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 ¾¨Ó㴫ý 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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Our staff at Salisbury District Hospital have long been well regarded for the quality of care and treatment they provide for our patients and for their innovation, commitment and professionalism. This has been recognised in a wide range of achievements and it is reflected in our award of ¾¨Ó㴫ý Foundation Trust status. This is afforded to hospitals that provide the highest standards of care.
