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Anticoagulation UK, NCAT, Thrombosis UK, AF Association, Arrhythmia Alliance, and Anticoagulation in Practice, are delighted to launch the 2018 Anticoagulation Achievement Awards.

Established in 2017, the prestigious Anticoagulation Achievement Awards celebrate outstanding practice across multiple healthcare providers of exemplary anticoagulation services.

The awards are supported by an extensive judging panel representing multiple stakeholders, respected globally and representing clinical, provider and patient experience.


Anticoagulation UK (ACUK)

Anticoagulation UK (ACUK)

A UK registered charity founded in the year 2000. We work with patients, healthcare professionals, NHS trusts, Industry, Governments, other charities and patient groups and a wide range of other organisations.

Our Aims are: The prevention of thrombosis; The provision of information, education and support; The promotion of independence - supporting people to take an active part in their own healthcare.

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AF Association (AF Assoc)

AF Association (AF Assoc)

A UK registered charity which focuses on raising awareness of atrial fibrillation (AF) by providing information and support materials for patients and medical professionals involved in detecting, diagnosing and managing atrial fibrillation.

AF Association works closely with medical professionals, Department of Health, government, NHS Trusts, strategic health authorities, patients, carers, patient support group members and allied groups.

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Thrombosis UK

Thrombosis UK

A UK registered charity that is dedicated to promoting awareness, research and care of thrombosis.

Established in 2002, Thrombosis UK works closely with government, NHS, healthcare professionals and patients to inform and support the implementation of clinically informed, effective and patient centred care to prevent and protect individuals at risk of venous thromboembolism (VTE) and to promote best management of those who have suffered a VTE.

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Arrhythmia Alliance (A-A)

Focusing on working together to improve the diagnosis, treatment and quality of life for all those affected by arrhythmias.

A-A is a coalition of charities, patient groups, patients, carers, medical groups and allied professionals. Although these groups remain independent, they work together under the A-A umbrella to promote timely and effective diagnosis and treatment of arrhythmias.

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Arrhythmia Alliance (A-A)

Anticoagulation in Practice (AiP)

Anticoagulation in Practice was established approximately seven years ago and comprises healthcare professionals and patients interested in the area of anticoagulation. Healthcare professionals include GPs, practice nurses, pharmacists, healthcare scientists, haematologists, community nurses and anticoagulation specialist nurses.

Previously a collective of special interest groups, the AiP Society has developed into a more robust body, unifying the concerns of both healthcare professionals and patients into a single organisation.

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Anticoagulation in Practice (AiP)

National Centre for Anticoagulation Training (NCAT)

NCAT - The National Centre for Anticoagulation Training NCAT was founded in 2005 as a training and education resource for health care professionals involved in cardiovascular, thrombosis and anticoagulation management. NCAT has been developed to meet the educational needs of all health care professionals involved in anticoagulation management and provides CPD accredited course to support and further:

  • Training
  • Research
  • Spotlight Hot topics
  • Run educational events
  • Provide support materials and resources to accompany training

Course provided by NCAT are developed for a wide range of health care professionals including General Practitioners, Practice nurses, specialist nurses, nurse practitioners, district nurses, pharmacists and dieticians.

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National Centre for Anticoagulation Training (NCAT)


Applicants are invited to apply for one or more of the categories.

Awards will be presented in The Houses of Parliament on Wednesday 10th October 2018 by Lyn Brown MP and members of the Judging Panel.

Best comprehensive thrombosis management centre

Best resource sharing information about anticoagulation therapy for patients and carers

The centre best able to demonstrate adherence to NICE Quality Standards for Atrial Fibrillation

Best work in prevention of hospital acquired thrombosis (HAT)

Best work in the prevention and treatment of cancer acquired thrombosis (CAT)

Best work in the prevention and treatment of thrombosis during pregnancy and the puerperium

Best on-going management of thrombosis by a community based or primary care service

VTE Hero (invite nominations from HCPs and Patients)


Anticoagulation Awards Judge | Dr Chris Arden

Dr Chris Arden

Chris Arden is a GP near Winchester, Hampshire. He also works in a community cardiac clinic in Southampton as a GPSI in cardiology, assessing patients with suspected heart failure, atrial fibrillation, palpitations, hypertension and valvular heart disease. He has BSE accreditation in echocardiography.

The community cardiac service provides echocardiography, ambulatory ECG, blood pressure and event recorder monitoring; receiving consultant mentorship support from secondary care and working in partnership with specialist heart failure and cardiac rehabilitation nursing colleagues.

Chris Arden is Editor in Chief of the Primary Care Cardiovascular Journal, a member of the Primary Care Cardiovascular Society, British Society of Echocardiography, British Society of Heart Failure and British Heart Valve Society. He is on the editorial board of the British Journal of Cardiology.

Anticoagulation Awards Judge | Sue Bacon

Sue Bacon

Sue is a Nurse Specialist in thrombosis and anticoagulation and the Lead Anticoagulation Nurse with North Bristol NHS Trust.

With extensive experience in thrombosis service development, service management and embedding patient-centric care, Sue is now responsible for managing services supporting North Bristol Trust to ensure the safe and appropriate management patients requiring anticoagulation therapy.

Anticoagulation Awards Judge | Dr David Collas

Dr David Collas

I started as a Consultant at Watford General Hospital 20 years ago and developed the stroke service shortly afterwards, starting with an AF clinic to promote the use of warfarin in stroke prevention, then very much underused. I also developed the VTE service and trialled the venometer device for the early detection of DVTs.

We opened our Acute Stroke Unit in 2004 offering thrombolysis from 2006 and we moved over from warfarin to NOAC for stroke prevention in AF in 2012. We have presented our evolving experience of using old and new anticoagulants at a variety of international meetings between 2012 and 2014 (European and Nordic Stroke Conferences , Heart & Brain, and the World Stroke Congress, and these have been published in Cerebrovascular Diseases, Gut and the International Journal of Stroke). Watford has participated in several anticoagulant stroke trials – CLOTS, NAVIGATE-ESUS and currently PRESTIGE. I sit on our hospital Thrombosis Advisory Panel and continue to work for improved stroke prevention through local meetings, the East of England Expert Working Group, the Arrhythmia Alliance and AF Association, and am honoured to be a judge on the prestigious Anticoagulation Achievement Awards.

Anticoagulation Awards Judge | Dr Matthew Fay

Dr Matthew Fay

Dr Fay is a GP at The Willows, Bradford, part of the Westcliffe Primary Care Partnership Group. With a special interest in cardiovascular care, Dr Fay has been a NHS National Lead for AF and advocate for exemplary innovation in the management and care of individuals and anticoagulation therapy. With extensive experience in service development, management and education of patients, Matt is champion for both primary care and patients.

Anticoagulation Awards Judge | Professor David Fitzmaurice

Professor David Fitzmaurice

Professor David Fitzmaurice is a GP and Professor of Cardiorespiratory Primary Care at The University of Warwick. He has a longstanding research interest in cardiovascular disease, in particular oral anticoagulation management. He was one of the first GPs awarded an MRC Career Scientist Award based on this research enabling him to develop as one of the primary care research leaders of today.

Anticoagulation Awards Judge | Professor Beverley Hunt

Professor Beverley Hunt

Prof Beverley Hunt is an international expert in thrombosis and is Professor of Thrombosis at Kings College and a Consultant at Guy's & St Thomas' NHS Trust. She is also a Medical Director for Thrombosis UK and a founder member of the steering group for World Thrombosis Day. She has an active research group with over 290 publications.

Anticoagulation Awards Judge | Stephane Jaglin

Stephane Jaglin

Stephane qualified as a Doctor of Pharmacy in 1994 in Nantes (France) and moved to the UK in 1998 where he worked as a community pharmacist for 14 years. He transferred to the secondary care sector in 2009 as clinical pharmacist within a treatment centre providing elective procedures in major orthopaedic surgery, general surgery, gynaecology, ENT and ophthalmology specialties. Stephane developed a particular interest in anticoagulation, especially postoperative Venous Thrombosis prevention and perioperative management of anti-thrombotic drugs. He created a thrombosis committee for the hospital of which he is the lead and is now heavily involved in the development of national policies for VTE prophylaxis and perioperative use of anti-thrombotic medicines.

Anticoagulation Awards Judge | Jo Jerrome

Jo Jerrome

Jo Jerrome is a patient advocate and a Lay member on national and local health committees including NICE, WE AHSN, research and development groups spanning thrombosis, AF, stroke and patient safety. As a carer Jo has first hand experience of the value of feeling informed and included in healthcare consultations and decision making. Jo has worked both as a volunteer and employee for third sector organisations and health partnerships. Former Deputy CEO of a coalition of charities - Arrhythmia Alliance, AF Association and STARS, Jo was appointed CEO of Thrombosis UK in April 2016.

Anticoagulation Awards Judge | Eve Knight

Eve Knight

Eve Knight is Co-Founder and Chief Executive of the leading thrombosis charity Anticoagulation UK (ACUK).

Eve has been instrumental in the foundation of the Anticoagulation Achievement Awards.

She has been a co-author of many papers and articles including:

  • EHRA paper Bleeding Risk Assessment and Management in Atrial Fibrillation Patients, a position document from the European Heart Rhythm Association.
  • Endoscopy in patients on antiplatelet or anticoagulant therapy, including direct oral anticoagulants: British Society of Gastroenterology (BSG).
  • European Society of Gastrointestinal Endoscopy (ESGE) guidelines.
  • How Can We Avoid a Stroke Crisis.
  • Improving Care for Patients with Acute Heart Failure: before, during and after hospitalisation.
  • Point of Care Monitoring article for Hospital Healthcare Europe.

Eve is a member of many boards and steering groups including The International Self-Monitoring Association of Anticoagulated Patients (ISMAAP); AntiCoagulation in Practice; The AntiCoagulation Self Monitoring Alliance (ACSMA); Cancer associated Thrombosis in Europe; Pan London prevention of AF related stroke group.

Past involvement includes membership of the Government Modernisation Board for the NHS; The External Advisory Group for the National Service Framework for Coronary Heart Disease; The National CHD Task Force.

She is a Section Editor for the British Journal of Cardiology and the British Journal of Primary Care Nursing.

In 2014 she was presented with the ACSMA Outstanding Achievement Award for her services to Anticoagulation.

In 2015 She received The Quality in Care for Anticoagulation award for Services to Anticoagulation.

Anticoagulation Awards Judge | Joanne Loades

Joanne Loades

Joanne Loades is a cardiovascular specialist nurse who held a variety of roles within the NHS before setting up in business as an independent nurse consultant in 2010; delivering clinical, educational and consultancy services to a number of NHS, charitable and commercial organisations across the UK. As a former Clinical Lead for Education for Health, Joanne passionately believes in educating healthcare professionals to improve patient care. She is the current Chair of the Nurses and Allied Health Professionals Working Party of The British and Irish Hypertension Society and is also an Education Committee member of The European Society of Cardiology Council for Cardiovascular Nursing and Allied Professions. Joanne has authored many publications in the nursing and cardiology press both in the UK and internationally. She is currently engaged as a Clinical Associate with the National Association of Primary Care and is a Specialist Advisor to the Care Quality Commission.

Anticoagulation Awards Judge | Trudie Lobban MBE

Trudie Lobban MBE

As Founder & CEO of Arrhythmia Alliance and the AF Association I have been involved in the care and provision of improved services for people with arrhythmias and in particular atrial fibrillation (AF). AF Association is the only organisation to focus purely on the most common heart rhythm disorder and leading cause of AF-related stroke. A-A is a coalition of organisations and individuals working in partnership with healthcare professionals, patients, carers, policy makers, AHSN’s, CCG’s and service delivery.

Anticoagulation Awards Judge | Simon Noble

Simon Noble

Simon is a Clinical Professor in Palliative Medicine at Cardiff University and Honorary Consultant at the Royal Gwent Hospital in Newport. His research interests are in the management of venous thromboembolism in advanced cancer, the anti-cancer effects of heparins and the quality of life associated with VTE. Simon is involved at a national level in the delivery of evidence-based thromboprophylaxis for hospitalised patients through the All Party Parliamentary Thrombosis Group and through his work as Chair of the All Wales Hospital Acquired Thrombosis (HAT) Prevention Steering Group. He currently sits on the NICE guideline development group for prevention of VTE in hospitalized patients.

Anticoagulation Awards Judge | Huw Rowswell

Huw Rowswell

Huw is a nurse consultant in thrombosis at Plymouth Hospitals NHS trust and has worked in this field since 2009. He is involved with the identification and carrying out root cause analysis on all cases of hospital acquired thrombosis and has published outcome data showing a significant reduction in such events but also cases associated with inadequate prevention. This is achieved by using real time feedback to clinicians of such events and presenting annual data on number of thrombotic events by admitting speciality.

He is the current chair of the Clinical Leaders of Thrombosis and joint research lead for the national nursing and midwifery network part of the VTE exemplar network.

Anticoagulation Awards Judge | Simon Toh

Simon Toh

My team won the AAAwards for 'Best Work in the Prevention of Hospital Acquired Thrombosis' last year for a series of animated patient videos accessible via any smartphone. I am currently the local PI, and one of the highest recruiters, for the GAPS RCT of TEDS in surgery. I have been a Consultant Surgeon in Portsmouth Hospital NHS Trust for 18years performing emergency and elective general surgery, including for oesophageal cancer, a high risk group of patients for post-op VTE.

We have been early adopters of Vitalpacs technology that provides the clinical team real-time VTE prophylaxis data to improve compliance. I have co-published over 30 papers, speak regularly at national and international surgical meetings with research interests in oesophageal cancer, reflux, and patient informatics. I direct VIMARS Portsmouth, a surgical simulation/teaching facility. I have led the Rocky Appeal Charity for the past 8yrs raising £3.4 million for keyhole robotic theatres.

Thanks to ourSponsors

Kindly supported by unrestricted educational grants.

Anticoagulation Awards Sponsors - Bayer, Roche and LumiraDx

Funding provided is to support the awards, but sponsors have no involvement or input in the content, agenda, outcome or event management of the Anticoagulation Achievement Awards

The Anticoagulation Awards is a not-for-profit national awards scheme dedicated to shining a light on UK anticoagulation services that deliver exemplary care.

We would like to thank all of our sponsors for their generosity and dedication in supporting us to achieve this mission.

Anticoagulation Achievement Awards


Finalists & Winners2017

In 2017, the inaugural award ceremony for the prestigious Anticoagulation Achievement Awards was hosted by Andrew Gwynne MP in the Terrace Pavilion, House of Commons on Wednesday 11 October 2017.

The awards were presented by:

  • Andrew Gwynne MP
  • Sir David Amess MP
  • Kavita Oberoi OBE
  • Helen Williams
  • Baroness Walmsley
  • Lynn Faulds Wood
Anticoagulation Achievement Awards - Download Brochure



Best Comprehensive Thrombosis Management Centre

Staffordshire Thrombosis and Anticoagulation Centre (STAC) University Hospitals of North Midlands, Stoke on Trent

Staffordshire Thrombosis and Anticoagulation Centre (STAC) provides a full range of DVT prevention, diagnosis, treatment and follow-up service through a multi-disciplinary team based at Royal Stoke University Hospital.

Serving a population of over 700,000 people in Stoke-on-Trent, Stafford and surrounding areas our services include, same-day walk-in DVT diagnosis, Counselling and anticoagulation induction of nearly 400 new patients every year, inpatient anticoagulation, outpatient follow-up and monitoring of over 8000 patients via STAC centre, 37 community clinics, 14 affiliate GP centres.

Specialised anticoagulation nurses completed comprehen-sive annual follow-up of over 6,500 patients via telephone clinics last year, ensuring all patients were reviewed at least once, in line with national recommendations.

A weekly thrombosis MDT for complex patients and provid-ing leadership and support to highly successful hospital VTE prevention team are other successes. STAC provides a dedicated telephone help-line for patients and a web-based advice line for GP’s and hospital doctors managed by thrombosis consultants.

DOAC clinics, Peri-operative clinic and a dedicated clinical governance team for adverse event monitoring, reporting and investigation are also provided within the set-up. An active audit programme with several presentations in national and international meetings have been other highlights.

Patient feedback (April 2017) confirmed a very high level of satisfaction (98%) from over 300 respondents. External benchmarking confirmed an above average overall TTIR (>70%) and STAC achieved all Key performance indicators in the last 12 months.

GP Care NHS Community DVT Service Bristol

GP Care Ltd has been providing a comprehensive Community DVT Service for NHS patients living in the Bristol and South Gloucestershire area for the last 9 years. By moving the service out of secondary care and into primary care, our aim has always been to improve the patient’s overall experience as well as to deliver significant savings to local NHS commissioners.

There are three distinct phases to the service:

Phase 1: In line with NICE guidance, referring GP uses the Wells score and near patient D-dimer testing to assess the clinical probability of DVT.

Phase 2: Where probability of DVT is high, patient receives a guaranteed same or next day Ultrasound scan at one of four anticoagulation clinics.

Phase 3: Where DVT is confirmed, patient attends for anticoagulation therapy at a local primary care Treatment Centre. The patient’s GP receives a full record of treatment and a management plan on the day of discharge.

Since July 2012, following NICE approval of DOACs as an anticoagulant for patients with DVT, GP Care have developed safe alternative pathways to warfarin pathway.

The service delivers Innovation with:

  • Community locations close to patient’s homes, choice of treatment
  • Primary and secondary care partnership, integrated protocols and patient administration systems. Concentrated expertise at our community based treatment centres providing a specialist, local service
  • Information, guidance and training programs, delivered to primary care and other professionals
  • Patient support group offering peer support and information on management and prevention
  • Training of nurses to undertake diagnosis through ultrasound scanning

Best written advice on anticoagulation therapy for patients and carers

Great Eccleston Heath Centre - Preston

Great Eccleston Health Centre is a rural GP Surgery in the North West of England. It has provided anticoagulant monitoring for its patients for the last 10 years. As many patients, living remotely, find it difficult to attend hospital clinics, they welcome their monitoring being closer to home. Our annual patient satisfaction audit shows high levels of satisfaction.

The service enables a close support network from our nurses and doctors in providing the care and advice patients need. With more patients on long term warfarin, we have increased our clinics from once to twice a week, allowing increased flexibility for the patients but also tighter monitoring of newly initiated patients or those outside of the therapeutic range. Clinics are run by experienced nurses using INR Star which is amongst the leading software for anticoagulation management, with GP support available during clinic times, enabling us to remain safe and effective.

However, in 2016, a patient received severe facial bruising after dental treatment, and was found to have a raised INR in a subsequent routine clinic visit. We raised this as a significant event with the dental surgery, and reviewed our own information-giving policy. It was felt that, while patients are given verbal safety information at initiation and at other points in their treatment, they don’t always recall this later on, and many patients are on warfarin for many years. An information leaflet was produced, and all patients now keep this in their yellow monitoring books for easy reference.

Wessex Academic Scientific Health Network Starting Anticoagulation with Jack

Anticoagulants are prescribed to prevent harmful blood clots that can lead to stroke. They are designed to prevent or treat clots, but can increase the risk of bleeding. Recognising the need for better information for patients and carers, based on patients’ experiences, the idea for Jack came to light.

Our new video, 'Starting Anticoagulation with Jack' has been developed to meet this need for patients, their family and carers after anticoagulants have been prescribed. It explains about clotting and why abnormal clots can form as people age. The different types of medicines are shown, and Jack and his son talk about Jack’s concerns, side effects and sources of support. It is supported by a Patient Information Leaflet and also available in a format with subtitles.

The production of this film has been a collaborative piece of work bridging primary and secondary care, industry and has included patient charities throughout production so that the patient remains the focus of the work. The AHSN network and has been pivotal in supporting implementation in local practice.

How can Jack help you to support patients with counselling on anticoagulants?

The centre best able to demonstrate adherence to NICE Quality Standards for atrial fibrillation

Cardiff and Vale University Hospital Board – Stop a Stroke

The Stop a Stroke project led by a clinical team supported by service improvement practitioner within Cardiff and Vale UHB set out to develop a model for providing Primary Care clinicians with the knowledge, skills and confidence to deliver anticoagulation reviews for patients with atrial fibrillation. The challenge was to provide a service in Primary Care usually associated with expertise found in Secondary Care.

The team used the pilot AF Audit Plus tool to identify patients who need a treatment review. During phase 1 of the project Plan, Do, Study, Act (PDSA) cycles were used in 4 GP clusters to test which interventions achieved the greatest impact on. In the model that has been developed, clinical members of the project team attend a GP cluster meeting to provide education on anticoagulation.

The Stop a Stroke webpage contains all guidance documents, FAQs, links to e-advice and patient information resources. These tools have been built based on the feedback from GPs, pharmacists and nurses in primary care.

The data suggest that 40% of AF patients within C&V who are not on the appropriate treatment can be anticoagulated. So far the number of AF patients on anticoagulation has increased by 209. The project has taken place in 4 out of 9 GP clusters in Cardiff and Vale and will expand to the remaining 5 in 2017. The learning from the Stop a Stroke project is being shared across Wales.

West of England Academic Health Science Network. Don’t Wait to Anticoagulate, preventing strokes amongst patients with atrial fibrillation

In collaboration with pharmaceutical giant Bayer and Gloucestershire Clinical Commissioning Group (CCG), the West of England AHSN planned, developed and delivered the Don’t Wait to Anticoagulate project (DWAC) to help prevent strokes amongst patients with atrial fibrillation (AF) by optimising medicines management in primary care.

Co-designed with a wide range of stakeholders, including NICE, patient representatives and clinical partners, DWAC offers a range of user-friendly resources for clinicians, pharmacists and patients to aid shared decision-making and to optimise anticoagulation for AF patients, supported by quality improvement (QI) and clinical skills training. This includes the website

The project was rolled out to over 100 GP practices in the West country during three 12-week phases. Modelling of the changes in prescribed treatments during this period indicates that DWAC has potentially prevented 27 strokes amongst people with AF, representing an estimated saving of over £629,000.

Additionally, feedback from users confirms that the DWAC approach has led to improved patient care, increased confidence in shared decision-making, and improved working practices in AF care pathways through a multidisciplinary approach. There has been a strong shift in focus from “Why anticoagulate?” to “Why not anticoagulate?”

DWAC is enjoying widespread interest and national recognition, with the initiative currently being adopted and spread across the North West of England, Yorkshire and Humberside, Buckinghamshire and East Berkshire with a further 85 GP practices involved and many more engaged to start, plus further spread across the West.

Sandwell and West Birmingham Hospitals NHS Trust and Sandwell and West Birmingham(SWB) Clinical Commissioning Group(CCG) - Streamlining primary and secondary care management pathways for stroke prevention in atrial fibrillation: the simple ‘Birmingham 3 step’ approach

NICE guidelines on AF (2014) advised against aspirin for stroke prevention, advocating oral anticoagulation (OAC) for all AF patients with ≥1 stroke risk factors. In line with NICE guidance CG 180 2014, OAC rates should be at 85%, with an exception rate of 15%.

Sandwell and West Birmingham Clinical Commissioning Group (SWBCCG) data from the Quality Management and Analysis System in 2014 reported AF prevalence lower than the national average (0.98% vs. 1.46%), suggesting under-detection of AF. Of these, only 65.9% were taking OAC, 15.6% received no therapy, with the remainder receiving antiplatelet therapy.

Brief outline of service

Dr Sarwar (SWBCCG) and Prof Lip (Sandwell and West Birmingham Hospital) have led a collaborative programme of simplifying and streamlining the patient management pathways, through upskilling AF half day workshops, to increase awareness, improve detection, simplify the OAC decision-making process and optimise OAC treatments.

Care pathway or treatment

The ‘Birmingham 3-step approach’ was cascaded to the GP practices at the training/upskilling events to increase awareness and to facilitate pragmatic-prescribing of OAC.


Results and conclusions


Implications for patient/service benefit

The intuitive approach with the ‘Birmingham 3 step’ approach has had a cumulative, dynamic effect on primary care in our region. This has facilitated collaborative working with Trusts and reinforced at grass root levels of dealing with inequalities in this important cohort of patients. Plans in place are to roll out the programme to other CCGs in the region.

Best work in the prevention of hospital acquired thrombosis (HAT)

Plymouth Hospitals NHS Trust - Using Radiology records and real time clinician feedback to reduce hospital acquired thrombosis

In 2010, following NICE guidance on reducing hospital acquired thrombosis (HAT), outcome data on this was initiated locally. Radiology records continue to be used to review targeted scans: V/Q SPECT, CTPA and Doppler ultrasound. Positive events are matched against the hospital management system to ensure HAT criteria, fulfilled. Root cause analysis on HAT events is completed ensuring: whether risk assessment took place, what prophylaxis given, if this was appropriate and whether other errors or omissions around VTE prevention were identified.

For HAT events associated with inadequate thromboprophylaxis (TP), the responsible discharging team are to review and feedback about the episode. For other cases of HAT, a standard letter is sent to the discharging Consultant, to inform them about the event in their patient.

In 2010 there were 2.09 HAT events per 1000 admissions and fifty associated with inadequate TP. By 2016 this had reduced to 1.47 HAT events per 1000 admissions with 9 cases of inadequate TP. Both statistically significant reductions. In addition, HAT events by admitting speciality as a fraction of patients admitted are identified annually. In 2010, this demonstrated neurosurgery as having the highest risk for HAT at 0.84% of all admissions. As a result, the VTE prevention team worked with the neurosurgeons to ensure post-operative reassessment of bleeding risk was undertaken and to increase the use of mechanical TP.

There appears to be little doubt that the combination of real time feedback and working closely with specialties is associated with a significantly reduced incidence of HAT.

Portsmouth Hospital NHS Trust, Department of Surgery, Surgery & Cancer Clinical Services Centre Patient Safety Up Award

An innovative idea by Mr Simon Toh, Portsmouth Hospital, led to a Patient Safety-Up Award in 2016 resulting in 2 live videos and 2 animations to improve compliance with best practice DVT prophylaxis. They can be accessed 24/7 on patients’ smartphones via a QR app or link.

Patients are sent home with a striking leaflet designed to be stuck to their fridge to remind them of their individual need for prophylaxis (with precise duration of self-injection of heparin or TEDS to wear) and QR code links to:

  • Pre-operative measures to reduce risk of thrombosis
  • Correct wearing of TED Stockings
  • How to safely inject heparin
  • What to look for to diagnose DVT or PEs

The video-animations have been carefully scripted by a clinical team under Mr.Simon Toh working in close collabora-tion with a media team from the University of Portsmouth under Toby Meredith.

We ensured they are understandable even to an 8-yr old; used nudge methodology with humour and characters that reflect the diversity of patients (Gary, Luke and Lucy). The remit was brevity & simplicity; to be effective rather than comprehensive. These videos are easy to update as advice changes unlike out-of-date paper copies (a green solution).

The initial feedback from patients has been very positive and we have rolled out the videos to all our patients and via the thrombosis network to other NHS Hospitals. Try this for yourself – scan this QR code on your phone or surf to: and Lucy will show you how to inject heparin safely.

Abertawe Bro Morgannwg University Health Board (ABMUHB) - Nurse Led Thromboprophylaxis Re-Assessment Tool

English Hospital Trusts attached a CQUIN payment to Venous Thromboembolism (VTE) Risk Assessment (RA) to achieve a 95% uptake. Welsh Health Boards’ have no financial incentives.

Since 2012 a Nurse led Thromboprophylaxis (TP) Re-Assessment tool has been used on all wards in the Princess of Wales Hospital Bridgend. On admission Clinicians complete and document a Thromboprophylaxis Risk Assessment. Nurses hold the key in ensuring TP Re-Assessment takes place during the patient’s admission.

The tool has a 2 fold benefit:

  • Nurses prompt clinicians to complete TP risk assessment improving number of patients risk assessed and treated appropriately.
  • Ensures all patients are re-assessed daily or as their condition alters.

The TP Re- Assessment tool was added to the Welsh Care Metrics in 2013 as a tool to measure quality of care at ward level. Monthly indicators include:

  • Number of patients risk assessed for VTE on admission
  • Number of patients re-assessed for VTE during admission

Root Cause Analysis (RCA) is undertaken in all reported VTE’s in hospitalised patients, or within 90 days of discharge, case notes must confirm one or both of the following:

  • A documented risk assessment
  • Appropriate Thromboprophylaxis prescribed

Confirmed Hospital Acquired Thrombosis are reported to the admitting Consultant using the DATIX incident reporting system. This completes the investigation and provides feedback to improve future performance.

Quality Assurance:

  • Governance arrangements are overseen by unit quality and patients safety group
  • Assurance arrangements overseen through monthly performance reviews and monthly Quality and Safety committee
  • Data displayed on HAT dashboard

Since the implementation of the Nurse Led Thromboprophylaxis Re-Assessment Tool, we can now clearly demonstrate a consistent 85%+ uptake of TP RA and a consistent reduction of the number of HATs in the Princess of Wales hospital.

Best work in the prevention of cancer acquired thrombosis (CAT)

Hull & East Yorkshire Hospitals Trust (HEYHT) - Nurse led pathway for management of incidental pulmonary embolism/vte in cancer patients

In 2008 the applicants formed a working group to address the findings of an 18-month retrospective audit (August 2006 to January 2008) of cancer patients diagnosed with incidental pulmonary embolism (IPE), which found poor communication, a lack of standardised care and unnecessary often lengthy admissions, along with a lack of any documentation of assessment, treatment outcome and complications.

They developed a nurse-led service in accordance with the Medical Research Council (MRC) guidance to streamline diagnosis and assessment, and standardise management of IPE.

The service became operational in March 2010 and to date has managed upwards of 390 patients. It is evidence - and protocol (SOP)-driven and is evolving all the time as new evidence and data is collected. A multidisciplinary team (MDT) meets every 2 months to assess the management of patients, pathway integrity and safety, and implement new evidence.

The core elements of the service include a training programme for CNSs and radiographers that includes a training DVD and video, and is adaptable to any NHS Acute Oncology practice, with recent adoption by York University Hospitals and work ongoing with Coventry and NLAG as part of service improvement drives. We have also developed a Patient Information Leaflet and, as of 2016, the service has expanded to include out-of-hours and weekends. To date in HEY we have trained 4 specialist nurses, 6 nurse practitioners and 22 radiographers.

Our clinical material has recently evolved to capture patient reported outcomes and a patient survey has shown how much patients value the service.

Special Patient Nominated Award

Hull & East Yorkshire Hospitals Trust (HEYHT) - Nurse led pathway for management of incidental pulmonary embolism/vte in cancer patients

This prestigious award acknowledges the importance for healthcare providers to listen, discuss and involve the greatest stakeholder - the patient, in in the decision-making process.

Evidence is clear, managing anticoagulation, even more complex when alongside illness and long-term conditions, has far better outcomes when there is shared understanding, consideration of well-being and the prescribing of appropriate therapies.

The winner of this category has been personally nominated by a patient, and will receive an engraved crystal tribute in recognition of their work.

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