Sunday 19 May 2024
Internal Reference Number: FOI_6503
Date Request Received: 07/03/2022 00:00:00
Date Request Replied To: 29/03/2022 00:00:00
This response was sent via: By Email
Request Summary: Acute management of Venous thromboembolism, Thromboprophylaxis
Request Category: Campaigning organisation
| Question Number 1: Acute management of Venous thromboembolism: Confirm whether the Trust routinely prescribes direct oral anticoagulants (DOACs) in preference to low molecular weight heparin (LMWH) and warfarin for the management of standard acute venous thromboembolism (VTE)? | |
| Answer To Question 1: DOACs are the preferred option | |
| Question Number 2: Please provide a copy of the Trusts’ management policy on management of acute venous thromboembolism (VTE). | |
| Answer To Question 2: https://mg.salisbury.nhs.uk/media/1158/suspected-dvt-august-2016-v12.pdf https://mg.salisbury.nhs.uk/media/1157/suspected-pe.pdf | |
| Question Number 3: Does the Trust provide all patients with an unprovoked VTE a medical opinion from a thrombosis physician? | |
| Answer To Question 3: All patients are seen in the VTE clinic by specialist nurse and referred to haematology clinic if meets the requirements for thrombophilia testing. | |
| Question Number 4: Does the Trust definition of an ‘unprovoked VTE’ include women using the combined oral contraceptive pill or hormone replacement therapy (HRT)? | |
| Answer To Question 4: Yes – if the commencement of the COCP / HRT was more than 2/12 prior to the VTE | |
| Question Number 5: Do investigations after an unprovoked VTE follow NICE guidance? | |
| Answer To Question 5: Yes | |
| Question Number 6: Per week, how many clinics are devoted to seeing patients with VTE in the Trust? | |
| Answer To Question 6: 5 – (Daily Mon-Friday) | |
| Question Number 7: How many full-time equivalents are employed by the Trust to provide thromboprophylaxis and care of thrombosis patients from? a. Nursing b. Pharmacists c. Medical | |
| Answer To Question 7: A) x1 Band 7 – role covers Anticoagulation service / VTE treatment and prevention. B) x1 pharmacist, member of the thrombosis committee and assists with policy development. C) x1 haematology consultant (22.5hrs – provides support to anticoagulation & thrombosis service) | |
| Question Number 8: Thromboprophylaxis: - Does the Trust routinely meet the 95% VTE Risk Assessment level required by NHS England? - Please provide the monthly percentage (admissions numbers/VTE risk assessments carried out) for VTE risk assessments carried across the Trust between 1st October 2021 – 31 December 2022. - Does the Trust have dedicated funding for a team ensuring VTE prevention occurs? | |
| Answer To Question 8: Monthly audit of VTE risk assessments completed. Consistently more than 95% achieved. Oct – Dec 99.8%, 99.2%, 99.7%. Dedicated team of nurses for VTE management but not specifically VTE prevention. | |
| Question Number 9: COVID-19 - Please provide a copy of the Trust’s thromboprophylaxis protocols used to treat in-patients with COVID-19 pneumonia. | |
| Answer To Question 9: https://viewer.microguide.global/guide/1000000295#content,7f081fd3-6d95-403c-b65c-d5d5eb9f92ee | |
| Question Number 10: Psychological care - Do VTE patients within the Trust have access to clinical psychological support? - How many sessions per week are provided by the Trust for VTE clinical psychological support? | |
| Answer To Question 10: No provision currently provided. | |
| Question Number 11: Cancer-associated VTE - Does the Trust have a dedicated clinical lead for cancer associated thrombosis (CAT)? - Does a protocol exist for managing VTE in those with cancer? - Please provide a copy of the Trusts’ protocol for managing VTE in those with cancer. | |
| Answer To Question 11: No designated lead for CAT. All patients are seen in the VTE clinic. No protocol available specifically for CAT. | |
| Question Number 12: VTE prevention and management in the community - Please provide copies of VTE care pathways developed to support community clinicians with regards to: (i) Anticoagulation medication changes (ii) Anticoagulation dosing. | |
| Answer To Question 12: All patients are referred to the anticoagulation / VTE clinic. Letter generated with individualised plan for GP to follow. | |
| Question Number 13: - Does the Trust have specific VTE guidance for: (i) System wide protocols? (ii) E-consultation facilities? (iii) On call clinician to discuss problems and seek advice from? | |
| Answer To Question 13: i. VTE guidance is available. All VTEs are assessed by VTE nurses ii. There are facilities to do e-consultations but most patients are seen following vascular Doppler scan which is unable to be performed virtually. iii. OOH number available to speak with Haemostasis consultant within the region. | |
| Question Number 14: - Please provide copies of the Trust’s protocol documents for VTE prevention and management in (i) System wide protocols (ii) E-consultation facilities (iii) On call clinician to discuss problems and seek advice from | |
| Answer To Question 14: i. VTE policy: https://viewer.microguide.global/guide/1000000295#content,2deca650-60d4-4ef3-b41d-d88c64bcb158 ii. No documents iii. No documents | |
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