The South West Neuromuscular Operational Delivery Network (SWNODN) team deliver paediatric and adult neuromuscular outpatient clinics across the South West. They also run a number of transition clinics to streamline the transfer from paediatric to adult clinics. The clinics are run by a SWNODN Consultant Neurologist, or Consultant Paediatric Neurologist, who are supported by a Specialist Neuromuscular Advisor and a Specialist Physiotherapist.  A Specialist Clinical Psychologist is available in the adult service. 

As many neuromuscular conditions can affect other organs in the body, the SWNODN Consultants also attend a number of joint specialty clinics across the region where they work in collaboration with other consultants who may specialise in cardiology, respiratory, genetics, for example.  This is to ensure patients get the best quality care in the most convenient location possible, with the correct specialists.

Paediatric Clinics

Dr Anirban Majumdar and Dr Archana Murugan, both Consultant Paediatric Neurologists with the Network, run a weekly paediatric neuromuscular clinic in the Bristol Royal Hospital for Children.  They also attend other hospitals around the region to either run, or work with a local Paediatrician, to deliver neuromuscular clinics.   

The SWNODN Neuromuscular Advisors and Paediatric Neuromuscular Physiotherapists often attend other outpatient clinics run by Paediatricians who have professional links with the Network. 

Transition Clinics

Transition clinics form part of the pathway of care between paediatric and adult neurology services. Their purpose is to streamline the process of transferring between the services and support the young adult and their family. The transition clinics are held across the South West.  They are attended by the paediatric and adult Consultant Neurologists, the paediatric and adult Neuromuscular Physiotherapists, a Specialist Clinical Psychologist and a Neuromuscular Advisor.

Adult Clinics

Dr Andria Merrison runs a weekly clinic at Southmead Hospital Bristol and delivers an outreach neuromuscular clinic in Gloucestershire.  Dr Clare Wood-Allum runs clinics at Southmead Hospital Bristol one to two times per month and runs regular clinics in Mount Gould Hospital in Plymouth and Royal Cornwall Hospital in Truro.  Both consultants attend joint clinics with consultants who may specialise in cardiology, respiratory and genetics.

Joint Specialty Clinics

The Paediatric and Adult Neurologists all attend clinics where patients can be seen with other doctors who specialise in different areas of medicine, for example, Cardiologists, Respiratory Consultants or Geneticists. This provides a holistic approach to medical care as well as reducing the amount of clinics that patients may have to attend to get this specialist advice in one place. You may also see the Specialist Physiotherapist and Neuromuscular Advisor in these clinics.

We want to support all families to make an informed choice regarding their care, we encourage you to engage with the maternity team and work towards building up a sound relationship in partnership together so that you feel fully supported in your wishes for labour and birth, but also have the support of a healthcare professional in attendance wherever your birth may be. This is to ensure that you and your baby remain safe and well.

If you are considering a Freebirth, whilst we support all women in their informed choices for birth and it is within your rights to do so, we would strongly advise against this. If you are considering a Freebirth, please contact the Birth Choices team via email birthchoices@nbt.nhs.uk

For more information visit www.birthrights.org.uk

If you are referred to the Fetal Medicine Unit for a specialist opinion, information and possibly for further tests please read the following.

Who are we?

We are a small team of Doctors and Midwives who specialise in Fetal Medicine (problems found in the baby before birth). We will try to answer all your questions. Please ask a member of staff to explain anything you do not understand or to discuss anything that happened during your visit(s).

What to expect?

The Fetal Medicine specialist may carry out a detailed ultrasound scan in order to examine the baby. They will then discuss the findings with you and what this may mean.

It is recommended that your partner, a relative or close friend accompany you to provide support. Where possible please do not bring children with you to the appointment. This is recommended so that you can concentrate on what is happening at the appointment.

Please bring your maternity hand held notes with you to your appointment.

How long will my appointment take?

We aim to see you as soon as possible and within 3 working days of a concern being raised. However, there are some instances where we will arrange to see you later than this. This may be dependent upon the reason for the referral. Sometimes it is helpful to have a longer period of time between the scans to assist with interpretation of the scan findings. Some people are also referred to us early in the pregnancy and it is too early for you to be seen. A member of staff will advise you about when you can expect to be contacted / seen.

On occasion we will be asked to see emergency cases within 24 hours of the referral. This can mean re-prioritising our appointment times on a daily basis, although we try to avoid this.

Appointments take variable lengths of time. We try to tailor our counselling and length of visit according to individual needs.

We appreciate that this is a stressful time for you and your family, but sometimes the time of your consultation may be delayed leading to longer waiting times on the day and some consultations may take longer than we anticipated. We apologise for this in advance. Be assured that this does not mean your consultation will be made shorter.

Sometimes it is necessary to refer you to other Hospitals for further assessment or tests.

Who will be present during my scan?

As we are a major teaching hospital there may be several people present during your consultation. These include the Fetal Medicine Specialist, Senior Doctors who are training in fetal medicine, the Midwife who is co-ordinating the clinic that day and occasionally a Student Doctor or Midwife.

Please let us know if you would rather not have extra people present.

What will happen during my visit?

The aim is to provide as much information as possible for you and the professionals involved in your care to plan the ongoing management of your pregnancy.

Specialist tests may be offered as appropriate, with information and full explanation of the risks and benefits given so that you can decide whether you wish to have further tests or not. 

We will arrange with you when and how any further tests will be undertaken and how you will receive any results.

Scan Photography

We electronically store images to aid diagnosis, discuss with other specialists involved in your case and for audit purposes.

As far as possible personal details are restricted to maintain privacy and all images are kept on the fetal medicine unit database.

We are not able to record the scan on DVD for your own personal use but we may be able to provide scan pictures.

National Congenital Abnormality & Rare Diseases Registration Service (NCARDRS)

This department contributes information to NCARDRS (previously the South West Abnormality Register).

This register is

• To increase our understanding of congenital anomalies and help research into their causes, treatment and prevention.
• To look at trends - for example changes in the number of babies born with congenital anomalies, or changes in the pattern of where they are born. Any problems can be investigated.
• To give health professionals information to help them advise families about their chances of having a baby with a congenital anomaly.
• To help plan and develop NHS services.
• To monitor how good antenatal screening tests (blood tests and ultrasound scans) are at picking-up problems.

The NCARDRS leaflet is available to offer further information about this service visit gov.uk.

Location

The Fetal Medicine Unit is located in the Women & Children’s Quarter: 

Southmead Hospital
Cotswold Clinic / Fetal Medicine Unit
Monks Park Way
Bristol
BS10 5NB

Telephone:  0117 4146928    Hours: 9am - 4pm 

Parking is limited so please allow time to find a space. There are pay and display car parks located within the hospital.

Useful Contacts

Antenatal Results & Choices (ARC)

ARC offers non-directive information and support to parents before, during and after antenatal screening; when they are told their baby has an anomaly; when they are making difficult decisions about continuing with or ending a pregnancy, and when they are coping with complex and painful issues after making a decision, including bereavement. For more information for parents please visit the ARC website.

The helpline is answered by trained staff Monday to Friday, 10.00am-5.30pm.

Call 0845 077 2290 or 0207 713 7486 from a mobile.

ARC, 345 City Road, London, EC1V 1LR

Admin telephone: 020 7713 7356

Email telephone: info@arc-uk.org

Meeting an anaesthetist during your pregnancy and delivery

An anaesthetist is a fully qualified doctor with specialist training who you may meet at various points throughout your pregnancy and birth.

At the Antenatal clinic

You may be asked to come to the antenatal clinic to be reviewed by an anaesthetist if you have certain medial conditions which might make giving you an anaesthetic or pain relief more difficult. If so, you will meet a senior anaesthetist who will make a plan with you for your anaesthetic care during your birth. This will be documented in your maternity yellow notes.

You are also welcome to request an anaesthetic review if you have concerns regarding pain relief or anaesthesia that are not able to be answered by your midwife.

On the Delivery Suite

An anaesthetist is present on the delivery suite 24 hours a day. You will meet the anaesthetist if you would like an epidural for pain relief, who will discuss this in detail with you. [see also Pain Relief in Labour section].

Caesarean or assisted birth

If you require a caesarean birth or assisted birth (forceps or ventouse) in the operating theatre or another procedure in theatre you will be cared for by the anaesthetist.

The majority of women who need a procedure in theatre can have this done with a spinal or epidural anaesthetic which requires an injection in the back but allows you to remain awake.

Only occasionally is a general anaesthetic required. Before any procedure you will meet with the anaesthetist and discuss the planned anaesthetic.

On the Postnatal ward

If you have had any anaesthetic procedure then an anaesthetist will visit you on the postnatal ward the following day to ensure you have recovered from your anaesthetic. This may not be possible if you have an early discharge but the midwives will make sure there are no anaesthetic concerns before you go home. If you have any concerns after going home an anaesthetist can be contacted 24hrs a day via the Central Delivery Suite.

Acute illness

Anaesthetists may be involved in your care if you become unwell during your pregnancy or birth, for example with severe infection or bleeding. The anaesthetist is part of the team that will help look after you if this unlikely problem occurs.

GMC Number: 6073334

First year of qualification: 2003, Edinburgh

Specialty: Anaesthesia

Clinical interests: Anaesthesia

Secretaries: Anaesthetic secretaries

Telephone: 0117 414 5114

GMC Number: 6120470 

Year & location of first qualification: MBChB Edinburgh 2005

Specialty: Gastroenterology & Endoscopy

Clinical interests: Endoscopy & Endoscopy Training

Secretary: Debra Heath

Telephone number: 0117 414 6351

GMC number: 7014867

Year of first qualification: 2008, Cardiff University

Specialty: Emergency Medicine

Clinical interests: Clinical governance lead, silver trauma, simulation

Secretary: Tina Allen

Telephone number: 0117 414 7470

GMC Number: 7015000

Specialty: Breast Radiology

Planning an NBT sponsored study will require you to follow a comprehensive set-up process before your research can commence.

To assist you, the following is a step-by-step guide which details all the tasks you will need to action. If you have any queries or concerns about these steps, please get in touch with us via researchsponsor@nbt.nhs.uk.

Apply for confirmation that NBT can sponsor the study

Sponsorship assessment

Develop your protocol and other supporting documentation

Complete the Statement of Activities and Schedule of Events

Obtain draft contract from R&I

Apply to have the study included on the NIHR CRN portfolio

Invite sites to take part

Request sponsor sign-off of regulatory applications

Sponsor sign-off of regulatory applications

Submit your application to the relevant regulatory bodies for approval

Obtain regulatory approvals

Commence arrangements for sites to deliver the research

Negotiate/agree with sites the content of the statement of activities and/or clinical trial agreement

Obtain confirmation from sites that they have the capacity and capability to deliver the research

Interventional Studies Only: Collate information for green light approval

Interventional Studies Only: Issue green light approval

In our general neuropsychiatry service we provide psychiatric assessment for mental health problems associated with neurological disease.

We accept referrals from GP’s, and secondary clinicians such as neurologists and psychiatrists. We will consider any appropriate referral that meets our basic criteria and requires a tertiary service.

How to refer

We do not operate an emergency service for acutely unwell or at-risk patients.

Examples of the kinds of problems we can offer assessment and support for include psychiatric aspects of:

• Parkinson’s Disease
• Epilepsy
• Multiple sclerosis
• Young onset dementia
• Tourette’s Syndrome
• Neurodevelopmental disorders

Our service consists of an outpatient clinic staffed by psychiatrists. We also operate an inpatient service with a multidisciplinary team that includes medical and psychiatric nurse therapists, along with occupational therapists, physiotherapists and psychological therapists. We can offer elective (planned) admissions for assessment and treatment. We occasionally offer joint admissions under neurology and psychiatry where complex cases require an interdisciplinary assessment.