Please, please read –it’s long, but very important.I t might save some lives.

[HPNC]

I am a regular poster, but have changed my name. If you recognise me please don?t out me. My employers would not be happy that I have posted this.

A couple of weeks ago it was National Thrombosis Week.

Every year, in England, 25,000 ? twenty five thousand ? people die as a result of thrombosis.

That is more than the total deaths from HIV AIDS, breast cancer and road traffic accidents.

It is 25 times the number of deaths from MRSA.

Those 25,000 are the tip of a massive iceberg. They represent a fraction of the total number of people who suffer a thrombosis (blood clot, often called DVT or PE ?Pulmonary Embolism), often as a consequence of being admitted to hospital for medical or surgical treatment.

The single most effective patient safety intervention would be to assess a person?s risk of developing thrombosis when they are admitted to hospital, and to provide that person with the correct, appropriate treatment to prevent thrombosis occurring. (For example, correctly fitted stockings, plus or minus injections to reduce the risk of clotting).

The risk factors are well recognised and risk assessment is a straightforward process.

NICE have already established and implemented guidelines for prevention of thrombosis (thromboprophylaxis) in surgical patients.

NICE are currently drafting the guidelines for risk assessment and preventative treatment for all patients who are admitted to hospital. They will be implemented in 2009.

In April 2007 the Chief Medical Officer, Sir Liam Donaldson, wrote to the Chief Executive of every NHS Trust in England and Ireland stating that every Trust should establish a Thrombosis committee, and set up a system to risk assess every patient who is admitted to hospital, and that this should be mandatory.

By April 2008 only one third of NHS Trusts had taken any action. People are still suffering this horrible condition and still dying.

Please, if you possibly can, write to your local NHS Trust Chief Executive and ask what their Trust is doing to prevent patients dying unnecessarily from blood clots. Copy the letter to your MP.

If you, or a relative, are admitted to hospital for any reason, don?t just ask your doctor or nurse to wash their hands, ask them ?What is my risk of developing a blood clot, and what are you going to do to reduce my risk??

If you are pregnant, please ask your doctor and midwife the same question.

Thrombosis is still a leading cause of pregnancy-related death. If you are pregnant and are admitted to hospital for any reason (apart from straightforward labour and delivery) you should be risk assessed on admission.

We know what the power of mumsnet did for Waitrose baby bottom butter. I really hope we can achieve something here.

Thank you for reading, if you have managed to get this far.

HPNC, happy to write to my local Chief Exec, just to be clear: you mean the Acute Trust, not the PCT.

I think my only question is, how do you know only one third of Trusts have implemented a protocol? Or can you not say without revealing who you are?

How binding is a letter from the CMO, is it 'advice' as opposed to an order?

Hi Tribpot

All the CEs had to fill in a questionnaire last year and return it to the CMO office.

The information had to be corroborated by senior medical staff on site. It would be pointless to lie, as there will be inspections in due course.

The instruction from the CMO was in line with existing NICE guidelines and with the proposed NICE guidelines which will come in in 2009.

From that point on, Trusts will be subject to government inspections and sanctions - such as fines and loss of stars if they are not compliant.

My gripe is that there is no excuse for Trusts to drag their heels during this period of "grace", when so many people are dying.

IMO it is immoral for these Trusts to not make the effort to put measures in place now.

It is not for lack of clinical staff trying to get things done, but there is a lack of managerial support at senior level.

The guidelines apply to patients in Hospital, so it is the acute Trusts that should be the point of contact.