided by the council that you pay your council tax to.  There will be a number you can call or a weblink to apply for help.

Other help can be provided by the Red Cross, who are able to offer short-term support Find home care services near you | British Red Cross

Mobility aids and wheelchairs

We can offer advice about the potential benefits of mobility aids. Please ask your clinician if you would like to discuss this. The NHS web pages about mobility aids are a helpful guide: Walking aids, wheelchairs and mobility scooters - Social care and support guide - NHS

If you want a short-term wheelchair loan, the Red Cross offer a rental or hire service.  Rent or hire a wheelchair: Hire a wheelchair | Easy and affordable | British Red Cross

To access an NHS wheelchair for regular use please ask your GP for a referral.

You could also search the Internet for mobility centres as there are a number in the area, for example:

Mindfulness-based approaches

Mindfulness based or informed approaches have become well known in managing pain and other symptoms.

“Mindfulness means  ‘awareness’, yet surely when any of us are suffering from searing physical pain… we seem to be too aware of our suffering .

How on earth can learning to become even more aware possibly help?” (This quite is from Mark Williams' foreword to Mindfulness for Health by Vidyamala Burch and Danny Penman).

The awareness we work on in mindfulness is about seeing the yourself as having the  resources you need to manage your health. Mindfulness supports you to recognise and develop these resources.

There are some links below to more information and practices you may wish to try. Please be aware that the increased awareness developed by these practices is not always easy and most people need support to use them to gain the most benefit.  The Pain Management Service can support you in learning mindfulness as part of your self-management. 

The Frantic World the website of the finding peace and living well with health and illness: 

Some free mindfulness downloads:

Other useful resources

This is a 20 minute video by leading pain scientist Professor Lorimer Moseley explaining the science behind persistent pain: Professor Lorimer Mosely, The Pain Revolution, April 2017

Fibromyalgia

This is the NHS website with information about fibromyalgia: Fibromyalgia - NHS
 

© North Bristol NHS Trust. This edition published May 2025. Review due May 2028. NBT003769.

Foundation Phase Online Course

Regular Off Off

We normally offer patients the opportunity to take part in a pair of meetings called the “Foundation Phase” seminars. This short course has a number of aims, including:

• clarifying the symptoms of ME/CFS
• exploring in depth some of the key ME/CFS self-management areas
• sharing coping strategies between patients coming to the seminars
• finding ways of reducing the impact of the condition

The seminars have been developed with a lot of patient involvement and feedback, and each seminar we run involves sharing knowledge and experience which patients have already developed.

We had to stop offering these seminars in March 2020 to reduce the risk of Covid-19 infection, so we have put together this short online course, so that people can still access the ideas from the Foundation Phase seminars.

The first seminar is split into two parts. The first part clarifies the symptoms, consequences and triggers. The second part looks at activity management, particularly as a way of managing post-exertional malaise.

The second seminar is split into two parts as well. The first part is a short introduction to the impact of stress and the role of stress management. The second part is longer and focusses on sleep management.

We have made the workbooks which support these seminars available as a written guide, which you can choose to read by selecting the "Foundation Phase written guide" from the left hand menu. There is also an example of an activity diary available, and some guidance about completing an activity diary, which you can read by choosing the "Bristol M.E. Service: Activity, Rest and Sleep Diary" from the left hand menu.

Foundation session 1 part 1 

Foundation session 1 part 2 

Foundation session 2 part 1 

Foundation session 2 part 2 

 

 

Foundation Phase Online Course

What should I do if I take an SGLT2-inhibitor - Forxiga (dapagliflozin), Invokana (canagliflozin), Jardiance (empagliflozin), Steglatro (ertugliflozin)?

Regular Off Off

Canagliflozin, Dapagliflozin, Empagliflozin and Ertugliflozin are from a class of medication called sodium-glucose co-transporter 2 (SGLT2) inhibitors. Most people taking these medications will have type 2 diabetes but some may have type 1 diabetes. People taking these medications are at increased risk of Diabetic Ketoacidosis (DKA). This could happen even with normal blood glucose levels. DKA is rare in people with type 2 diabetes but it is a serious condition and could be life-threatening.

If you are taking any of these medications and feeling unwell we suggest you stop them till you are feeling better. It is important to keep well hydrated.

If you have symptoms suggestive of DKA (for example, excessive thirst, dehydration, vomiting, fast breathing, feeling drowsy, abdominal pains) we suggest that you stop taking these tablets, keep well hydrated, and follow the advice below: