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2010 NHS Operating Framework Mandates Venous Thromboembolism Prevention in the NHS

The All-Party Parliamentary Thrombosis Group (APPTG) has recently welcomed the Department of Health’s (DH) decision to mandate venous thromboembolism (VTE) prevention in the Operating Framework for the NHS in 2010/11. The All Party Group has been campaigning for its inclusion as a key step in reducing up to 25,000 annual avoidable deaths and saving the NHS over half a billion pounds a year.

The APPTG has been working alongside the Department of Health to prioritise VTE prevention in recent years. It has frequently demonstrated that mandating best practice is the most effective way to increase the quality of patient care and achieve significant cost savings for the NHS.

The announcement follows the recent publication of the APPTG annual survey of all acute Trusts in England. It found that only 41% of Trusts are able to demonstrate that all hospital inpatients are being risk assessed and are receiving appropriate preventative treatment as recommended by the Chief Medical Officer and NICE. Crucially, the move to mandate VTE prevention was supported by over three quarters of Trusts – 77% thought this would be the most effective way to drive compliance with VTE prevention policies at the ward level. Today’s decision will apply to all Strategic Health Authorities who will be able to recoup money paid to hospitals for procedures, where it transpires patients have not been risk assessed for VTE.

Professor Beverley Hunt, Medical Director, Lifeblood: The Thrombosis Charity said:

Our campaign for reducing deaths from hospital acquired VTE has always recognised that mandating VTE prevention is critical to ensuring all patients are risk-assessed and given appropriate prophylaxis. We are pleased VTE has finally been given the priority it deserves, and we can now begin to make a real impact in reducing estimated 25,000 unnecessary deaths that occur from the condition each year.”

Dr Richard Taylor MP, Vice-Chair of the All-Party Parliamentary Thrombosis Group, said:

“We are delighted the Government has responded to the growing momentum of the medical profession in its support for mandating VTE prevention. The challenge will now be to ensure that mandatory policies are audited by a meaningful indicator, so that compliance with risk-assessment and thromboprophylaxis policies are measured on a national scale.”


  • Venous Thromboembolism (VTE), includes the conditions deep vein thrombosis – when a clot forms in a vein, usually in the leg – and pulmonary embolism, which occurs when a blood clot that has formed in a vein breaks off and lodges in the lung. Deep vein thrombosis is more common in those who are ill and those who are immobile; patients in hospital are more vulnerable because they meet both these criteria. Deep vein thrombosis may lead to pulmonary embolism, which can be fatal.
  • The APPTG survey is available at
  • NICE Clinical Guideline 46 on the prevention of VTE in surgical patients was released in April 2007. The Guideline is available from
  • In October 2008, Sir Liam Donaldson, Chief Medical Officer, launched a national preventive strategy for venous thromboembolism. Risk assessment guidance was provided to all hospitals to help them identify patients at risk of developing venous thromboembolism. The Risk Assessment for Venous Thromboembolism (VTE) is available on the Department of Health website at
  • The core elements of a National VTE Risk Assessment have been developed by the Chief Medical Officer’s VTE Implementation Working Group (IWG) in close consultation with key partners and stakeholders.
  • The NICE VTE Guideline on reducing the risk of VTE in all patients admitted to hospital is expected in early 2010.

For further information, please contact Poonam Arora, Secretariat to the All-Party Parliamentary Thrombosis Group on 07854 160143

Published on: January 20, 2010

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