Clinics

New patients

We see most new patients at our Bristol Royal Infirmary clinics (level 4 of the BRI Queen's Building).  This allows most patients to see a surgeon, visit the preoperative assessment clinic (POAC) and meet with a nurse specialist in one visit.  If you might be eligible for a research trial, you may meet one of the surgical research nurses. 

The Preoperative Assessment Clinic by Video Link at Other Hospitals

We can now also provide this "one stop" assessment at Southmead Hospital for some patients.  Here, you will meet a surgeon and lung cancer nurse specialist in person, but will meet some of the other members of the team (assessment nurse and anaesthetist) via a video link to the pre-operative assessment team at Bristol Royal Infirmary.  This means that you can have your assessment closer to your home.  We are rolling this service out to other hospitals, starting at Gloucester Royal in late 2016.

You will not usually need to visit the hospital again until the morning of your operation. 

The Preoperative Assessment Clinic (POAC)

The purpose of this service is to ensure you are in the best possible health to undergo anaesthesia and surgery. You will be assessed by a nurse and reviewed by a member of the anaesthetic team if required. You may need to have some tests such as blood tests and possibly have examinations of your heart and lungs with additional tests as required. We aim to make this assessment as timely as possible, but this is a comprehensive assessment and we believe it is essential that you are assessed appropriately. You will be given the name of a preoperative assessment nurse, or 'case manager', who you can contact should you have any queries or further health concerns following this appointment and before your surgery.

POAC is located at A606 on level 4 of the BRI Queens' Building.   

Getting fit for surgery

The fitter you are before an operation, the better your chances of a good outcome.  There is a lot that you can do, even in just a few weeks, to get fit.

-If you are still smoking, try to stop as soon as possible. Your GP, local hospital or our clinic can help

-If you are on medications for emphysema/COPD, diabetes, high blood pressure or another long term condition, make sure to take them regularly.

-Be as active as you can.  Regular aerobic (fitness) exercise is ideal.  A half hour walk 3-4 times a week if you are able is a good start.

Children and teenagers

Children are usually seen in our general adult clinics.  Patients under 16 should bring a parent or guardian with them to clinic visits. Surgery for those under 16 will be performed at Bristol Children's Hospital.

Follow up clinics

Many procedures need follow up visits to check on your recovery and sometimes to discuss results and arrange further treatment.  For lung and other cancer patients, we will often follow you up in clinic for several years.  These clinics take place in your local hospitals to reduce travelling times when possible.  We currently undertake clinics in the following hospitals: 

Clinic locations and times

Location	Frequency	Day	Time
Bristol Royal Infirmary (BRI)	Weekly	Tuesday, Wednesday, Friday	9am-1pm
BRI nurse-led chest drain clinic Ward A700	Weekly	Monday	mornings
BRI nurse-led cancer follow up clinic	Weekly	Friday	9am-1pm
Southmead Hospital	Weekly	Wednesday	9am-1pm
Gloucester Royal Hospital*	Four per month	Thursday	2pm-4:30pm
Royal United Hospital Bath*	Weekly	Thursday	9am-11am
Weston General Hospital*	Two per month	Monday	9:30am-11:30am
Yeovil District Hospital*	Monthly	Tuesday	2pm-4pm
Musgrove Park Hospital, Taunton*	Weekly	Thursday	2pm-4:30pm

*clinics currently for post-operative visits only 

How often might I need to come back to clinic?

Most lung cancer patients come to clinic for five years following their surgery.  At the start this will be 2-3 weeks after surgery, then every 4 months for a year. If you remain well this will reduce to annual visits.  In particular cases we will vary this routine.  If another specialty (for example oncology) is involved, we may adjust your follow up to save unnecessary journeys.

For benign (non-cancer) patients, usually only one clinic visit will be needed after your surgery.  After some minor procedures we will just send the results to the doctor who referred you, and you don't need to come back to our clinic.

Going home after surgery

We will give you a plan for your follow up when you are discharged.  A written clinic letter will normally arrive within 1-2 weeks of going home.  If the date or location is inconvenient, please tell us and we will try to accommodate you.

Try and stay as active as possible when you get home.  Spend the day in a chair-not in bed, and keep doing the coughing and breathing exercise that the physiotherapist has shown you.  Take enough painkillers so that you can cough and breathe comfortably.   Try to get out the house at least once a day if you can, even if just for a very short walk.  Eat a healthy, balanced diet.  Keep taking our laxatives until your bowels have returned to normal, and wear the surgical stockings that you had in hospital for most of the day and night (its OK to take them off to clean them) until you are sure that you are fully mobile.

Once you are at home, any repeat prescriptions- for example for painkillers- and other routine issues are usually dealt with by your family doctor.  The practice nurse at your GP will normally be able to remove any stiches, if necessary.  If you are going home with a chest drain in place, or still need regular wound dressings, then we will involve your local district nurse before you go home.

If you have been smoking before surgery, do your best to stay off cigarettes now that you are at home.  Staying off cigarettes gives you the best chance of staying cancer free.  We will offer you smoking cessation support and nicotine replacement if appropriate before you go home.

The thoracic nurse specialist team is available if you have any specific questions about your surgery or follow up, at thoracicCNS@uhbristol.nhs.uk.