Blood clot guidelines 'routinely ignored' by clinicians

Blood-thinning medicines can help patients avoid developing blood clots Credit: Stephen Kelly/PA Wire/Press Association Images

Hundreds of lives could be saved in Wales if guidance to prevent blood clots was always adhered to in hospitals, according to a National Assembly committee.

An inquiry by the Health and Social Care Committee found that established guidelines to prevent venous thromboembolism (VTE) in hospitals were 'routinely ignored'.

The Committee heard:

  • Approximately 900 deaths in Wales in 2010 were due to - or associated with - hospital-acquired blood clots or thromboses

  • This figure is substantially higher than the combined number of people who died from MRSA, breast cancer or AIDS in Wales during the same year

  • Up to 70 per cent of such deaths could have been avoided had appropriate preventative measures been put in place

The Committee found that the National Institute for Clinical Excellence (NICE) had published guidelines in 2010, based on advice from medical experts, which recommended a risk assessment be carried out on each patient.

But the Committee also found that these guidelines were often ignored.

Risk assessment alone will not ensure patients avoid developing blood clots during hospital care. It has to be considered alongside the use of appropriate treatment - whether in the form of blood thinning medicines or specialist stockings - if lives are going to be saved. But the Committee has raised concerns at evidence that some clinicians routinely ignore guidelines set down by their peers. We are also concerned that assessment methods are not just inconsistent across local health boards in Wales but can be inconsistent across different departments within the same hospital.

The Committee's report makes five recommendations, including establishing a standard procedure to record and reduce cases of hospital-acquired thrombosis, and raising awareness of the risks through a public education campaign.

The Welsh Government says it welcomes the report and will 'carefully consider' its conclusions and recommendations.

We recognise VTE is a devastating condition and are committed to reducing its incidence across Wales. NICE’s guidance 'Reducing the risk of venous thromboembolism in patients admitted to hospital' was developed using the best available evidence, and therefore should be used to ensure patients are receiving the most appropriate care. The guidance does not, however, override the individual responsibility of healthcare professionals to make decisions appropriate to the circumstances of the individual patient, in consultation with the patient and/or guardian or carer, and informed by the summary of product characteristics of any drugs they are considering. The tools and resources developed by the 1000 Live Plus programme to support implementation of the guidance are there to assist clinicians to determine the best approach for their individual patients.