The End of Life Care at North Bristol NHS Trust aims to deliver care in line with nationally recognised priorities for care of the dying person:

1. The possibility that the person is dying is recognised and communicated clearly, decisions are made and actions taken in accordance with the person’s needs and wishes, and these are regularly reviewed and decisions revised accordingly.
2. Sensitive communication takes place between staff and the dying person, and those identified as important to them.
3. The dying person, and those identified as important to them, are involved in decisions about treatment and care to the extent that the dying person wants.
4. The needs of families and others identified as important to the dying person are actively explored, respected and met as far as possible.
5. An individual plan of care, which includes food and drink, symptom control and psychological, social and spiritual support, is agreed, coordinated and delivered with compassion.

In order to support staff in delivering high quality care that is tailored to the individual, we use a framework of care called the Purple Butterfly approach. This approach is used to acknowledge when the focus of a persons care is comfort and symptom control and to identify their priorities and needs.

At NBT we are committed to providing high quality, personalised care at end of life. Alongside use of the Purple Butterfly approach we deliver regular palliative and end of life care teaching to all grades of staff and undertake audits to measure quality and effectiveness.

If you are a relative, carer, or friend caring for someone at the end of life, visit Caring for patients at the end of life | North Bristol NHS Trust (nbt.nhs.uk) for more information. 

Most palliative and end of life care at NBT is provided by the ward doctors and nurses led by the consultant in charge of the patient’s care. For patients and families with more complex palliative and end of life care needs, the ward team can refer to the Hospital Specialist Palliative Care Team who will work with them.

Specialist palliative care is available to any patient within North Bristol NHS Trust who has an advanced, progressive, life-threatening illness with a high level of need.

The Hospital Palliative Care Team is an advisory service providing specialist assessment and advice on the management of a range of issues that patient’s and their relatives and carers may face. This may include:

• Physical symptoms such as pain or sickness
• Coming to terms with difficult news
• Talking through treatment choices
• Help with talking to other family members
• Practical advice on benefits
• Spiritual support
• Facilitating patient choice in planning future care (advance care planning)
• Facilitating rapid discharge from hospital at end of life
• Referring to community health care professionals and palliative care services
  to ensure continuity of care
• End of life care

Visits by the Specialist Palliative Care Team are made from Monday to Friday, 9am to 5pm.

The team consists of consultants, clinical nurse specialists, specialist registrars, occupational therapists, chaplains and social workers. A number of nurses in the team are qualified nurse prescribers. This means that following an assessment they may prescribe medications to help relieve any symptoms that the patient may be experiencing. The nurse prescriber will discuss this with the patient and/or carer in further detail.

The team also delivers an extensive education programme to many groups of staff in the hospital aiming to develop knowledge and skills in palliative and end of life care.

Contact

Medical Photography 
Gate 38 Level 3
Brunel building
Southmead Hospital
Westbury-on-Trym
Bristol
BS10 5NB

Email: Photography@nbt.nhs.uk
Telephone: 0117 4146500

We continue to triage all the TWW referrals, but as of January 1st 2018 the LCNS will also be reviewing all abnormal CXR with a high suspicion of lung cancer and requesting a full staging CT scan.

We will also inform the patient and GP practice and request an urgent TWW referral.

When you send your patients for CXR, please advise them that depending on the results they may be contacted directly from the hospital.

To enable us to request further investigations please ensure the TWW form is completed in as much detail as possible, such as smoking status, performance status, anticoagulation medication and relevant past medical history.

Telephone: 0117 4141900

Email: sarah.smith@nbt.nhs.uk

Email: deborah.walton@nbt.nhs.uk

For Information about Lung Cancer care pathways, visit http://pathways.nice.org.uk/pathways/lung-cancer

www.arthritiscare.org.uk Arthritis Care exists to support people with arthritis. It is the UK’s largest organization working with and for all people who have arthritis. It is a user led organization which means people with arthritis are at the heart of the work – they form the membership, are involved in all of the organisation’s activities and directs it does.

www.backcare.org.uk BackCare is a registered charity that aims to reduce the burden of back pain by providing information and support, promoting good practice and funding research. The charity acts as the hub between patients, (healthcare) professionals, employers, policy makers, researchers and all others with an interest in back pain.

www.fibromyalgia-associationuk.org Fibromyalgia Association UK is a registered charity administered by unpaid volunteers. FMA UK was established in order to provide information and support to sufferers and their families. In addition, the Association provides medical information for professionals and operates a national helpline.

www.painconcern.org.uk Pain Concern provides information and support for pain sufferers, those who care for them and about them, free factsheets and leaflets to help you manage your pain.

www.patient.co.uk This provides non-medical people in the UK with good quality information about health and disease. The authors (all medical professionals) do this by writing evidence based information leaflets. They also review health and illness related websites and link to many of these from the web directory included on this website.

www.patients-association.com The Patients Association is a national charity providing patients with an opportunity to raise concerns and share experiences of healthcare.

www.patientvoices.org.uk This website has many health-related stories from ordinary people. The idea is that people working in health and social care will see these stories and carry out their duties in a more informed and compassionate manner.

selfmanagementuk.org Free self-management courses providing tools and techniques to help you to take control of your health and manage your condition better on a daily basis. The majority of the courses are delivered by trained tutors who have experience of living with a long-term health condition.

www.taoist.org/uk Website for the Taoist Tai Chi Society of GB, a registered charity that teaches tai chi to the community to help people improve their health and wellbeing.

www.u3a.org.uk U3As are self-help, self-managed lifelong learning co-operatives for older people no longer in full time work, providing opportunities for their members to share learning experiences in a wide range of interest groups and to pursue learning not for qualifications, but for fun.

The North Bristol NHS Trust HIV/Aids Service is based at Southmead Hospital Bristol.

Where patients are known to be HIV positive they should be referred to the HIV Specialist nurses via email: brecon.nurses@nhs.net

HIV/Aids fax number: 0117 4149426

Palliative Care Home Support Service

The Palliative Care Home Support Service (PCHS) provides personal care and emotional support for patients who wish to be at home in the last 4 to 6 weeks of life. The team visits patients across the Bristol and South Gloucestershire areas.

The service can provide 1 to 3 care visits to patients between 9am and 9pm for patients registered with a Bristol GP and 1 to 2 care visits to patients between 9am to 5pm for patients registered with a South Gloucester GP.

The service accepts patients with any diagnosis however; they must meet the following criteria:

• 18 years of age or older
• Assessed as being in the last 6 weeks of life
• Registered with a GP in the Bristol or South Gloucestershire area

Referrals can be made by any health or social care professional; by either fax or by telephone.

Bristol Care Co-ordination Centre (BCCC) for End of Life Care, co-ordinates the care for patients considered to be within the last 3 months of life.

• Marie Curie
• Hospice at Home
• The Fast Track Team who link closely with BCCC

Southmead Emergency Department (ED) & Minor Injury Unit (MIU)
Gate 35, Level 0, Brunel building, Southmead Hospital, BS10 5NB.

ED Main Reception
Telephone:  0117 4145100 or 0117 4145101

ED Observation Unit
Telephone: 0117 4144120 or 0117 4144121

General Pharmaceutical Council www.pharmacyregulation.org

Royal Pharmaceutical Society www.rpharms.com

United Kingdom Clinical Pharmacy Association 

College of Mental Health Pharmacy www.cmhp.org.uk

Guild of Healthcare Pharmacists www.ghp.org.uk

UK Medicines Information www.ukmi.nhs.uk

North Bristol NHS Trust uses medicines according to the BNSSG Joint Formulary, which can be found at www.bnssgformulary.nhs.uk/. The BNSSG Joint Formulary is regularly updated and monitored by the BNSSG Joint Formulary Group, which includes NBT, University Hospitals Bristol NHS Foundation Trust, Weston Area Health NHS Trust and the local Clinical Commissioning Groups (formerly Primary Care Trusts).

The BNSSG Joint Formulary promotes medicines which are safe, effective and value for money. It is a joint venture between primary and secondary care ensuring that patients have continuity of medicines whether at home or in hospital.