Mandatory training includes any statutory or compulsory training that you are required to do. 

Information will be provided at your Induction on how to access LEARN, our eLearning platform, and complete your training. 

Remember your mandatory and statutory training must be completed within your first week and local orientation should be completed within four weeks of your arrival. Your line manager must also sign your local orientation form and update your records.

Depending on your role and responsibilities you may be required to undertake a number of clinical competencies.
 

We encourage staff to choose to travel to work in a way which will make a positive contribution to our commitment to reaching carbon net zero by 2030.

If you can, walking, wheeling or cycling to work are the best options, followed by public transport.

You can save money, improve your own and others’ health and wellbeing and help make air quality in the local area better.

Contact Travel Smart for more information on any of the options below.

Free personal travel plan

We can create a bespoke travel plan to identify all the ways you can travel to our sites, just send us your postcode and shift times.

Walk or run

• Shower, changing and personal locker facilities on site.
• Route planning support.

Cycle

• Secure cycle stores for parking your bike.
• Borrow an electric, standard or folding bike from us for a month, for free.
• Save money on a new bike and spread the cost over 6-18 months with the Cycle to Work scheme.
• Free bike safety checks, maintenance lessons and giveaways.
• Route planning support.

Catch a bus

• Discounted tickets from FirstBus and Stagecoach.
• Conveniently located bus stops.
• More than 25 buses arrive every hour during peak time.

Motorcycle

• Free parking on-site by applying for a free electronic permit, contact parkingenquiries@nbt.nhs.uk .
• Secure, undercover parking.
• Discounts at various stores and discounted CBT.

Car sharing with colleagues

• Free online platform Join My Journey matches you with other staff.
• Dedicated parking spaces alongside a car share passenger permit.
• Guaranteed Ride Home Policy.
• Save money by splitting petrol and parking costs.

Car parking

To park on-site, there is a Parking Permit System.

• You can apply on your first day of Induction. Further information will be provided.
• Must only park in dedicated staff car parks.

There are different permit types available:

Peak: For use 24/7, 365 days a year. Charged at 1.4% of your annual salary.

Off-Peak: For use on nights (from18:00 till 09:30 Monday to Friday) and all day on Saturday & Sunday. Charged at 0.6% of your annual salary.

Occasional: Limited to 90 days a year parking. This is a free permit but must be used in conjunction with a scratch card. Scratch cards cost £20 for a book of 10.

New starters are eligible for a one-off parking permit to cover the first day/s of induction. This will be sent with your induction information.  

Travel for work purposes

• Access to Pool Cars.
• Free for you to use and cheaper for your department.
• 24/7 online booking system.
• Can be booked from 15 minutes to 365 days in advance.

Instructions for day/night urine collection for cystinuria

Please read these instructions carefully, make sure that you are prepared, and follow each of the steps to ensure proper collection.

The collection bottles contain a preservative (strong liquid acid), this must not be thrown away.

Care should be taken not to spill or touch any as it could burn your skin, even when mixed with urine. If you spill the acid, advice for first air for skin/eye contact is on the back of the container.

How do I collect the specimen?

1. Choose a day when you will be at home.
2. When you get up in the morning, pass urine (pee) into the toilet. The collection of urine will start from this time. Please write
3. the date and time on the ‘Day’ collection bottle.

• Collect all the urine you pass into the the ‘Day’ collection bottle and finish this collection by emptying your bladder into the bottle before going to bed. Please write the date and time of this on the ‘Day’ collection bottle.
• Any urine passed overnight should be collected in the ‘Night’ collection bottle.
• When you wake the next day, empty your bladder and collect this urine. You should add this to the ‘Night’ collection bottle. Please note the date and time of this on the ‘Night’ collection bottle.

After the sample has been collected

Check the cap is screwed on firmly.

Carefully fill in all details required on the container labels including your name, date of birth, and hospital/NHS number.

Please note: any container received unlabeled cannot be accepted and you would have to repeat the collection.

If you don’t have your NHS/hospital number, or the barcode label, please contact your GP surgery, ward, or clinic.

What to do with the collected sample

Check that all the details have been filled in clearly on the label.

Deliver the container and the form as soon as possible direct to the laboratory, hospital or your GP.

Laboratory Specimen Reception, Pathology Sciences Building, Southmead Hospital, Bristol BS10 5NB

Opening hours 08:00 to 22:00.

Further Information

Further information can be found at:

www.labtestsonline.org.uk

www.nbt.nhs.uk/severn-pathology

© North Bristol NHS Trust. This edition published October 2024. Review due October 2027. NBT002316.

What sample container will I receive?

A sample container is provided for a 24 hour urine collection. Some containers contain a preservative (strong liquid acid or powder). This must not be thrown away.

The label on the container will tell you if there is a preservative, and you should take care not to spill or touch any as it could burn the skin, even when mixed with urine.

If you spill the preservative, advice for first aid for skin or eye contact is on the back of the container.

When do I collect the sample?

It will be easiest if you choose a day when you will be at home for a 24-hour period. If you have to go out, take your container with you. On your chosen day, begin at the usual time when you wake. The end of the collection is 24 hours later.

Start of collection: 8am or when you wake

Empty your bladder completely and flush the urine down the toilet. You will now have an empty bladder and the collection of urine starts from this point.

Write the date and time on the bottle. For the rest of the day and overnight collect all urine passed, into the container.

You may find it easier to collect the urine in clean smaller container, and straight away carefully pour it into the sample container.

End of collection: 8am or 24 hours later

After 24 hours (at the same time as the previous day) empty your bladder completely and add this urine to the container.

Don’t add any more urine. Write the date and time. This completes the collection.

Make sure that during and after the collection the container is kept in a cool place.

You will need to stop the collection and start again with a new container if:

• You have a bowel movement (poo) and are unable to collect the urine separately.
• Any of the urine is accidently discarded during the collection.

After the sample has been collected

Check the cap is screwed on firmly. Carefully fill in all details required on the container label including your name, date, and hospital/NHS number. 

Please note: any container received unlabeled cannot be accepted and you would have to repeat the collection. 

If you don’t have your NHS/hospital number or the barcode label please contact your GP surgery, ward, or clinic.

What to do with the collected sample

Check that all details have been filled clearly on the label. Deliver the container (and the request form if you were given one), as soon as possible directly to the laboratory, hospital, or your GP. 

Laboratory Specimen Reception 
Pathology Sciences Building 
Southmead Hospital 
Bristol 
BS10 5NB 
Opening hours: 8am-10pm

Further Information

Further information can be found at:

www.labtestsonline.org.uk

www.nbt.nhs.uk/severn-pathology

© North Bristol NHS Trust. This edition published July 2024. Review due July 2027. NBT002424

What is Basal Cell Carcinoma?

Basal cell carcinoma (BCC) is the most common type of skin cancer, which develops in the top layer of the skin (epidermis). They usually grow slowly, and they rarely spread to other parts of the body.

Basal cell carcinomas can occur anywhere on the body but are most common in areas that are exposed to the sun such as your face, head, neck, and ears.

If left untreated, Basal cell carcinomas will continue to grow and can eventually cause an ulcer; hence they can have the name ‘rodent ulcer’. They can start to destroy surrounding skin if they are left to continue to enlarge over time.

Most Basal cell carcinomas are painless, although sometimes they can be itchy or bleed.

What does Basal Cell Carcinoma look like?

Basal cell carcinomas can vary in their appearance.

• They are often first noticed as a scab that bleeds and does not heal completely or a new lump on the skin. Basal cell carcinomas can develop as a nodule that progressively and slowly enlarges.
• Some Basal cell carcinomas are superficial and look like a scaly red flat mark on the skin.
• Others form a lump and have a pearl-like rim surrounding a central crater and there may be small red blood vessels present across the surface.
• Any new lesions need to be shown to a doctor.

What causes Basal Cell Carcinoma?

Although the cause is not fully understood, those with the highest risk of developing a Basal cell carcinoma are:

• People with pale skin who burn easily and rarely tan (generally with light coloured or red hair, although some may have dark hair but still have fair skin).
• Those that have had a lot of exposure to the sun, such as people with outdoor hobbies or outdoor workers, and people who have lived in sunny climates.
• People who have used sunbeds or have regularly sunbathed.

What types of treatment are used?

Most Basal cell carcinomas are removed surgically, and the lesion is sent to the lab, to be examined under the microscope. It may take two to three weeks for the results of the biopsy to be sent back to the consultant.

Occasionally it is necessary to repair the area with a skin graft or other types of plastic surgery.

Some very superficial lesions can be treated with topical creams.

If all the cancer has been completely removed or treated, you should view yourself as ‘cured’. If no further treatment is required, you may be informed by letter, without the need to return to the hospital.

Looking ahead

If you have had one Basal Cell Carcinoma, new Basal Cell Carcinomas may sometimes develop over the years.

• Check your skin monthly for any existing or new skin lumps or moles that enlarge, change colour, bleed, or itch. Most changes are harmless, but they may indicate the start of a new skin cancer. See your General Practitioner if in doubt.
• Take care whilst in the sun by wearing protective clothing and using high factor sunscreens (SPF 30+).
• Wearing a hat with a large brim is recommended.
• Avoid strong sunshine from 11am to 3pm.
• Avoid using sunbeds.
• Pass on the message to friends and family about protecting themselves and checking their moles and skin.

How to contact us

Skin Cancer Clinical Nurse Specialists

0117 414 7415

What is a Squamous Cell Carcinoma?

• Squamous Cell Carcinoma (SCC) is a type of skin cancer that usually starts in the skin where the cells multiply and alter the skin’s appearance.
• SCCs are typically slow-growing forms of skin cancer and usually remain in the outer layer of the skin.
• They can differ greatly in their appearance, but most usually appear as a scaly or crusty area of skin or a lump, with a red, inflamed base.
• Squamous cell carcinomas are often tender, but most small SCCs are not usually painful.
• They have the potential to spread to other organs of the body (Metastases), but this is more common if left untreated for a long time.

What causes a Squamous Cell Carcinoma?

Although the cause is not fully understood, there is strong evidence to suggest that Ultra-violet (UV) rays from the sun or sunbeds can damage the skin, which may contribute to the development of a squamous cell carcinoma.

Other less common causes are radiation therapy, trauma, chemicals, and viruses. Some people who have lowered immunity are also at risk.

What types of treatment are used?

Surgery is usually the first choice for treating a suspected squamous cell carcinoma. The most common surgical procedure is to excise the lesion along with some normal looking skin around it. This is normally done as a day case operation, with the patient awake. The diagnosis is then confirmed by sending the lesion away to be examined under a microscope. It may take two or three weeks for the results of the biopsy to be sent back to the consultant. Occasionally, it is necessary to repair the area with a skin graft or other types of plastic surgery.

Looking ahead

If your squamous cell carcinoma has been caught early, it is curable. However, if you have had one SCC others may develop in future years. You need to examine your skin for any unusual changes once a month.

• Check your skin monthly for any existing or new skin lumps or moles that enlarge, change colour, bleed, or itch.
• Most changes are harmless, but they may indicate the start of a new skin cancer. See your doctor if in doubt.
• Take care whilst in the sun by wearing protective clothing and using high factor sunscreens (SPF 30+).
• Wearing a hat with a large brim is recommended.
• Avoid strong sunshine between 11am and 3pm.
• Avoid using sunbeds.
• Pass on the message to friends and family about protecting themselves and checking their moles and skin.

Although rare, in a very small percentage of people SCC may recur at the site of removal or in the surrounding skin. Even more rarely they may spread to lymph nodes producing swelling in the neck, armpit, or groin, depending on the site of the initial cancer. You will be given instructions about where and how often you should examine yourself for lumps.

Any new lesion or sore that develops either at or near the site of the original SCC or any lumps noted in the neck, armpit or groin should be reported to your doctor.

Follow-up

Many patients can be discharged once treatment is complete. If you need follow up appointments, which will depend on several factors, this will be discussed with you.

How to contact us

Skin Cancer Clinical Nurse Specialists

0117 414 7415

Completing an Activity Diary: guidance notes

Activity Diaries can be helpful for several reasons:

• They can help people to develop successful pacing skills.
• They can help people to work out a "baseline" for different activities so that they can decide how to make progress with these activities.
• They can help people to monitor their sleep patterns so that they can work out where the problem areas are and make appropriate plans.
• They can help people to monitor their balance of activity and rest.
• An Activity Diary can offer clues about where there might be room for new activities in the day.
• An Activity Diary can set a "benchmark" for someone's activity and rest levels at a given time. If somebody keeps their diary, they can look back at it and spot the areas where progress has been made.

How To Complete an Activity Diary

We have two types of activity diary that you can try. The first one has been developed so that it can be used by people with a visual impairment who use a screen reader, but it is also a good option for someone who wants to write some detail about their activities. We are grateful to the West of England Sight Loss Council for their advice about this diary. You can download the Word document below and fill it in on your own computer. Follow the steps below.

1. The first column is for you to record the time of day that you started each different activity.
2. The second column is for you to write a short description of what you were doing: for example, walking, showering, listening to the radio.
3. The third column is for you to write in whether the activity was high, medium or low demand, or restful. It is up to each individual to decide which activities are high, medium, low demand or restful. Think about how much energy (physical, mental or emotional) each activity might demand from you. In this way, you'll be able to make the diary suit your own current situation. You can also record any time spend sleeping.
4. If your sleep is broken, make a rough estimate of how long you were awake, and fill in the diary with the colour for rest, high, medium or low demand activity depending on what you did whilst you were awake.

The second type of activity diary is visual: it involves using colour to record and show levels of activity. You can download the pdf activity diary which can be printed out and shaded in, depending on how long you did an activity for.

1. Look at the Key at the bottom of the diary: it has five boxes, one for sleep, one for rest, three for different levels of activity. Choose a colour or a pattern for each of these boxes, and fill it in. Choose colours or patterns which will contrast well.
2. Now look at the first line of the diary: it starts at midnight on the first day, and each box represents an hour. Use your colour or pattern to fill in the boxes, showing what you're doing at different times of the day.
3. It is possible to fill in only part of the box if an activity lasts for part of an hour. Complete the rest of the box with other colours or patterns, depending on what you did next.
4. It is up to each individual to decide which activities are high, medium, low demand or restful. Think about how much energy (physical, mental or emotional) each activity might demand from you. In this way, you'll be able to make the diary suit your own current situation.
5. If your sleep is broken, make a rough estimate of how long you were awake, and fill in the diary with the colour for rest, high, medium or low demand activity depending on what you did whilst you were awake.

Week one

Date: __/__/___

Week two

Date: __/__/___

© North Bristol NHS Trust. This edition published August 2023. Review due August 2026. NBT003472

Following injury, your wrist may be swollen, bruised and painful due to the overstretching of the soft tissues such as ligaments, tendons or muscles. This is often called a sprain and it is a common injury. In order to help the natural healing process, follow the advice below.

During the first 24-72 hours

• It is important to rest and elevate the wrist as much as possible to prevent further swelling. Rest with the arm elevated on pillows, ideally with your wrist above the level of your heart.
• Use over the counter pain killers as needed.
• To relieve the pain and swelling, apply a packet of frozen peas or crushed ice in a damp tea towel to the painful area. For maximum effect, apply for up to 20 minutes, every 2 hours. Cold can burn, so remove if uncomfortable.
• You may have been provided with a splint. This can be worn to support the wrist while the ligaments are healing and enable you to use the arm more comfortably. It can be removed when resting, washing or at night.
• Check that your shoulder, elbow and fingers/thumb are moving fully.
• Once the pain and swelling begin to ease, start gently moving the wrist and hand to prevent stiffness. Move into discomfort but not pain.

After 3 days

If you have not already started to move your wrist, then it is now essential that you do so to prevent future stiffness.

Exercise 1

• Sitting, grasp your injured arm well above the wrist so that your palm is face down towards the floor. Slowly move the hand up as far as possible, then stretch down as far as possible.
• Repeat 10 times.

Exercise 2

• In the same position as above, move the hand towards the thumb side of the wrist and then towards the little finger side.
• Repeat 10 times.

Exercise 3

• Combine the above movements and move the wrist in as large a circle as possible.
• Repeat 10 times.

Exercise 4

• Tuck your elbow into your side, turn your palm up and then down. Move as far as possible in each direction.
• Repeat 10 times.

For the hand

Exercise 5

• Make a tight fist with your fingers and then stretch the fingers out as far as possible.
• Repeat 10 times.

Exercise 6

• With your palm facing upwards, stretch your thumb across toward the base of the little finger. Then stretch out to the side as far as possible.
• Repeat 10 times.

Exercise 7

• Continue moving the thumb around in circles, stretching as far as possible.
• Repeat 10 times.

As each day goes by, you should be able to move the wrist more freely and with lessening discomfort. The amount of movement should eventually be the same as that on your unaffected side. Start returning to light activities, steadily building up the daily use and progressing to more demanding activities. It may be some weeks before full strength returns. Depending on how badly your wrist is sprained, it may take between 4 - 12 weeks to recover, sometimes longer.

For those returning to sport

This should not be resumed until the wrist is free of pain, supple and strong. For those sports that directly involve the wrist, it is important to ‘warm up’ first (exercises 1 - 7 may be used). Then gradually build up sporting activity and strength.

The injury may take longer to heal if you suffer from diabetes or if you smoke.

For advice on stopping smoking please visit www.nhs.uk/smokefree or discuss this with your GP.

If you are concerned about your progress, contact your GP.

© North Bristol NHS Trust. This edition published April 2024. Review due April 2027. NBT002263

What is a mallet finger?

A mallet finger is caused by rupture of the tendon to the tip of the finger. Sometimes, the tendon may pull off its bony attachment. As a result, you are unable to straighten your finger tip on its own, although it can be pushed straight. Unsupported, the finger tip will have a characteristic ‘droop’. In most cases, it is not painful, but more of a nuisance.

Sometimes if the mallet finger has been caused by a sports injury, the end of your finger may well be painful, red and swollen.

How is the mallet finger treated?

Your finger is placed in a special plastic splint holding the tip straight for 6 - 8 weeks. During this time, the finger tip must be kept straight at all times, so healing can take place. It is essential that you carefully follow the instructions given to allow healing.

Your splint

• Your splint should be a comfortable fit, not too tight or loose. If it becomes loose, then you should return to us for a better fitting splint.
• The splint holds the tip joint straight, but should allow full movement of the middle joint of the finger to avoid it stiffening.
• You must ensure that the finger stays dry within the splint, which is not an easy task! Use a large protective rubber glove. Should your finger get wet inside the splint, then you will need to remove the splint and dry it and your finger.
• Each time you remove the splint you increase the risk of bending your finger and re-damaging the healing tendon. So, only remove it when absolutely necessary like when the finger and splint need cleaning or if they get wet.

When removing the splint

It is essential to follow the instructions below and it is helpful if you have someone else around when you do it.

• First, place your hand on a flat, firm surface i.e. a table.
• Loosen the tape and gently remove the splint keeping your finger flat on the table.
• Wash the top and sides of your finger with soap and water. To get underneath you can lift the finger up on its tip (maintaining the straight position).
• Dry the finger thoroughly.
• The splint will also need cleaning, but it is easier if someone does this for you.
• Carefully slide the splint back into place without allowing any bend, re-tape and secure. Make sure that the tape does not restrict the movement of the middle joint of the finger.

You will soon get used to this routine and it should be followed for the full 8 weeks.

After the 8 week

You will re-attend and be given further guidance and instructions. The splint will be removed leaving a stiff, but straighter fingertip. In some cases, the healed finger will have a residual ‘droop’ to the tip.

It may take several months for your finger to fully recover its function. Any redness, swelling and tenderness of your skin over the end of your finger may persist for the first few months after the injury. These symptoms will usually improve.

In summary

• Keep your splint on.
• Keep your fingertip straight.
• Keep it dry.

© North Bristol NHS Trust. This edition published April 2024. Review due April 2027. NBT002261.