Nicola McQuaid, Peter Davies, Tamara Everington
The 2018 updated National Institute for Health and Care Excellence (NICE) guidance on venous thromboembolism (VTE) (NICE 2018) includes significant changes and extensions to the 2010 guidance on VTE risk assessment and thromboprophylaxis for hospital patients (NICE 2010). The purpose of this guidance was to support further reduction in the incidence of hospital‐associated thrombosis (HAT), which is estimated to cause 50–60% of VTE. Over the last decade, pioneering work to reduce HAT has been led through the UK VTE Exemplar Network of hospitals (Department of Health 2010; Roberts et al, 2013; Catterick & Hunt, 2014; Rowswell & Nokes, 2017).
One aspect of this work was to encourage hospitals and commissioners of healthcare to enter into contractual arrangements that ensured root cause analysis (RCA) of all hospital‐associated VTE events to support system learning and inform future practice.
Salisbury NHS Foundation Trust became a member of the VTE Exemplar Network in 2008 and has been collecting data on incidence of HAT for over 10 years. All new patients diagnosed with deep vein thrombosis (DVT) or pulmonary embolism (PE) in our community are referred through the direct access specialist VTE service and data is also collected on deaths with VTE in hospital. Whole leg scanning is performed for DVT through a specialist vascular service. The coroner and local GPs will generally advise us of deaths from VTE in the community due to a strong engagement culture, but it is possible small numbers of deaths from VTE in the community may be missed.