Personal Injury, Serious Injury & Clinical Negligence

NICE publish guidelines on blood clots

Quicker diagnosis, treatment and links to cancer

What has been published?

On 27 June 2012 the National Institute for Health and Clinical Excellence (NICE) published guidance on diagnosing and treating blood clots. The guidelines set out best practice in how to test and treat venous thromboembolic (VTE) diseases such as deep vein thrombosis (DVT) and pulmonary embolisms (PE), stating tests should be carried out within 24 hours if symptoms are noted (symptoms include pain, tenderness and swelling in the calf, skin that is red and feels hot and chest pains).

Blood clots when present in the legs or lungs can cause significant problems, such as long term pain, swelling, disability and even death. Many are left undiagnosed and therefore remain untreated. NICE is aiming to reduce the number of patients suffering by implementing measures which provide for more testing and treatment.

What does NICE do?

NICE is an independent organisation responsible for providing guidance, promoting good health and preventing and treating ill health. They produce guidance for the NHS, local authorities, for those with specific diseases, relating to procedures and seek to ensure that high quality is maintained throughout all aspects of the care service.

How do the guidelines apply?

At the moment the guidelines are simply that – guidelines. Healthcare professionals are expected to take them into account when exercising their clinical judgment; however the guidelines do not override the individual responsibility of the healthcare professional to make decisions appropriate to the circumstances of an individual patient.

There are no financial penalties for non compliance with the guidelines which could hinder their use and impact. However, the NHS is expected to follow them and continue increased screening for VTE, which went from 50% of patients with suspected VTE being screened in September 2010 to 90% being screened in December 2011. NICE also wants to reduce variation in treatment provided.

Cancer

VTE has number of different causes and so there is a need to identify other health problems at an early stage. The NICE guidelines seek to raise awareness of the link between VTE and cancer. Cancer can increase the risk of developing blood clots and a strong link has been discovered between blood clots being a sign of cancer (reportedly 4,000 patients were found to have cancer after being hospitalised with DVT). This link could improve diagnosis of both diseases and assist with early and effective treatment being given.

What do the guidelines include?

  1. Details of investigation which should be carried out for DVT and PE
  2. Treatments for DVT and PE
  3. There is also a suite of tools for healthcare professional to support implementation of the guidelines.

Where can they be found?

The NICE Guidelines on: Venous thromboembolic diseases: the management of venous thromboembolic diseases and the role of thrombophilia testing can be found at:

https://www.nice.org.uk/guidance/cg144

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