Hospital at Home provides acute healthcare to patients in the comfort of their own home.

The service is delivered by our team of specially trained nurses who visit each patient in their home to deliver the care they need.

The Hospital at Home team work closely with each patient and their team of doctors and consultants to develop a personalised care plan that can be delivered at home. The team will schedule regular visits, daily or more frequently, dependent on individual need, to deliver the treatment and care required. Patients will also have access to advice and support outside of their visits.  

Whilst receiving treatment as part of the Hospital at Home service patients remain under the care of their hospital consultant, and are only discharged from us once they have completed their treatment programme.

Why feedback is important

We are passionate about listening to the feedback we receive from our patients and carers. It is vital to improving and guiding our services and helps maintain caring, exceptional and safe care.

The importance of feedback is not what is collected but what is done with it.

We respond to your feedback by listening to you, and then communicating with management, as well as clinical and non-clinical staff. We make changes, praise staff and investigate where we need to. This page is where we tell you what changes we have made in response to your feedback.

Doctors

Dr Robert Przemioslo
Dr Melanie Lockett
Dr Ana Terlevich
Dr Zeino Zeino
Dr Leonard Griffiths
Dr Sam Murray
Dr Ankur Srivastava
Dr James Maurice
Dr Vipin Gupta
Dr Susanna Meade
Dr Kathryn Wright

Physician Associate

Rebecca Noller

Nurse specialists

Inflammatory Bowel Disease

Debbie Corris
Rebecca Antliff
Wendy Parry
Anna Serwicka

Liver

Katharine Caddick 
Lisa Lillywhite  
Erika Angeletti 

Alcohol Team

Sally Quigley 
Tracy Rogers 
Sandra Westwell  
Ryan Quinn 
Sarah Smyth - Peer Support Volunteer 
Paul Adams - Transplant Peer Support Volunteer 

Specialist Pharmacist 

Carla Leung

Dieticians

Bridie Watson

Management Team

Graham Bartlett - General Manager 
Abigail Warren - Specialty Manager 
Megan Smith - Support Manager 

Administrative team

We have five secretaries who work directly for two consultants each and a team of five administrative support staff.

8A Ward Sister

Kate Mann 

Clinical Matron

Emma Gilchrist

Inpatient services 

If you attend hospital and are diagnosed with a gastrointestinal or liver condition, you may need to stay in ward 8A, which is where our specialist unit is located, in the Brunel Building, Green Tower, level 4. 

The ward is supported by a consultant and a team of 2-3 doctors, a registrar, and a physician associate. 

The Nursing Team is led by Sister Kate Mann. 

Visiting times are 11:00-19:00. Any other times outside these hours and you will need to speak to the Ward Manager. 

Ward phone Numbers: 0117 414 2155 and 0117 414 2156. 

 © North Bristol NHS Trust. This edition published April 2025. Review due April 2028. NBT003608. 

Gastroenterology and Liver Medicine (Hepatology) Outpatients

You might be invited to visit the department in these situations: 

• You have spoken to your GP, and they think you need to see a gastroenterologist.
• You have seen another hospital team, who believes you need further tests by a gastroenterologist.
• You have left hospital where you were diagnosed with a gastrointestinal condition. 

We have gastroenterology clinics led by consultants every Monday, Tuesday, Wednesday, and Friday. Some of the conditions we treat are: 

• Obscure stomach or bowel bleeding.
• Malabsorption.
• Inflammatory bowel disease (IBD).
• Chronic diarrhoea.
• Coeliac disease that has not responded to a gluten-free diet. 

There are special IBD nurse clinics on Monday, Tuesday (at Cossham hospital), Wednesday, Thursday and Friday.  

We also have special dietitian clinics every Monday, Tuesday, Wednesday, Thursday, and Friday.  

Your doctor, nurse, or GP can refer you to these clinics. 

Contact information

If you are known to have a form of IBD and are also under the Gastroenterology team at North Bristol Trust, you can contact the IBD specialist nurses for advice: ibdnurses@nbt.nhs.uk or 0117 414 6354 

North Bristol Liver Unit 

You might be invited to visit the liver unit if: 

• Your GP thinks you need to see a liver specialist.
• Another hospital team thinks you need more tests by a liver specialist.
• You've been diagnosed with a liver condition after leaving the hospital. 

Our liver clinic runs every Thursday and you may see different doctors from the team. You may also see liver nurses, alcohol specialists, a dietitian who specialises in liver care, and a technician who performs a test called a fibroscan. 

We work closely with the liver transplant team at King’s College Hospital in London. Every three months, we have a joint liver transplant clinic at Southmead Hospital with doctors from King’s College. 

We also have liver nurse clinics on Tuesdays, Wednesdays, Thursdays, and Fridays for patients with viral hepatitis or cirrhosis (scarring of the liver). 

If your liver disease is related to alcohol use, there is a clinic on Mondays for this. You might be referred by your doctor, nurse, or GP. This clinic is run by an alcohol specialist team and may include a fibroscan. 

Contact information

If you are already a patient at the liver unit, you can contact the liver nurse specialist for advice by emailing livernurses@nbt.nhs.uk or calling 0117 414 6466. 

Medical Day Unit 

You might be asked to attend this unit by your consultant, specialist nurse, or GP for treatments like  

• Blood transfusions. 
• Iron infusions.
• Paracentesis (a procedure to drain fluid from the abdomen due to liver disease), 
• Intravenous medications for treating IBD (inflammatory bowel disease). 

Once you have been referred, you can contact the unit directly at 0117 414 3200. 

Who do I contact if I have not heard about my appointment? 

Please contact the outpatient booking team in the first instance: 

0300 555 0103 or email OutpatientsContactCentre@nbt.nhs.uk 

© North Bristol NHS Trust. This edition published April 2025. Review due April 2028. NBT003609. 

Facial prosthetics
Prostheses are fabricated specifically for each person to replace facial features with artificial replicas, such as eyes, ears, noses, parts of the mouth and cheek. A prosthesis is an artificial body part made from a rubber silicone and/or acrylic material. They are coloured to best match the skin tone and blend in with the surrounding area.
Prostheses may be attached in a number of ways depending on each person’s health and needs, including via medical adhesives, head-bands, spectacles or implants.

You can see a few examples of facial prosthetics below:

Body prosthetics
Body prostheses are fabricated with aim to restore contour of the body shape, such as following chest, calf, buttock, thigh, nipple and breast tissue loss. These prostheses sit externally between the skin and clothing.

You can see an example of a finger prothesis below:

Burns splints and scar management devices
Splints are fabricated to aid the healing process after burns to help prevent contraction. Similarly, scar splints are fabricated and continually adjusted to aid reducing scar contraction.

Surgical support
Custom splints and stents are fabricated to support a variety of surgical procedures, such as nasal stents to keep the nostril aperture open during healing.

Cranial plates
Custom titanium, acrylic and silicone implants are designed and fabricated to replace bone lost in the skull to restore protection and contour. The implant is the provided to the surgeon for implantation.

Gold eyelid weight assessment and fabrication
A tantalum weight is applied externally to your upper eyelid to assess the appropriate weight required for lid closure. A gold eyelid weight is then manufactured and provided to the surgeon for implantation.

Surgical planning
State of the art 3D technology is used to plan complex reconstructive surgery and design custom implants and surgical guides for additive manufacture (3D printing) in titanium. These guides and implants are used in surgery to aid the surgeon with intricate and complex reconstruction.

Plagiocephaly, brachycephaly and cranial splints
Bespoke splints are fabricated and fitted for suitable paediatric patients referred to us by specialist consultants. Clear helmets are used to help improve aesthetics of paediatric patients with misshapen heads. Helmets may also be used for post-surgical applications.

Reconstructive Prosthetics at North Bristol NHS Trust are an accredited training unit for the Scientific Training Programme (Reconstructive Science) as part of the South West Consortium, in conjunction with Gloucester Royal Hospital, Poole Hospital and Royal Devon and Exeter Hospital.

Reconstructive Prosthetics provides services to help rehabilitate patients following a traumatic event, disease removal or body-part absence from birth, when surgical reconstruction is not possible or favourable. 

We can provide smaller bespoke facial and body prosthetics, burns and scar splints, aid planning surgical procedures with surgeons, as well as manufacture implants (such as cranioplasty plates and gold eyelid weights).  We provide an internal/external device for the surgeon or patient to use, all of which are custom-made specifically for each person.

Usually referred to us by a consultant surgeon, you will receive an appointment from us to discuss your needs. During your initial appointment, we will discuss with you what we can provide, how it may help you and what is involved in the process. 

For prostheses, you may be required to attend several appointments to take impressions, try prototypes made for you in wax, colour match silicone to your skin tone and to fit the final prosthesis.

Other devices may take less time and may only require one or two assessment appointments (such as for gold eyelid weight appointments).

If you are given a prosthesis or device to use, this may require regular follow-up to us for adjustments or renewing for the time that you use it.

Most people have a frenulum under their tongue. This frenulum can sometimes be referred to as a tongue tie if it is tight and restricting the movement of the tongue.

In Bristol about seven - eight % of babies will have a tongue tie divided to help them breastfeed easier.

What are the signs that my baby may have a tongue tie?

• Baby unable to latch onto the breast
• Your baby may latch but then slip off the breast and need to keep reattaching
• Baby may latch and feed well but it is very painful for mother.

Tongue tie may mean that your baby doesn’t remove your milk very well and this can cause problems with:

• Engorgement 
• Mastitis
• Baby losing more than 10% of birthweight
• Baby taking more than 14 days to regain birthweight.

If you think your baby may have a tongue tie please speak to your midwife or health visitor about your concerns. You can also talk to a breastfeeding counsellor at your local support group.  Your midwife or health visitor will assess feeding and then can refer you to the Infant feeding specialist midwife for assessment of tongue function.

Tongue ties are only divided if they are causing problems with breastfeeding. If your baby has a frenulum that is not causing any problems then it will not need to be treated. This is why we don’t examine all babies for tongue tie at birth.

Many women experience tears to some extent during childbirth as the baby stretches the vagina. For some women, the tear may be deeper and involve the muscle at the bottom of their back passage, called the ‘anal sphincter’. This muscle is important in preventing the leakage of gas (‘wind’) or faeces (‘poo’) during normal daily activities. Therefore, it is very important to identify a 3rd or 4th degree tear and repair it properly. If the tear involves only the anal sphincter muscle, it is called a 3rd degree tear. If the tear extends further into the lining of the anus or rectum, it is known as 4th degree tear.

How common are 3rd or 4th degree tears?

Overall, a 3rd or 4th degree tear occurs in about three in 100 women having a vaginal birth. It is slightly more common in women having their first vaginal birth, compared to women who have had a vaginal birth before.

What increases my risk of a 3rd or 4th degree tear?

These types of tears usually happen unexpectedly during birth and most of the time it is not possible to predict when it will happen, however, it is more likely to happen if:

• This is your first vaginal birth
• your baby is born facing upwards
• You have a large baby
• You have a long labour
• You need help with the birth by forceps or ventouse
• You have had a 3rd or 4th degree tear before.

What will happen if I have a 3rd or 4th degree tear?

This will need to be repaired in the operating theatre under an epidural or spinal anaesthetic or very occasionally a general anaesthetic. During the procedure, antibiotics are given to prevent infection and a catheter (tube) is passed into the bladder to allow drainage of urine.

After your repair, it is recommended that you take the following medications:

• Regular pain killers. Do not wait until you are in pain, but take them on regular basis for the first few days and subsequently as you require them
• A course of oral antibiotics for one week to reduce the risk of infection that could lead to break down of the repair
• Laxatives for approximately two weeks to make it easier and more comfortable to open your bowels.

None of the medications will prevent you from breastfeeding your baby, however, if you have any concerns please speak to your midwife.

You will be advised to:

• Wash your hands before as well as after using the toilet
• Wash your perineum after every visit to the toilet, preferably with warm water
• Pat/wipe the area dry with toilet paper. Always wipe, front to back to avoid contamination from your back passage
• Change your sanitary towels regularly, at least every three to four hours
• Avoid standing or sitting for long periods
• Check your perineum for signs of infection. If the area becomes hot, swollen, weepy, smelly, very painful or start to open, or you develop a temperature or start feeling unwell, please let your midwife or GP know
• Begin doing your pelvic floor exercises as soon as you can – this will strengthen the muscles around the vagina and anus, increase the blood supply and help with healing.

You will be offered physiotherapy advice about pelvic floor exercises before going home.

What can I expect to go home?

After having any tear or an episiotomy, it is normal to feel pain or soreness around the tear for two to three weeks after giving birth, particularly when walking or sitting. Passing urine can also cause stinging. Continue to take your painkillers when you go home.

Most of the stitches are dissolvable and the tear should heal within a few weeks, although this can take longer. The stitches can irritate as healing takes place and uou may notice some stitch material fall out, both are normal.

To start with, some women feel that they pass wind more easily or need to rush to the toilet to open their bowels. Most women make a good recovery, particularly if the tear is recognised and repaired at the time. Six to eight in ten women will have no symptoms a year after birth.

When can I have sex?

It is best to resume sex after the stiches have healed and the bleeding has stopped but there is no right or wrong time. For some people, it is within a few weeks but for others it can be when they feel ready.

Follow up

If you had a 3rd degree tear, you will be contacted by one of the gynaecology specialist nurses after three months from having your baby to ask whether you are still having problems such as: uncontrollable leakage of wind, staining of underwear with faeces or uncontrollable leakage of faeces.  If you are having any of these or other problems, you will be referred to the uro-gynaecology clinic, where we see women with problems of the pelvic floor. If you have really troublesome problems, talk to your midwife or GP so that you can be seen sooner than three months.

If you had a 4th degree tear, you will be referred to the uro-gynaecology clinic three months after having your baby. If you have really troublesome problems, talk to your midwife or GP so that you can be seen sooner than three months.

What about having another baby?

There is no reason to suggest having a vaginal birth next time is not possible. You will be able to discuss your options for future birth (vaginal delivery or planned caesarean section) with an obstetrician early in your next pregnancy. Your individual circumstances and preferences will be taken into account. Please book with your midwife early in the next pregnancy, so that you can be referred to be seen in Antenatal clinic by a Consultant Obstetrician to discuss your options for delivery.

Commercial umbilical cord blood collection refers to a service offered by commercial companies to harvest and store stem cells following family requests even though there may be no medical indication.

A significant number of private companies are now heavily marketing their cord blood services through GP surgeries, antenatal clinics and direct contact with the public. There is a cost and requires a third person to collect umbilical cord blood in the third stage of labour in the provided container. This is then sent to the company for the harvesting and storage of stem cells.

The major clinical use of cord blood has been for life threatening conditions such as cancers of the blood. Cord blood contains the stem cells which are responsible for producing all the blood cells in the body. These cells can be used successfully as an alternative to bone marrow for transplants. Some families are at particular risk from rare inherited disorders. For these women cell banking may provide an easier route to a cell match that may be needed in their family. Under these circumstances arrangements can be made by professionals through the NHS Cord Blood Bank (NHS CBB) for their blood to be collected and stored.

At delivery

If the Clinician feels at any time that cord blood collection maybe detrimental to the wellbeing of the mother or baby the collection service will not be available. Examples of this would be premature birth, Emergency caesarean section or maternal haemorrhage.  There will be no change in how the delivery of the placenta is managed (3rd Stage) and any samples should be only be taken from a delivered placenta.

The responsibility for the quality or quantity of the sample collected or for delays in transportation or storage will lie with the external company providing the service.

If you wish to take the blood yourselves using a DIY kit, midwives will not be able to assist in this procedure. You will be given the delivered placenta as soon as it is practical to do so and the midwife will leave you to manage this procedure independently.

Please confirm with your midwife where you need to dispose of the needles you have used

Policy for Cord Blood Collection for Stem Cells at North Bristol NHS Trust

The Royal College of Midwives (2002) and the Royal College of Obstetricians (2006) do not support the commercial collection of cord blood for low risk families due to the current lack of research evidence to support the procedure. This service of commercial cord blood collection for stem cells for low risk families is therefore not offered at North Bristol NHS Trust. If parents still decide to go ahead with this procedure the maternity unit request that the parents will provide a trained third party to obtain the sample. The advice and training for this should be available from the private company offering the service. When there is medical indication for cord blood collection due to a family history of life threatening conditions such as cancers of the blood, please discuss this with your obstetrician who will be able to refer you appropriately for arrangement and advice of the process for collection. A third party will be requested to be available from them to perform the cord blood collection. The midwife will be unable to assist in this process following your baby’s birth.

For RCOG advice on Cord Blood banking and Storage (RCOG 2006) visit at www.rcog.org.uk