Services A to Z

Referrals to the national complex mesh surgical service will be accepted from any Urogynaecology service in Scotland.

• The local urogynaecology consultant will have reviewed the patient clinically and agreed with the patient to refer to the service in Glasgow for consideration of partial or total mesh removal.
• The consultant will refer the patient using the agreed Multidisciplinary Team (MDT) referral form.
• The GGC MDT will discuss the patient, review all the information provided by the local urogynecologist and recommend a treatment plan.
• The patient will then be contacted by both the psychology service and the clinical nurse specialist for support and information regarding what to expect at their forth coming clinic appointment.
• The patient will attend the clinic and meet the team.
• They will discuss the proposed treatment plan and any surgical options available to them.

We recognise that Every Woman is Different and will have different needs and thus every stage of patient treatment is determined by a team of experts working closely together to provide individualised care.

Patients referred to the service will be seen through the specialised mesh clinic by a team of clinicians along with other members of the MDT. We will obtain as much information about your mesh implant and any treatment carried out to date from your local unit. Patients will have full assessment (history and examination) and will be offered investigations as appropriate.

Investigations can include:

• Cystourethroscopy (telescopic assessment for bladder and urethra)
• Ultrasound scan – Translabial /transperineal and endovaginal
• MRI scan
• Other investigations like sigmoidoscopy (telescopic exam of lower bowel), Examination under anaesthesia , diagnostic laparoscopy and CT scan can be requested if deemed necessary.

We may ask some of the above tests to be done at your local hospital for your comfort and convenience.

Your case will be discussed at our complex mesh MDT and the outcome will be relayed to you by one of the surgical team members and further appointment/s will be arranged.

Surgical Treatment options offered :

• Injection of local anaesthetic and steroids
• Conservative surgical/minimum access procedures using Laser
• Partial mesh removal (removal of exposed vaginal mesh) and (part or whole of vaginal portion of the mesh)
• Complete mesh removal
• Removal of vaginal and extra vaginal portion/s of mesh
• Groin dissection
• Partial and complete removal of abdominal inserted mesh for prolapse.

Team offers both open and laparoscopic (key hole) approach.

Information about above surgical procedure can be accessed by clicking here and about the perioperative process here.

Complex Mesh Specialist Nursing

Nurses within the Complex Mesh Surgical Service are Specialist Urogyneacolgy trained who have an expert knowledge and understanding of the use of mesh for the treatment of Pelvic Organ Prolapse and Stress Urinary Incontinence.  We understand the potential physical and emotional impact of the complications experienced from the use of mesh.  We aim to offer person-centred care throughout your journey through the Service.

Our role within the Complex Mesh Surgical Service is to provide care and support to all individuals within the clinic setting. 

We recognise that it can sometimes feel overwhelming to attend hospital appointments.  We are there to offer support throughout, to ensure you feel able to voice any concerns you may have, to discuss any difficulties you may experience and to help you to identify your goals for treatment.

We will contact you prior to your first multidisciplinary clinic appointment to introduce ourselves and answer any questions about the clinic that you may have.  We will then be there to support you during your multidisciplinary clinic appointment, and throughout your journey with the service.

If you undergo mesh removal surgery, we will meet with you with in the ward before you are discharged home from the Hospital. We will arrange a dedicated time for post-operative telephone follow-ups.

In addition, it is important to us that people using the service are aware that we can be contacted at any other time by telephone, should there be any queries or concerns (see ‘Contact Us’).  We aim to support you to achieve the best possible outcomes for you as an individual.

The Complex Mesh Surgical Service

Lifestyle Information

This information is to help you know what you might be able to do in the days or weeks before any mesh related surgery. This will speed up your recovery and help you get the best outcome possible.

Even small positive changes in lifestyle make a difference and encourage you to be as healthy and strong as you can be.

Lifestyle changes that target your activity, weight and diet may help your bladder and bowel symptoms. 

Being Active

Being active is one of the best things we can do for our physical and mental health.

Sometimes it can be hard to stay active when we have pain, leakage from the bladder or bowel, or struggle to find the motivation. Even small amounts of regular activity can make a difference.

 The following tips might help:

• Start with small and regular activity that you enjoy and that is easy to do such as walking, or suitable exercise classes
• Try and find an exercise partner to help you stay motivated
• Plan to be active every day
• If you already go to classes, ask the instructor to help you with easier options for when you feel less strong or more uncomfortable
• Work towards increasing your daily activity over time

We know that physical activity can boost self-esteem, mood, sleep quality and energy.

The Government guidelines are shown below BUT not everything will suit everyone – get advice on the right strength training for you.

Managing your weight

 A healthy weight is important for overall wellbeing and can help you prevent and control many diseases and conditions. National guidelines recommend that a body mass index (BMI) of less than 30 can help reduce symptoms of mixed urinary incontinence and prolapse. The link below will give you general information about the effects of a high BMI on your pelvic floor and the risk of complications during and after surgery.

Losing weight can be hard and you may need lots of help and support:

• Ask your friends to help you
• Speak to your GP
• Find out what is available locally

The links below may be useful:

• 12 Week Weight Management Programme
• How to lose weight safely – Food and nutrition
• Lose weight – Better Health – NHS
• Managing your weight – NHS

Have a healthy balanced diet

What you eat and drink is very important for bladder and bowel health. Staying active also helps.

Fluids

It is important to drink enough each day even if you have bothersome bladder symptoms. Try to drink at least 1.5litres to 2litres of fluid per day. You may need to increase your fluids gradually to help retrain your bladder. It is recommended that you limit the amount of caffeine and fizzy drinks such as coke, coffee, energy drinks and alcohol because they are known to irritate the bladder.

Drinking enough may also help with constipation and encourage a regular bowel habit.

Food

A balanced diet with enough fibre and physical activity can help to regulate your bowel movements, prevent constipation and improve rectal emptying. The right stool consistency may help manage symptoms of bowel urgency and leakage of poo.

Understanding how to have the right stool consistency is particularly important at the time of surgery to help prevent straining and constipation post operatively.

The Eatwell guide from the NHS gives an idea of what the balance of foods should be.

Further information and help is also available from the following links:

• Food and nutrition – Healthy living
• Eat well – NHS

Other lifestyle modifications which may help manage pelvic floor symptoms

• Stopping smoking and managing any respiratory conditions such as asthma may reduce your cough. You may also feel fitter and more able to take part in physical activity. This in turn can benefit your mental health and wellbeing.
• Reducing alcohol intake. Alcohol is known to irritate the bladder. Other benefits of cutting down may be improved mood, sleep quality and feeling more energetic

For further help with this, see you GP for local services and have a look at the following website pages:

• Stop Smoking – NHS Inform
• Quit Smoking – NHS
• Healthy Living – Alcohol Information

If your ability to make helpful lifestyle changes are not possible due to low mood, please seek help to find the right support for you.

Got a date for surgery?

Knowing what to expect from surgery can help reduce preoperative anxiety. The following link and short video will help to support and guide you:

You will also be seen ahead of your operation to get information on pre and post operative care.

Complex Mesh Clinical Psychology Service

Clinical Psychologists are trained to have an expert understanding of how people think, feel and behave.  These skills are used to help people cope with difficult situations, feelings, and experiences.

We recognise that complications from mesh for pelvic organ prolapse or incontinence have the potential to result in exceptional challenges that people may not ordinarily face.  We also understand that it can be difficult to cope with these difficulties alone.

Our role within the Complex Mesh Surgical Service is to provide support to individuals for any mesh-related difficulties they may encounter.  We recognise that in addition to the expert care of your physical needs, having good social and psychological support is an important part of your overall wellbeing.

Our aim is to meet with as many people in the Complex Mesh Surgical Service as we can.  This allows us to introduce ourselves, as well as assessing whether you have any concerns relating to mesh that we could address together.

We do this by:

• Offering an initial appointment with a Clinical Psychologist prior to assessment by the multidisciplinary team (MDT)
• Attending MDT clinic appointments

We also offer appointments to anyone who requests support at any stage in their assessment or treatment within the Complex Mesh Surgical Service.  If there are mesh-related difficulties that you would like help with, we offer individualised support. 

This may include:

• One-off discussions or suggestions
• Individual appointments (by telephone, video call or face to face)
• Joint working with other professionals (e.g surgeons, physiotherapists, GPs)
• Signposting to other services

If you would like our support, you can let us know by speaking to us (in our appointment prior to the MDT clinic appointment, or in the MDT clinic appointment) or by telling another member of the Complex Mesh Surgical Service. Please note that we are only able to accept referrals for people who are being seen within the Complex Mesh Surgical Service.

Information on what to expect from sessions with a Clinical Psychologist within the Complex Mesh Clinical Psychology Service, can be found in our patient leaflet.

Contact us

To request or ask about support from the Complex Mesh Clinical Psychology Service, please speak with any member of the Complex Mesh Surgical Service MDT.

If you are struggling with low mood and cannot wait to speak to someone, please contact your GP for advice, or call NHS 24 on 111.

The following organisations can also offer an immediate ‘listening ear’:

Samaritans 116 123 (free 24-hour helpline)

Breathing Space 0800 83 85 87 (free helpline, 6.00pm to 2.00am weekdays, 24 hours at weekends)

The Complex Mesh Surgical Service

Physiotherapy is now considered as one of the first non-surgical options that should be offered for the management of stress urinary incontinence and for prolapse.

Pelvic Health physiotherapists have undergone additional training and have specialist expertise in bladder, bowel and vaginal health. Our goal is to support and work with people to lessen the impact of pelvic floor problems and help restore their quality of life. Common pelvic health problems may be bladder and bowel incontinence or emptying difficulties, prolapse and painful sexual intercourse. Physiotherapy aims to improve function and minimise the symptoms that can impact on the physical and psychological aspects of life. Education and understanding of the anatomy and function of the bladder, bowel and pelvic floor muscles is a key part of this.

Why is there a specialist physiotherapist in the Complex Mesh Surgical Service?

1. Many of the women seen in the Complex Mesh Surgical Service (CMSS) may have seen a physiotherapist already and the specialist physiotherapist can help to decide whether further physiotherapy input will be of benefit.
2. People attending the CMSS may come from all over Scotland. The specialist physiotherapist will share information, advice and expertise with the physiotherapists who may be involved in the agreed management plan. We aim to ensure continuity of care within the local setting.

Who can be seen in the Complex Mesh Physiotherapy Service?

Physiotherapy is a key component in managing mesh related pelvic floor problems and if indicated the specialist physiotherapist will aim to see all the people attending the CMSS. If the physiotherapist is not available on the day, and further physiotherapy is needed, a referral will be made. 

How can a specialist physiotherapist help?

The physiotherapist in the CMSS will give you an opportunity to talk about your current symptoms and help you to understand what might make a difference and improve your quality of life.  This may include:

• Discussing bladder, bowel, vaginal or rectal symptoms such as incontinence, urgency, frequency, sexual discomfort and pain
• Reviewing lifestyle habits that may be contributing to current symptoms
• Signposting to other sources of information that may help with encouraging good bladder and bowel habits
• With consent, the specialist physiotherapist may do a vaginal or rectal examination to assess the pelvic floor muscle strength, tone, relaxation and pain.
• Feedback will be given on examination findings and a treatment plan will be discussed and agreed.
• Providing sources of further information including links to reliable patient information sites

Where surgery is the agreed plan, physiotherapy support will be provided before and after your surgery (link to the pre op and post op info tbc)

Useful Links and Resources

• Pelvic Floor Muscles | POGP
• Bladder & Bowel Incontinence | POGP
• Healthy Bladder | POGP
• Vaginal Prolapse | POGP
• Menopause | POGP
• Persistent Pelvic Pain | POGP
• Later Years | POGP
• ERAS Document

• Urinary incontinence and pelvic organ prolapse in women: management
• Information for the public | Pelvic floor dysfunction: prevention and non-surgical management | Guidance | NICE

Consultant Anaesthetists at complex mesh surgical service have experience in looking after patients referred to the Centre/Service with complications related to mesh used for stress urinary incontinence and pelvic organ prolapse. They work as part of multidisciplinary team and will be present at the complex mesh clinic. 

The role of the Consultant Anaesthetist is to carry out risk assessment, pain assessment and assess suitability for surgery. Some conditions will require further investigations and/or optimisation prior to surgery to minimise those risks, which is usually done via referrals to the patient’s GP or other health practitioners. 

If opting for surgery Consultant Anaesthetist will discuss what post-operative pain management techniques are available and risks associated with each. 

The Multidisciplinary Team

There is a large team of clinicians from different specialties working as part of the Scottish National Complex Surgical service. The team is thus multi-disciplinary and patients will see many team members during their journey through the service.

The Multidisciplinary Complex mesh team include:

• Surgical team (3 Sub-specialty Accredited Urogynaecologists) and (2 Functional Specialist Colorectal Surgeons)
• Anaesthetic /Pain Specialist Consultants
• Radiologists
• Clinical Nurse Specialists
• Specialist Mesh Physiotherapists
• Sub-specialty Fellows
• Psychologist
• Pharmacist

Our clinics are all multidisciplinary meaning patients can be seen by several team members, thus avoiding where possible multiple appointments. The team also hold joint weekly meetings to discuss referrals and patient care.

We are also supported by numerous administrative and support staff for in patient and out patient care.

Patient Information Leaflets

The following links provide useful information for patients coming through our service.

National Institute Clinical Excellence (NICE)

• Treating complications from mesh used for pelvic organ prolapse: patient decision aid (nice.org.uk)
• Treating complications from mesh used for stress urinary incontinence: patient decision aid (nice.org.uk)

British Society Urogynaecology

• The British Society of Urogynaecology (BSUG)
  • BSUG Obturator
  • BSUG Retropubic
  • BSUG Removal of Vaginal Mesh for Prolapse
  • BSUG Removal of Abdominal Mesh for Pelvic Organ Prolapse and Rectal Proplapse

Published Papers and Presentations

1. Total Trans-obturator Tape (TOT) Removal; a  case series including pain and urinary continence outcomes. Sami Shawer, Vijna Boodhoo, Oliver Licari, Stewart Pringle, Veenu Tyagi, Vladimir Revicky, Karen Guerrero. International Urogynecology Journal (2022)

• Total trans-obturator tape (TOT) removal; a case series including pain and urinary continence outcomes – PubMed

2. Use of Magnetic Resonance Imaging in Women with Suspected Complications Following Insertion of Implants for Pelvic Organ Prolapse and Stress Urinary Incontinence Surgery. P.H. Krishnaswamy, V. Hiteshna Boodhoo, J. McNeil, V. Tyagi, K. Lesley Guerrero. European Journal of Obstetrics and Gynecology and Reproductive Biology (2022),
   
   – Use of Magnetic Resonance Imaging in women with suspected complications following insertion of implants for pelvic organ prolapse and stress urinary incontinence surgery – PubMed

3. ICStelevision:
   • (192) #23186 Trans-Obturator Tape Removal; vaginal and groin dissection – YouTube
   • (192) #23190 Excision of urethral diverticulum with partial excision of trans-obturator tape – YouTube
   • (192) #23182 Total Trans-obturator Tape (TOT) Removal; a case series demonstrating post-operative pain… – YouTube
   • (192) #23191 Laparoscopic Retropubic Tape Removal (bladder mesh perforation) – YouTube

The Complex Mesh Surgical service is located in Clinic K, First Floor, New Victoria Hospital, 52 Grange Road, Langside, Glasgow, G42 9LF.

The hospital switchboard can be reached by calling 0141 2016 000.

We are a specialist multi-disciplinary team providing care and treatment to women who are pregnant or postnatal and are at risk of, or are affected by, mental illness. We also offer expert advice to women considering pregnancy if they are at risk of a serious mental illness.

We offer evidence-based treatments in a way that is best suited to you, your baby and family. Mental health problems are not uncommon during this time but they are known to respond well to care and treatment. We are able to see women at:

• maternity hospitals
• outpatient clinics
• home settings
• remotely via video calls

There are various reasons why you may have been referred. Perhaps:

• you have been treated for a mental health problem in the past and you are planning a further pregnancy or are already pregnant.
• your GP, midwife, obstetrician or health visitor feels that you may be unwell and could benefit from our help.
• there is a family history of certain mental health problems, such as bipolar affective disorder or postpartum psychosis, which can sometimes increase the risk of mental health problems after childbirth.

Our multi-disciplinary team are a group of professionals with different skills and expertise who work together to provide a package of care and treatment that is appropriate for you. The team includes psychiatrists, mental health nurses, a nursery nurse, a social worker, healthcare assistant, support staff and administrative staff. We also have students on training placements.

Following an initial assessment your careplan will be tailored to your individual needs. Common treatments may include talking therapies, medication and working with you and your baby together. You may be offered the following:

Outpatient Clinic Assessment and Treatment

This usually involves you attending one of our clinics where staff will assess your particular needs and discuss options regarding any care and treatment you may require.

We will usually either send you a letter with an appointment date or ask you to contact us by phone to make an appointment. There are clinics at various locations. Where possible, we will try to give you an appointment near your home or the hospital where you will deliver your baby.

At the first appointment we would ask you to bring your maternity record. You are welcome to bring a partner/family member or friend to the appointment, but we find it helpful to speak to you alone for some of the time.

Treatment and Support at Home

It may be helpful to receive care and treatment in your own home. Our community outreach team can provide this. Staff from the team can work with you, your family and with others involved in your care e.g. your GP, midwife, health visitor or social worker.

Maternity Hospital Assessment

Occasionally your midwife or obstetrician may ask us to see you while you are on the antenatal or postnatal wards. They will discuss this with you before we visit.

If you are pregnant and receiving care from the Perinatal Mental Health Service, then your psychiatrist and any other team members involved in your care will agree a mental health care and treatment plan with you. This plan will be agreed a few weeks before your delivery in preparation for the birth and the early postnatal period. With your agreement, the care and treatment plan will be shared with your midwife, obstetrician, GP, health visitor and others involved in your care to ensure that you receive the agreed treatment.

You will be allocated a named healthcare professional who will be your main point of contact via the telephone number for our service. If you need to speak to a healthcare professional outwith working hours call 111. In an emergency call 999.

If you are unable to keep your appointment we ask that you give us as much notice as possible if you need to rearrange or cancel your appointment. This allows us to make best use of our clinical time. To cancel or rearrange your appointment please call us.

If you need an interpreter to be present or require any specific support to attend your appointment please inform our administration staff when you receive your appointment letter.

We will ask for your consent before sharing any information with friends, family members and carers. Additional support is available for carers (see below).

When you talk with a health professional in private you will expect that what is said remains confidential. This principle is central to trust between patients and their doctor or other health professionals. Details of your care and treatment, including anything you tell us, remain confidential and will only be shared within our multidisciplinary clinical team (which includes health and social care staff).

All health professionals are bound by law and professional codes of conduct to this duty of confidentiality to their patients.

Once you have been seen, we will write back to the person who referred you. Usually we also send copies of our assessment to your GP, health visitor, obstetrician, midwife and social worker (if you have one) – unless you do not give permission for us to do so.

Occasionally there may be serious concerns for your safety or for the safety of others. In these circumstances we have a responsibility to discuss relevant information with other agencies, including social services, who can offer help, support and protection.

In most cases, you have the right to access you health records. You can discuss this with your Perinatal Team member. You can also do this by writing to the Medical Records Manager, Leverndale Hospital, 510 Crookston Road, Glasgow, G53 7TU.

If you are unhappy with any aspect of the service, please talk to a member of the team who will investigate the issues that you have raised and get back to you. Alternatively you may wish to contact the Nurse Team Leader on 0141 211 6500. If the issue cannot be resolved and you wish to make a formal complaint, staff will provide you with information outlining the process.

A carer is someone who looks after a partner, relative or friend who cannot manage without help because of illness, frailty or disability. They may or may not live together.

If you would benefit from support in your caring role, local carers services can help. They can provide you with help and support regarding a number of issues including access to respite, short breaks, information and advice on a wide range of topics, emotional support and access to carers support groups. To find information about your local carers service anywhere in Scotland please contact:

The Carers Information Line

Telephone: 0141 353 6504

Email: info@glasgowcarersinformation.org.uk

We accept referrals from a wide range of professionals. Please contact us for details on referral criteria and forms to access our services.

We provide an Advice line for Professionals to discuss referrals. This service is available weekdays (except Wednesday) from 9.30am to 12.30pm on 0141 211 6500.

It is very understandable to feel distressed, worried, anxious and fearful at this difficult and uncertain time with Coronavirus, especially if you are pregnant or have recently had a baby. Please find below some websites and resources that we hope will be helpful in providing you with some information and suggestions for coping through this challenging time. These are likely to change on a regular basis, so please check the websites for their latest updates.

• SIGN Guidelines: Patient Information
• RCPsych: Mental health information on perinatal disorders
• Action on Postpartum Psychosis: Insider Guides
• Ready Steady Baby! (revised 2018)

A carer is someone who looks after a partner, relative or friend who cannot manage without help because of illness, frailty or disability. They may or may not live together.

If you would benefit from support in your caring role, local carers services can help. They can provide you with help and support regarding a number of issues including access to respite, short breaks, information and advice on a wide range of topics, emotional support and access to carers support groups. To find information about your local carers service anywhere in Scotland please contact

The Carers Information Line

Telephone: 0141 353 6504

Email: info@glasgowcarersinformation.org.uk

Youngminds

A leading UK charity committed to improving the emotional wellbeing and mental health of children and young people.

My Mum’s got a Dodgy Brain

A film for and by children who have a parent with a mental health problem, made in collaboration with Devon Partnership NHS trust.

Maws – Our Journey

This film has been made as an educational resource for both those experiencing perinatal mental health issues, and for health care professionals. It follow the ‘Maws’ journey through their own experiences of perinatal mental health. Exploring personal accounts of perinatal mental ill health, the aim is to encourage shared experiences and better health care support for new mums. Produced by NHS Greater Glasgow & Clyde and the Mental Health Network Glasgow.

Head Up, Heart Strong

This film tells the story of six women. Their recovery from extreme episodes of pre and post natal depression to how they overcame this. 

My Mum’s got a Dodgy Brain

A film for and by children who have a parent with a mental health problem, made in collaboration with Devon Partnership NHS trust.

The Mother and Baby Unit (MBU) admits women who are experiencing severe mental illness in the later stages of pregnancy or if their baby is under 12 months old.  The six bedded unit enables mothers to be supported in caring for their baby whilst having care and treatment for a range of mental illnesses including:

• postnatal depression
• postpartum psychosis
• severe anxiety disorders
• eating disorders

Maintaining this contact is critical to the wellbeing of both mother and baby as it not only aids the mother’s recovery but also strengthens the mother-infant relationship and infant development.

We offer a wide range of medical, psychological and psychosocial interventions to women from across the West of Scotland. The unit is staffed by a multi-disciplinary team of professionals including:

• psychiatrists
• mental health nurses
• nursery nurses
• social worker
• psychologist
• health visitor
• nursing assistants
• parent-infant therapist
• peer support workers
• administrators
• input from other professionals where needed

Our YouTube video may help give you an idea of what to expect if you are admitted to the Mother and Baby Unit.

The MBU is located at Leverndale Hospital in Glasgow and can accommodate up to six mothers with their babies.

Our staff are specially trained to support you through your recovery and to help you in caring for your new baby. Any decisions about admission and treatment will be discussed with you and, where appropriate, with your family.

The unit tries, as much as possible, to maintain a homely atmosphere within the context of a hospital setting. You will be allocated a single room for you and your baby. You will also have access to a range of facilities including:

• a communal TV lounge and dining room
• laundry facilities
• bathroom and shower rooms
• kitchen and baby food preparation facilities
• family sitting room
• group activity room
• garden area with seating

For your baby

There are certain things you may need to bring including:

• child health record
• baby formula if bottle feeding
• any creams or medication that your baby requires
• nappies
• clothing for your baby including an outdoor jacket
• bibs
• baby wipes if you prefer to use them
• toiletries
• favourite small toys
• pram

We will supply other equipment such as a cot, high chair, bath, bouncy chair, steriliser, bottle warmer and toys.

For yourself

• day time clothing
• outdoor jacket
• nightwear
• a note of medication you are prescribed including dose and timings of when you take them
• if breast feeding, breast pads and nipple shields if you use them
• sanitary towels
• toiletries
• loose change for pay phone

You should not bring:

• valuables, jewellery or large amounts of money
• credit cards
• Any items made of glass for safety reasons
• Alcohol or illicit drugs
• any drugs or medication that have not been prescribed.

The hospital does not accept any responsibility for loss of, or damage to, personal belongings unless handed in to staff for safekeeping and a receipt obtained.

When you arrive

A member of staff will meet you and show you to your room and explain the layout of the unit. They will be happy to answer any questions you may have. Staff will advise you of the usual routine within the unit and provide you with any equipment you may need for your baby during your stay. For safety reasons we will check through your belongings with you to ensure there are no sharp objects or medication which may have been brought into the unit.

Please tell staff if you:

• Have had recent illnesses such as a fever, diarrhoea, vomiting or any rashes or spots.
• Need help with your mobility and need any specialist equipment
• Have any problems with your eyesight, speech, hearing or any other disabilities
• Have any problems with swallowing or dietary requirements
• Have an Advanced Statement which outlines your preferred choices regarding your care.

Care and treatment

Our focus is to help you get better as soon as possible and develop a healthy and safe relationship with your baby. We can help in a variety of ways and your care and treatment is provided by staff with extensive experience and expertise.

On admission, you will be informed of your Named Nurse and Named Nursery Nurse who will jointly develop a care plan that will meet your needs and provide any support you might need with your baby. You will also meet with a psychiatrist who will work with you to make a management plan during your admission. As part of your assessment, and with your permission, we will usually ask to meet with your partner and/or other family member.

Staff from our Multidisciplinary Team (described in the next section) will be available to assist you and your family with support in relation to finances, housing and family based issues. Staff will be available throughout your stay to discuss your treatment, progress and plans for discharge. The team will meet on a weekly basis to review your care.

Common treatments may include medication, talking therapies, group therapies and working with you and your baby together. There is a programme of therapeutic activities on the unit and your mental health and nursery nurses will plan individual and group activities with you.

A small number of patients are admitted to the unit under compulsory provisions of the Mental Health Act. If this is the case, staff will explain your rights under the Act and help you, if you wish, to appeal against your detention. Staff will also help you contact an independent advocacy service that can support you in putting across your views on your care and treatment.

The Multi-Disciplinary Team (MDT)

The care you receive in hospital will be provided by a group of professionals with different skills and expertise called the multi-disciplinary team (MDT). They work together to provide a package of care and treatment that is appropriate for you. You may not personally meet all the members of this team but they will contribute to discussions about the most appropriate treatment package for you.

The members of a MDT commonly include:

• Doctors – A Consultant Psychiatrist will be responsible for aspects of your care whilst you are in hospital. Other ward doctors may be involved in your everyday care.
• Nurses – you will meet various members of nursing staff who are there to coordinate and meet your individual needs on the ward.
• Nursery Nurses
• Health care assistants- HCA’s support the work of the qualified nurses to provide care and support for you during your stay on ward.
• Psychologists
• Social Worker
• Pharmacists – advise on medication information and management
• Occupational Therapists- OT’s are able to assess your ability to live your life in the way you want. They also ensure that you have the skills to function and maintain yourself in your home either with support or on your own.
• Recreational Therapy
• Patient Activity Co-ordinators
• Other Allied Health Professions – Art Therapy, Physiotherapy, Dietetics, Speech and Language Therapy and Podiatry.

The structured therapeutic activities within the ward are considered to be an integral component of your care and treatment and will be discussed with you during your admission. A timetable of meaningful activity is available on the ward.

Your baby’s needs

Within the first few days you will be introduced to the team GP and health visitor. They will discuss with you any medical care your baby might need during your stay, or any advice and support you might want in relation to your baby’s wellbeing and development. The GP will also ask your permission to carry out a routine physical examination of your baby. Our health visitor will be available to monitor your baby’s development and administer any immunisations your baby might require during your stay. They will also keep in touch with your baby’s own GP and health visitor.

We all have a responsibility to ensure that the needs of your baby are always given priority. You will continue to have responsibility as a parent to ensure that your baby is kept safe and to help them grow and develop. Our staff will assess how you are able to care for your baby and offer support and guidance if required.

Depending on how your illness affects you, our staff may support and guide you in meeting your baby’s needs. If we have concerns that there are particular problems in caring for your baby, this will be discussed with you and, where relevant, your partner, about how the needs of your baby can be best met.

Sometimes staff may seek help for you and your baby from social services if we feel you need extra support or where there are concerns that your baby’s needs are not being met. On rare occasions it may be in your baby’s best interests to be cared for out with the hospital setting whilst you are recovering from your illness.

Booklets explaining parental responsibilities and rights are available from staff.

Meals

The hospital will give you a menu for choosing your meals. For more information please see the booklet ‘Information about Food and Health in Hospitals’ which is available in the ward. Halal, Kosher, Vegan and Allergen free meals are available on request. There are also meals available for those on specific medication regimes.

Patient Laundry

There are laundry facilities within the ward as we are a regional unit. Wherever possible, we do encourage relatives to take laundry for washing as per the Health Protection Scotland leaflet ‘Washing clothes at home: information for people in hospital or care homes and their relatives’. Please ask your nurse for a copy.

Student Teaching

Leverndale Hospital is a teaching hospital; an important part of our work is clinical teaching and training of students in medical, nursing and other professions. You have the right to decide whether or not you wish to take part in student teaching.

The MBU adheres to the NHS Greater Glasgow and Clyde guidance to reduce the risk of cot death (Sudden Unexplained Death in Infants)

This includes bed-sharing, smoking, alcohol/drugs and sleep pods/positioners.

Whilst we recognise parents may make decisions about how they manage sleep practices for their baby at home, the MBU must take the necessary steps to ensure the best guidance is followed for the safety of your baby in hospital and we are unable to allow any practices that goes against this.

Our specialist staff are happy to work with you during your admission to help adapt any sleep practices.

If you feel this may be a barrier to your admission, please discuss this further with the clinician arranging your admission.

Mobile phones should only be used for outgoing calls. They should be switched off or in silent mode at other times to avoid disruption to your programme of care, and to other patients and their babies.

To protect patients’ privacy, camera phones must not be used to take photographs or recordings in any part of the hospital.

Due to the possible effects of medication and severe mental illness, we do not allow mothers to drive whilst admitted to the MBU.

You must tell the DVLA if you have a driving licence and develop a ‘notifiable’ medical condition/disability or your condition has got worse.

The DVLA website provides more information on:

• Telling the DVLA about medical conditions
• ‘Notifiable’ medical conditions

Leverndale Hospital is a smoke-free hospital.

This means you are NOT allowed to smoke in any NHS building, entrance, doorway, grounds or car park.

Visitors to the hospital are NOT permitted to smoke anywhere within the hospital grounds. 

Trying to stop smoking is one of the most important steps you can take for your own physical health. If you are coming into hospital and would like to stop smoking whilst an in-patient, please speak to nursing staff about the ‘Inpatient Smoking Cessation Service’. Nicotine Replacement Therapy will be offered to all smokers on admission.

We operate a ‘zero tolerance’ approach towards alcohol and illicit drugs within all of our facilities. If service users or visitors are found to be in possession of, using or supplying these substances on any of our premises, the police will automatically be informed. This could result in discharge, visitors being banned and criminal charges being brought.

Your visitors are welcome to come to the unit but we would ask that they telephone the ward beforehand to notify staff of their intention to visit. The numbers of visitors may be limited as it is difficult to accommodate a large number at one time. We would appreciate your co-operation with the following:

• When visitors arrive at the unit they will be asked who they have come to see. This helps us ensure no unwanted visitors can come onto the unit.
• Where appropriate, and with your permission, we are happy for your partner or family member to approach staff during visits to discuss your care.
• We appreciate that your visitors may have a long distance to travel. Wherever possible, we will try to be flexible in relation to visiting but ask that they visit between 2.00-4.00pm and 6.00-8.00pm in order not to interfere with your treatment programme. However, we can usually allow partners to visit for longer periods.
• To ensure minimum disruption to other patients and babies in the unit, visitors are not permitted in the communal lounge and dining area. You may sit with your visitors in the garden area, your bedroom or the family room.
• Children are welcome but an adult must accompany any children who visit you in the unit and are responsible for supervising them at all times.
• Animals are not allowed within the hospital, except for assistance dogs i.e. guide dogs and hearing dogs.
• Mobile phones can only be used within the visiting area. To protect patients’ privacy, camera phones must not be used to take photographs or recordings in any part of the hospital.
• Food (hot/cold) and refreshments are available for visitors from Cafe Connect and Restaurant, both located at Leverndale Hospital

Families may have to travel some distance when visiting the unit. If your partner or other family members would like information regarding overnight accommodation in Glasgow, please ask them to speak to a member of staff. Assistance with travel costs may be available from your local Social Work Department. We can help you contact them if necessary.

If you would like to discuss any spiritual needs or see someone from your own faith, please ask to speak to the healthcare chaplain. They can speak with you or find someone of your own faith for you to talk to. You don’t have to be religious or to belong to any particular faith to talk to the chaplain;

Ms Anne MacDonald DCS, Leverndale Hospital, 510 Crookston Road, Glasgow G53 7TU. Telephone: 0141 211 6695

If you have any particular needs concerning your faith or beliefs, please make these known to a member of staff.

Our service aims to provide care that meets your physical, psychological, spiritual, cultural and social needs. Here are some of the ways in which the hospital might meet your individual needs:

• Providing an interpreting service for patients whose first language is not English

• Providing a sign language interpreter for patients who are Deaf, Partially Sighted or Blind

• Offering food which meets your religious and cultural requirements

• Help in arranging visits from your church or faith community

At any time during your stay in hospital you may ask for any of these services by speaking to the nursing staff.

There are a number of Money Advice Services. These services can:

• Help you identify benefits you are entitled to
• Help you fill out benefit forms
• Help to support you in benefit appeals
• Deal with creditors on your behalf
• Look at options to have accounts put on hold
• Help you to keep track of what you spend
• Provide legal assistance.

Please approach a member of staff for information on this service

After your admission, we will start to plan with you arrangements for your discharge home. This helps to avoid any unnecessary delays to your discharge. We will liaise regularly with the relevant health and social care teams to plan any ongoing care and treatment that you may require after discharge.

Preparation for your discharge will be made according to your individual need. To help you adjust to being home again, you may have periods of leave from the unit. This usually begins with a few hours out and can be increased to one or more days and nights out at a time.

When you eventually return home, we will arrange for you to be seen by a psychiatrist or community psychiatric nurse (CPN) and, where appropriate, a social worker. If you live in the Glasgow area, this is likely to be a member of staff from the Perinatal Mental Health Service Community Team. We will also contact your GP and health visitor, and any other services involved in your care to let them know about the plans for your ongoing care and treatment. For those living out with NHS Greater Glasgow and Clyde we will work closely with your local services to ensure you have safe and effective follow-up.

If you are prescribed medication you will receive a seven day supply before you leave the unit. You should make an appointment with your GP as soon as possible after discharge to obtain further prescriptions for your medication.

When you talk with a health professional in private you will expect that what is said remains confidential. This principle is central to trust between patients and their doctor or other health professionals. Details of your care and treatment, including anything you tell us, remain confidential and will only be shared within our multidisciplinary clinical team (which includes health and social care staff).

All health professionals are bound by law and professional codes of conduct to this duty of confidentiality to their patients.

We will ask for your consent before sharing any information with friends, family members and carers.

Once you have been discharged, we will write to your GP, health visitor, obstetrician, midwife and social worker (if you have one).

Occasionally there may be serious concerns for your safety or for the safety of others. In these circumstances we have a responsibility to discuss relevant information with other agencies, including social services, who can offer help, support and protection.

In most cases, you have the right to access you health records. You can discuss this with your doctor or named nurse. You can also do this by writing to the Medical Records Manager, Leverndale Hospital, 510 Crookston Road, Glasgow, G53 7TU.

Independent advocacy helps you to make your voice stronger and to have as much control as possible over your life.

Independent advocacy workers are separate from services. They do not work for hospitals, social work or other services. This might be useful if you feel you need support to speak up, to understand what is being said and to make decisions. Many people find that when they feel ill or upset they are not as good at saying what they want and they need support to speak up.

Please ask a member of staff for further details.

NHS Greater Glasgow and Clyde takes extremely seriously the health, safety and welfare of all its employees, patients and visitors. It believes that violence and/or aggression towards staff and others is unacceptable.

Staff have a right to be able to perform their duties without fear of abuse or violent acts from patients or members of the public. No member of staff should consider violence or aggression to be an acceptable part of their employment.

In cases of incidents involving violence and aggression against members of staff, encouragement and support will be given to the individual involved to enable them to pursue the incident through reporting it to the Police.

If you are unhappy with any aspect of the service, please talk to a member of the team who will investigate the issues that you have raised and get back to you.

Alternatively you may wish to contact the MBU Ward manager.

If the issue cannot be resolved and you wish to make a formal complaint, staff will provide you with information outlining the process.

We also welcome positive feedback.

A carer is someone who looks after a partner, relative or friend who cannot manage without help because of illness, frailty or disability. They may or may not live together.

If you would benefit from support in your caring role, local carers services can help. They can provide you with help and support regarding a number of issues including access to respite, short breaks, information and advice on a wide range of topics, emotional support and access to carers support groups.

To find information about your local carers service anywhere in Scotland please contact

The Carers Information Line

Telephone: 0141 353 6504

Email: info@glasgowcarersinformation.org.uk

If you want to find out how to travel to the hospital please call Traveline on 0871 200 22 33 or see www.travelinescotland.com

Our ward staff are happy to suggest convenient accommodation options near to the hospital. Call 0141 211 6539.

Visit Scotland has a number of hotels, B&Bs, hostels, guest houses and self-catering options.

If your partner or someone you care for is in a Mother and Baby Unit (MBU), you are entitled to financial help with travel, meal costs and accommodation.

LGBT Youth Scotland are working to make Scotland a place where all LGBTQ+ young people can flourish and thrive. On their website you can find your local youth groups and access their live chat for digital support. There’s also lots of really practical resources on many different topics such as coming out, sex and relationships and gender.

• Access the LGBT Youth Scotland website
• View the LGBT Charter of Rights poster
  
  

This organisation supports LGBTQ+ people aged 16+ years with service, social events and resources. The LGBT Helpline Scotland is available for LGBTQ+ people but also parents, friends and professionals who are supporting LGBTQ+ people. The Helpline team will be able to give information on sexual health, coming out, gender identity amongst other issues.

• Access LGBT Health and Wellbeing website

Scottish Trans work to improve gender identity and gender reassignment equality, rights and inclusion in Scotland.

• Access the Scottish Trans website

The Glasgow Stroke Psychology Service considers inpatient referrals for a range of psychological problems that are associated with a confirmed diagnosis of stroke. The service offers psychological assessment, formulation and intervention, including neuropsychological assessment and advice/rehabilitation. The service also offers consultancy to other professionals to help them meet a patient’s psychological needs within their work.

Intervention may take different forms, this might include brief individual work with the patient or family or recommendations for staff working with the patient. Referrals will be responded to as quickly as possible. If the patient will shortly be discharged, please consider whether an outpatient referral would be more appropriate.  Likewise if the psychological problem is not directly related to the individual’s stroke, please refer to Liaison Psychiatry using their regular referral protocol.

• The psychological problem is associated with the person’s stroke and is impacting on their ability to engage in effective rehabilitation.
• The psychological problem requires input on an inpatient basis (e.g. the problem is having a significant negative impact on rehabilitation, input is required to facilitate discharge planning etc). If this is not the case, highlight any concerns to the stroke liaison nurses upon discharge for consideration of referral to Stroke Clinical Psychology Service on an outpatient basis.

Referrals should be instigated by a senior member of the ward team and the patient must consent to the referral being made. If the patient has already been referred to the Liaison Psychiatry Service, please clearly state the additional referral question that you wish the Glasgow Stroke Psychology Service to address. If you are uncertain about the appropriateness of a referral then please speak to the local Stroke Psychologist to discuss the case further. 

• To download an up to date copy of our referral form please click here: Inpatient referral form
• For additional guidance on the suitability of potential referrals please consider our suitability guidance: Referral flow chart

The service considers referrals for a range of psychological problems that are associated with stroke.  The service offers psychological assessment, formulation and intervention, including neuropsychological assessment and advice/rehabilitation.  The service also offers consultancy to other professionals to help them meet a patient’s psychological needs within their work. Examples of difficulties we might be able to help with include:

• Psychological distress, including mood-related difficulties (e.g. anxiety, depression) that:
  • Does not resolve over time
  • Interferes with life activities and/or rehabilitation
  • Cannot be managed by other members of the multidisciplinary team
• Adjustment disorder (e.g. to loss of function, role or mobility)
• Health Anxiety disproportionate to diagnosis
• Neuropsychological assessment
• Management of cognitive difficulties

• The psychological problem is associated with the person’s recent onset confirmed stroke.

If you are uncertain about the appropriateness of a referral then please speak to the local Stroke Psychologist to discuss the case further. Where mental health difficulties are present but not related to the stroke, referrals should be directed to the relevant community mental health service.