Sir William Gowers Unit - Preparing for your stay

Gowers is a specialised assessment and treatment unit for people who have seizures due to epilepsy and other causes. The ward is part of Queen Square Division within University College London Hospitals NHS Foundation Trust (UCLH).

Patients come to the unit from all over the UK and overseas. It is based at the Epilepsy Society’s Chalfont campus in Buckinghamshire.

To find out more about Epilepsy Society, please visit www.epilepsysociety.org.uk.

Finding Us

Please visit www.epilepsysociety.org.uk/contactus

Public transport Train - To Gerrards Cross from Marylebone, London. The journey takes about 20 minutes on the train. A Taxi Rank is available for the remainder of your journey to Gowers (about three miles).

Tube - Metropolitan Line to Chalfont & Latimer. A Taxi Rank is available at the back of the station - for the remainder of your journey to Gowers (about three miles).

For travel advice, contact Transport for London on 0343 222 1234 or visit www.tfl.gov.uk. Or National Rail Enquiries on 03457 48 49 50 or visit www.nationalrail.co.uk

• The unit accommodates both men and women. However, you will not share a room, bathroom or toilet with someone of the opposite sex. It is not possible to allocate a room number or type of room before your admission.
• Toilets are located in the day room, outside the dining room and near the bedrooms. All toilets are wheelchair accessible and large enough for those needing supervision or assistance.
• There is a large day room with a television, a pool table, puzzles and table football
• Hand gel is located outside the doors of all communal areas and in each bedroom.
• We will provide all of your meals taking into account your special dietary requirements. Please note there are no cooking facilities available for patients.
• An interpreter service is available if needed. Some staff are familiar with Makaton.
• Manual handling equipment including hoists are available for patients who need support with transferring.
• There is a large bath available for disabled individuals who are unable to use the shower - this can be used under the supervision of our nursing staff.
• Wi-Fi - you will be able to log into the UCLH guest network when you are admitted, please ask staff if you need assistance.

• Your admission letter
• Your current contact, next of kin and GP details
• Your glasses, hearing aids (and spare batteries), dentures (with labelled container) and any mobility aids, wheelchair or other specialist medical equipment
• All your current medication (anti-epileptic drugs and any other medication you take). Please bring in their original boxes. Our pharmacy carries a limited number of medications and ordering can take 48 hours
• Sufficient clean clothing to last for the duration of your stay on the unit, including night wear, slippers, a dressing gown, an outdoor coat and shoes
• During the summer, you may want to bring sunglasses, sun hat and sun cream
• Towels and wash bag with your usual toiletries (such as toothbrush and toothpaste, hair brush, flannel, soap, sanitary items and shaving gear). Hair conditioner helps to remove EEG electrode glue. All of our bedrooms have a single wardrobe and several small drawers to keep your belongings in. We are unable to store large suitcases but you should keep an overnight bag with you in case you need to be transferred to another hospital.

Electrical items

Small electrical items such as a hairdryer, shaver or personal stereo (with headphones) are permitted but they must be checked by our electricians before use. You can bring a mobile phone, tablet computer or laptop. Wi-Fi is available to connect to the internet. Televisions are not permitted.

Safety and security of your belongings

UCLH does all it can to keep the ward as safe and as secure as possible; please note that the hospital will not be liable for any personal property loss or theft if the item has not been handed in for safekeeping to staff. Please do not bring valuable items or large amounts of cash into the unit. Safe storage areas are provided in rooms and you can also keep your valuables locked in these. Please keep your property safe on the unit and label all of your belongings with your name.

Please bring an up-to-date copy of your prescription which accurately outlines the medications and dosages you are currently taking. You may be able to claim help for the cost of travel to our ward if you are in receipt of certain benefits.

For more information about this, please read leaflet HC11 ‘Help with Health Costs’ which is available to download at www.nhs.uk/healthcosts or ask our ward administrator when you arrive.

Your admission letter will tell you what time to arrive. When you arrive at Gowers, please report to the ward administrator in the reception area. We will show you to your bed area and around the unit. You will also be introduced to the nursing team.

All staff wear a name badge with their name and job title which should be visible at all times, if you cannot see an individual’s badge, please ask them to show it you.

Shortly after your arrival to Gowers, you will be seen by a junior doctor for your admission medical. This can take up to two hours to complete. It is helpful if you are accompanied to this by someone who knows you well and is familiar with your seizures.

The nursing team will help you to settle in and undertake a nursing assessment to identify the support you need during your stay as an inpatient on Gowers. Individuals are admitted to Gowers for various reasons. Some are admitted for assessment and/or treatment changes because their diagnosis is not clear or their seizures are difficult to control with medication. Others are admitted for investigations as part of an assessment before or after surgery for epilepsy.

Amongst the investigations available to patients staying on Gowers are:

• Magnetic Resonance Imaging (MRI) which is a type of brain scan.
• Electroencephalogram (EEG) which is a recording of brain activity.
• Ambulatory EEG which is a prolonged EEG recording lasting for up to several days.
• Video EEG Telemetry which is simultaneous video and EEG monitoring.
• Neuropsychiatric evaluation.
• Neuropsychological evaluation.
• Blood tests and/or other specimens.
• Electrocardiogram (ECG) recording of the heart rhythm

These specialist investigations aim to improve our understanding of your condition which may help your doctor to provide you with the best possible treatment. We also hope that your stay on Gowers will help to minimise the impact of your condition in daily life.

• During the assessment you will be observed by staff and your seizures may be filmed as they occur on camcorders which are carried by the nursing staff. This is an important part of the assessment process. We will discuss this with you when you are admitted and will ask you to sign a consent form to ensure that you are in agreement with this.
• There is also continuous video observation in our six video EEG telemetry rooms. This footage is continually observed by nursing staff so that they can respond promptly if seizures occur or are suspected (please see below for further information about this.
• We will ask you not to leave the ward unless you are with a member of staff so that we can keep you under observation for the duration of your assessment. If you choose to leave without staff, you will need to sign a disclaimer.
• At night, checks are carried out by nursing staff every 15 to 30 minutes. This means you may be disturbed during the night by staff entering your room. If this causes you problems, please discuss with the nursing staff. Before you go to sleep make sure your call bell is within easy reach.
• There is audio (sound) monitoring in the bedrooms your own in your room. Please be aware that staff will be able to hear what you say in the bedrooms. These can be switched off, please ask staff; do not disconnect them from the wall.

Some individuals may undergo assessment with Video EEG Telemetry during their stay. Video telemetry uses a video camera to record throughout the day and night whilst a portable EEG monitors brain activity. This means that if a seizure occurs, a comparison can be made between brain activity measured by EEG and video footage which shows what is happening to you.

This test can help with diagnosis and identify the type of seizure that occurs which guides treatment. We will ask for your written consent before you undergo Video EEG Telemetry.

What to expect during Video EEG Telemetry

• You will be allocated to one of our six telemetry bedrooms which have video cameras on the ceiling. These will record constantly and you might hear it moving as it focuses on your position in the room. These rooms have their own en-suite bathrooms
• You will be asked to stay in the room for the duration of the test which can be for up to 5 days. Your meals will be brought to you in your room. You can be visited by friends and family. 
• A nurse will monitor the video footage at all times and will be able to hear what you are saying some of the time. When the EEG technicians review the recordings from the camera they will also be able to hear what you are saying.
• It may be easier for you to wear clothes that button up the front such as a shirt or cardigan (rather than ones you take off over your head) to make it easier to get changed whilst the EEG wires are in place.
• You are not allowed to smoke in the room but please let us know if you are likely to require nicotine patches.
• You can use a mobile phone, laptop or tablet computer.  
• Do not use any hair products (such as hair gel or spray) before the telemetry as this makes the electrodes hard to attach. Hair extensions should be removed.
• Televisions with DVD players are available in our telemetry rooms. We have a selection of DVDs on the ward but you can also bring your own DVDs from home.
• If the recordings are helpful with your diagnosis and treatment they will be safely and securely stored. If not, they will be destroyed.

During your stay on Gowers it is very likely that you will see other people having seizures. This can be distressing if you are not use to it but you should be reassured that the nursing staff on Gowers are trained and experienced in supporting individuals during and after seizures.

If you see someone having a seizure and there is no member of staff present, please do not attempt to provide support but instead please call for help immediately. The nursing staff will be able to show you the nurse call bells in each area of the ward.

You will very likely be asked to leave the room or area if someone is having a seizure to maintain their privacy and dignity.

Gowers welcomes the contribution visitors and carers make to the well-being of our patients. We offer flexible visiting times but our nursing team are responsible for deciding if any visiting restrictions are required on a daily basis and are subject to any Covid-19 pandemic or other restrictions in place during the admission period and are subject to change at short notice.

Visiting times are between 10am and 8pm.

Outside of these hours; please speak to the nurse in charge to agree alternative times. We have protected meal times which visitors are asked to respect. Carers are encouraged to participate in the care of their relative or friend and can visit freely.

Individuals who have previously been patients on Gowers are able to visit at the discretion of the nurse in charge but may be asked to attend with a responsible adult who is able to support them if necessary and are subject to any Covid-19 pandemic or other restrictions in place during the admission period and are subject to change at short notice. All visitors are required to sign the visitor’s book on arrival.

Our Admissions Department can provide information on local bed and breakfast accommodation if required. Please be aware that visitors are required to pay for this accommodation.

Visitors with diarrhoea and vomiting are requested not to visit the ward until they have been symptom free for 48 hours.

Nurses and doctors

The nursing team will be responsible for coordinating your care. You may also see a specialist nurse for additional support. You will be under the care of a named consultant, who will oversee your treatment. Your consultant will be assisted by junior doctors who will also see you on the ward.

Medications

Medications are stored in cabinets by your bedside. Self-administration of medicines is not permitted as the registered nurses need to monitor any changes or side effects very carefully.

Pregnancy

If there is a possibility you could be pregnant it is important to tell your doctor.

Mealtimes are:

Breakfast - 8am to 9am Monday to Friday & 8am to 10am at weekends - Cereals, toast, fruit and yoghurt are available. You can bring your own cereal if you prefer.

Lunch - 12.30pm – Hot and cold food, vegetarian options and a selection of desserts.

Supper - 5.30pm - Hot and cold food, vegetarian options and a selection of desserts.

The housekeeper can tell you more about the food available. We offer healthy food options and cater for special dietary requirements taking account of allergies, medical or religious needs. Please let us know at least seven days before your admission if you have any special dietary requirements.

• Fresh fruit is always available in the dining room.
• A limited volume of food or drinks can be kept in the fridge in our dining room but should be labelled with your name and date and use by date.
• Please do not bring uncooked food that requires heating.
• Please do not take hot food into your bedroom.

Drinks

Cold drinks are always available in the dining room and water is kept by your bedside. Hot drinks are available in the dining room at meal times and at other times of the day they are available in the lounge. Please do not take hot drinks into your bedroom.

Night time

We ask that you prepare for bed by 11pm. Please speak to the staff if you wish to stay up later. This may be possible if it does not disturb others.

Smoking

Smoking/Vaping is not permitted on Trust property. Patients and visitors must not smoke in the ward or around its entrances.

Flowers

Flowers are not permitted on the ward.

Telephones

There is a pay phone in reception for making and receiving calls. The number is 01494 601 430. Anyone may answer the phone so your callers will need to ask for you. Mobile phones are permitted on the ward. You may be asked to stop using your mobile phone if it is disturbing others. Your mobile should be turned off or switched to silent mode at night time. You must not use your mobile phone to make recordings or to take photographs of other patients or staff.

We want you to feel relaxed and comfortable during your stay with us during which you are likely to meet people from different backgrounds and with different experiences. We hope that you make new friends but you may not get on with everyone you meet. To help make everyone’s stay on Gowers a positive experience, we ask that individual:

• are polite and courteous at all times 
• respect other people’s privacy and personal space
• are considerate when playing music and watching television
• do not behave in an antisocial manner.

We do not allow alcohol or illegal substances to be used on the ward. We also do not tolerate physical or verbal aggression including racial or sexual harassment. If any individual is unable to follow this guidance, we will review whether it is possible for them to remain on Gowers. If you have concerns or experience difficulties with other patients, please raise these with a member of nursing staff as soon as you can.

You will be given a copy of the discharge summary which is also sent on to your GP. This will include information about changes made to your regular medication during your stay on Gowers. You will also be given a supply of discharge medication to last for two weeks following your discharge. Further supplies of medication should then be obtained from your GP.

Before you leave the unit, make sure you have been given your medication. The nursing staff will explain how and when to take this. You should also be given details of your follow up appointment if you are to be followed up by UCLH services at the National Hospital for Neurology and Neurosurgery or at Chalfont. If you receive support at home, please ensure that this support will be re-started after your discharge home.

The nursing staff will be able to help with this. If you feel that you may need support at home, please discuss this with the nursing and medical staff as soon as possible after your admission.

Before you leave the unit, please ensure that you ask the nursing staff for any medical certificates that you may need. Also, please take all of your belongings and collect any valuables given for safekeeping.

After discharge

If problems arise following your discharge home, please seek advice from your GP or attend your local Accident and Emergency Department via an emergency ambulance if appropriate.

If you are going to continue to be seen in UCLH outpatient services, you could make contact with the epilepsy specialist nurses. They offer a voicemail service and you can leave a message for them on 020 3448 8627 They aim to return calls within 48 hours during normal office hours.

Teaching and research

UCLH is a teaching Trust and you may be asked if medical or nursing students can observe or assist with your care. We are also a major centre for medical research. You may be asked to participate in research studies whilst you are with us. If you do not wish to participate in research studies and/or prefer that students do not assist in your care, please let us know when you arrive. This will not affect the treatment or care that you receive in any way.

Equality and diversity

Our staff is committed to ensuring the rights, dignity and Cultural values of our patients are respected. We will ensure that no person receives less favourable treatment on the 19 grounds of age, disability, gender, religion and belief or sexual orientation

We welcome your feedback and your comments will be used to monitor and improve the service we provide. We will ask you to complete our inpatient survey prior to your discharge from the ward. You can also give feedback via the UCLH website here: www.uclh.nhs.uk and via the NHS Choices website here: www.nhs.uk.

If you are unhappy with any part of your experience here please speak to the charge nurse or ward sister in the first instance. If necessary, your concerns can be escalated.

The PALS (Patient Advice and Liaison Service) provides an alternative personal contact point to assist patients, relatives and carers. If you have an issue relating to our service that you would like to discuss with them, contact the PALS team on 020 3448 3237 or PALS@uclh.nhs.uk

You can ask a member of staff to contact the PALS team for you. If you do need to make a complaint directly, please contact:

Complaints Department
UCLH Trust Headquarters
250 Euston Road
London, NW1 2PG

020 3447 7413 or complaints.officer@uclh.nhs.uk

Sir William Gowers Unit

Chalfont Centre for Epilepsy

Chalfont St Peter Bucks

SL9 0RJ

Telephone: 014 9491 7160