Neuropsychology - For Clinicians

Wide Off On Services & Referral

Clinical Neuropsychology is concerned with the assessment and rehabilitation / treatment of cognitive, emotional and behavioural difficulties occurring within the context of identified or suspected brain damage or neurological disease. The service provided is a neuropsychological one, i.e. medical responsibility for the care of the patient remains with their medical care provider.

Clinical Neuropsychologists at North Bristol NHS Trust are engaged along the entire pathway of care from acute neurosciences through to the community. They work with a number of specialist MDTs / services and see adult patients (18+) with a range of neurological aetiologies for their difficulties:

  • brain injury
  • stroke
  • encephalitis
  • brain tumours
  • epilepsy
  • neurodegenerative diseases
  • genetic and metabolic conditions affecting the central nervous system 

Clinical Neuropsychology services can be accessed from primary care upon referral to the Department of Neuropsychology, Rosa Burden Centre, Donal Early Way, Southmead Hospital, Bristol, BS10 5NB. Telephone for enquiries: 0117 414 0454.

Additional Clinical Neuropsychology services are available as part of the comprehensive brain injury rehabilitation services provided by the Frenchay Centre for Brain Injury Rehabilitation (inpatient rehabilitation) and the Head Injury Therapy Unit (community rehabilitation).

Other Clinical Neuropsychology services are offered within specialist teams including:

  • stroke
  • epilepsy surgery
  • multiple sclerosis
  • cognitive disorders (dementia) clinic.

Services for children with neuropsychological difficulties are provided by the Department of Paediatric Neuropsychology, Bristol Royal Hospital for Children, University Hospitals Bristol NHS Foundation Trust.

A neuropsychological assessment

A neuropsychological assessment provides an objective way of characterising cognitive, emotional and behavioural symptoms. This process typically involves completing a number of different cognitive tasks and questionnaires. The process is not painful or unpleasant but may take a number of hours.

Typically a neuropsychological assessment might involve assessment of:

  • Attention and concentration
  • Verbal intellectual skills
  • Visuospatial/Non-verbal reasoning and problem solving
  • Working memory and mental flexibility
  • Auditory memory
  • Visual memory
  • Language
  • Processing speed
  • Executive function
  • Mood and anxiety / stress
  • Test score validity

Results of an assessment are typically presented in report format and may also be discussed directly with the patient. 

The significance of the findings of the assessment in relation to the referral question, along with a short summary of the main findings, are typically briefly summarised at the end of the report.

Neuropsychological treatment

Where appropriate, treatment is offered to help improve or mitigate the impact of presented cognitive, emotional and behavioural difficulties. Within the Clinical Neuropsychology service this is provided within the framework of a brief goal-focused intervention model. Typically, this work involves aspects of cognitive rehabilitation, the implementation of strategies to compensate for cognitive problems and, where appropriate, brief psychological therapy interventions for associated psychological difficulties, typically within a cognitive-behavioural therapy framework.

Comprehensive post-acute multi-disciplinary neuro-rehabilitation, including neuropsychological input, is offered by the Frenchay Centre for Brain Injury Rehabilitation and the Head Injury Therapy Unit at Frenchay.

Neuropsychology

Neuropathology - For Clinicians

Wide Off On Services & Referral

The department of Neuropathology at North Bristol NHS Trust provides the following services:

  • Clinical neuropathology support for the neurosciences specialties
  • Neurosurgical biopsy histology
  • Diagnostic pathology of muscle and peripheral nerve, including in-house biopsy facilities
  • Neuropathology autopsies
  • Macroscopic assessment of fixed brain and spinal cord specimens
  • Post-mortem neurohistology
  • CSF cytology

For further information, download:[attachments]

Neuropathology Requesting

Neuropathology request forms are available from the Neuropathology department and should be completed in full.

Each request received by the laboratory is considered an agreement between the requestor and laboratory for provision of Neuropathology Services.

Refer to the Neuropathology User Manual for further details on requesting tests.

Neuropathology Reports

Reports are currently available on ICE and will be sent by secure email to the requesting Clinician. A hard copy of reports can be obtained by telephoning the departmental secretarial team.

Contact Neuropathology Neuropathology

Neurology - For Clinicians

Wide Off On Services & Referral

There are a number of drugs used for the treatment of neurological conditions that are subject to the Traffic Light System and/or Shared Care Protocols (SCPs).

The latest versions of the SCPs can be found on the www.bnssgformulary.nhs.uk or you should check with the Pharmacy. 

TIA Clinics

7 day service. For patients with TIAs or minor stroke.

First Seizure Clinic Referral

Please download the referral form

and attach to the referral made for the ‘First Seizure clinic – Neurology – Southmead’ service via NHS eReferrals.

 

Rapid Access Advice Neurology

Outpatients for Older People - For Clinicians

Wide Off Off

Outpatient clinics are held at Level 1, Brunel building, Southmead Hospital and at Cossham Hospital.

Comprehensive Geriatric Assessment (CGA) clinics. For older people who are developing difficulties with everyday activities, memory problems and taking a lot of medication. The service reviews the medical aspects of these problems to improve quality of life. The service is accessed via NHS eReferrals and has links with the Admissions Avoidance clinic run in the older persons medical unit.

Falls Service (delivered by Dr Seema Srivastava, Lead Consultant for Falls at Southmead Hospital Bristol and all Medicine for Older People consultants at Cossham Hospital). For patients who have fallen or at risk of falling who wish to stay steady and minimise further falls. The service consists of a consultant led specialist falls clinic with links to the community services.
Referrals can be made through the Emergency Department, GPs, Community Nurses and Intermediate Care.

Parkinson Disease (Dr Ronald Barber and Dr Jarrod Richards). Consists of an outpatient clinic based at Cossham Hospital.

Osteoporosis & metabolic bone disease (Dr Karen Harding, Dr Walsh and Dr Srivastava). Assesses patients with severe/complex osteoporosis, offers advice on alternative treatment for patients intolerant to oral biphosphonates and accepts referrals for patients with other metabolic bone problems such as Paget's disease and osteomalacia. Clinics are held at both Southmead Hospital Bristol and Cossham Hospital.

Cardiovascular Chest Medicine in Older People (Dr John Pounsford). Provides specialist assessment of older people with breathing difficulties thought to be due to their lungs. Clinics are held at Southmead Hospital Bristol.

Please fax referrals to 0117 4149448 or 0117 4149400.

Falls Clinic for Older People Referral

Wide Off Off

Referral Criteria for Hospital Medical Assessment of patients with falls

  • Patients with suspected Syncope
  • Patients with unexplained dizziness
  • Patients with recurrent falls where a cause has not been found despite performing a multi-factorial falls risk assessment or patient is falling despite interventions put in place to manage risks

Exclusions:

  • Patients who need Physiotherapy and Occupational Therapy only
  • Patients who have already had a Hospital Medical Assessment of Falls in the last 24 months.

Prior to Referral: GP and community nurse must have carried out a multi-factorial falls assessment including blood tests and accurate medication review as per CCG Integrated Falls Pathway. Please include details of these assessments with referral.

Access:

  • NHS eReferrals (General Older Person's Medicine and Falls Specialist Medical Assessment at Southmead or Cossham Hospital)
  • Written GP referral letter can be faxed to 0117 4149457
  • For South Gloucestershire CCG, GPs should use the new GPs Falls Risk Assessment and Referral template
  • For community Matrons, Community Nurses for Older People, Community Therapists, REACT team, download: 
  • Please fax falls clinic referrals from community teams to: 0117 4149457.

Guidance:

Palliative & End of Life Care Strategies

Wide Off Off

In 2008 the first national strategy for end of life care was published. The Department of Health’s End of Life Care Strategy (2008) provided guidance and recommendations to organisations that plan and commission care for those people who are approaching the end of their life with the aim of raising standards. Since this publication other strategies have built on this guidance have help inform end of life care in North Bristol NHS Trust (NBT).

It is the role of the Specialist Palliative Care Team and NBT’s End of Life Care Strategy Group to interpret and implement this guidance in a meaningful way.

One chance to get it right

 

 

One Chance to Get it Right.
Improving people’s experience of care in the last few days and hours of life.

www.gov.uk/government/uploads/system/uploads/attachment_data/file/323188/One_chance_to_get_it_right.pdf

 

 

Ambitions for palliative and end of life care

 

 

Ambitions for Palliative and End of Life Care
endoflifecareambitions.org.uk

 

Local Palliative & End of Life Care Services

Wide Off Off

General Practitioners (GP's) and Community Nurses are the main providers of palliative and end of life care in the community. Most GP practices use the Gold Standards Framework (GSF) - a simple tried and tested framework to help primary health care teams deliver the best possible care for people nearing the end of their lives. Initially developed for cancer patients, it is now used for any patient with a life limiting illness and in other settings such as care homes. For patients with complex palliative and end of life care needs the primary health care team may work alongside specialist community palliative care teams.

For more information Gold Standard Framework - Patients & Carers (goldstandardsframework.org.uk)

Marie Curie
Marie Curie Cancer Care is a charitable organization in the United Kingdom, which provides nursing care, free of charge to patients and their families. The charity is best known for its network of Marie Curie Nurses who work in the community to provide end-of-life care for patients with cancer and other life-limiting illnesses in their own homes. For more information, visit www.mariecurie.org.uk

St Peter’s Hospice
St Peter’s Hospice is Bristol’s only adult hospice caring for local people with incurable illnesses. The hospice is committed to improve the quality of life for patients while extending care and support to their families and loved ones.
The hospice works in collaboration with other community and hospital based healthcare professionals to develop, influence and provide flexible specialist services that meet the needs of people with life-limiting illness.
Services offered by St Peters Hospice include:

  • 24 Hour Advice Line
  • Community Nurse Specialists
  • In Patient Unit Care
  • Day Hospice
  • Hospice at Home
  • Medical Support
  • Psycho Social and Spiritual Team (Social Work, Spiritual Care, Music Therapy and Bereavement Support)
  • Complimentary Therapies
  • Fatigue and Breathlessness Programme
  • Physiotherapy and Occupational Therapy
  • Education Centre

St Peters Hospice
Charlton Road
Brentry
BS10 6NL

Telephone: Switchboard 0117 915 9400
24 Hour Advice Line 0117 9159430

For more information on current available services visit www.stpetershospice.org.uk

For patients who live in Gloucestershire and Somerset the local hospices are:

Longfield
Burleigh Lane
Minchinhampton
Gloucestershire
GL5 2PQ
Telephone: 01453 886 868
Email: info@longfield.org.uk

For more information visit www.longfield.org.uk

Weston Hospice Care
Jackson-Barstow House
28 Thornbury Road
Uphill
Weston-super-Mare
Somerset
BS23 4YQ
Telephone: 01934 423900

For more information visit www.westonhospicecare.org.uk

 Dorothy House Hospice Care                                                                                                             Winsley                                                                                                                                             Bradford on Avon                                                                                                                                           BA15 2LE                                                                                                                                                     Telephone 01225 722988                                                                                                                                

For more information visit www.info@dorothyhouse-hospice.org.uk