Hundreds of Lives Could Be Saved If Clinicians Did Blood Clot Safety Checks; RISK ASSESSMENT GUIDELINES OFTEN IGNORED, SAYS REPORT

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Byline: JULIA MCWATT Health Correspondent julia.mcwatt@walesonline.co.uk

HUNDREDS of deaths from hospital-acquired blood clots could be prevented if clinicians followed guidelines to prevent the condition, according to a damning report by the National Assembly.

During an inquiry into deaths from hospital-acquired blood clots or thromboses, the Health and Social Care Committee heard 900 deaths in Wales were associated with the condition - more than the combined number of people who died from MRSA, breast cancer or Aids in the same year.

Members of the committee were also told that up to 70% of such deaths could have been avoided if appropriate preventative measures had been put in place. In their report, published today, the committee found guidelines published by the National Institute for Clinical Excellence (Nice) in 2010, which recommend a risk assessment be carried out on each patient, were often ignored by medical staff.

The committee also said they had "grave concerns" about inconsistencies in risk assessments, even between departments within the same hospital.

Committee chairman, AM Mark Drakeford, said: "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 grave concerns about clinicians routinely ignoring guidelines set down by their peers. We are also concerned assessment methods are not just inconsistent across local health boards in Wales but inconsistent across different departments within the same hospital."

Following their findings, the committee has called on the Welsh Government to establish a mandatory standardised procedure to record cases of hospital-acquired thrombosis, and the performance of health boards in reducing the number of blood clot cases to be a priority.

Other recommendations include the Welsh Government considering whether compliance with the relevant Nice guidance should be included as a tier one priority for health boards, against which they will be performance-managed.

They also said a standard procedure to reduce hospital-acquired thrombosis, mandating clinicians to risk assess and consider prescribing appropriate measures to prevent the condition developing, should be introduced.

Health boards should also develop a standardised method to demonstrate a hospital-acquired thrombosis rate for each hospital in Wales and at a national level, and a root-cause analysis should be undertaken for each case in hospital or in patients presenting venous thromboembolism within three months of being discharged.

Meanwhile, a public education campaign should be devised to improve understanding of the risks of hospital-acquired thrombosis and the severity of the problem.

The Chartered Society of Physiotherapy (CSP) in Wales said patient mobility was key in preventing blood clots, but raised concerns that limitations in staffing levels meant many patients who needed assistance when moving were denied this opportunity.

Philippa Ford, policy officer for the CSP in Wales said: "The physiotherapy profession welcomes all the recommendations made by the Assembly committee in particular the recommendation relating to the need for risk assessment of the potential for hospital acquired thrombosis. …