First reported 18 Feb 2016•Latest report 12 Aug 2024
Definition
What this concern includes
Includes failures in clinical guidance, policies or decision criteria specifically governing VTE diagnosis, risk assessment, repeat assessment and management, including gaps in guidance for children and unclear guidance for when inpatient VTE risk assessments should be undertaken or repeated.
Not included
Excludes failures to provide thromboprophylaxis where the guidance and assessment process is adequate; those belong to the existing thromboprophylaxis concern.
Excludes generic clinical-guidance, training or policy deficiencies without an explicit venous-thromboembolism connection.
Excludes failures in treatment, monitoring or escalation after applicable VTE guidance has been reliably available and followed.
Excludes unrelated paediatric or adult clinical guidance concerns that do not materially concern VTE assessment or management.
Reports
8
Distinct published reports
Individual concerns
11
A report can raise multiple concerns
Date range
2016–2024
First to latest report issue date
Stated actions
10
Described in published responses
Reports over time
Reports over time
Reports about this concern issued each year.
* 2026 is projected from reports observed to 7 Sep 2026.
Most frequent recipients
Most frequent recipients
Reports about this concern sent to each recipient.
Department of Health and Social Care3
National Institute for Health and Care Excellence2
NHS England2
Barts Health NHS Trust1
East Lancashire Hospitals NHS Trust1
East London NHS Foundation Trust1
Pennine Care NHS Foundation Trust1
Royal College of Paediatrics and Child Health1
Royal Cornwall Hospital1
NHS trust4
Executive non-departmental public body3
Ministerial department3
Healthcare site1
Professional body1
Concerns and responses across reports
Only concerns grouped under this recurring concern are included. Select any concern, action or position to view the source wording.
Inner North London
Concerns raised2
Ambiguity in the venous thromboembolism policy
Venous thromboembolism policy failing to align with NICE guidelines
This report raised 6 other concerns. They are not shown here because they do not form part of this recurring concern.
Responses linked to these concerns
Each statement is shown once, even when linked to more than one concern.
Actions described in response An action is something a respondent says it has done, is doing, or plans to do in response to the concern raised.1
Action
Remove unclear VTE assessment information from the Physical Healthcare Policy and publish an update directing staff to the VTE policy.
Stated by East London NHS Foundation TrustStated in progressThe respondent said that this action was in progress when they made their response on 13 August 2024.
Respondent positions A position is what a respondent says about the concern when they do not describe a specific action.1
Position
The separate VTE policy is unambiguous and aligned with NICE guidelines, although VTE information in the Physical Healthcare Policy is unclear.
Stated by East London NHS Foundation TrustDisputes the concernThe respondent disagreed with part of the concern or the basis for it.
West Yorkshire Eastern
Concerns raised2
Lack of child-applicable guidance for diagnosis and management of venous thromboembolic diseases
Lack of validated child-specific screening tools for pulmonary thromboembolism
This report raised 1 other concern. They are not shown here because they do not form part of this recurring concern.
Responses linked to these concerns
Each statement is shown once, even when linked to more than one concern.
Actions described in response An action is something a respondent says it has done, is doing, or plans to do in response to the concern raised.1
Action
Ask the prioritisation board to consider whether guidance should be developed on venous thromboembolism in children.
Stated by National Institute for Health and Care ExcellenceStated plannedThe respondent said that this action was planned when they made their response on 9 May 2024.
Respondent positions A position is what a respondent says about the concern when they do not describe a specific action.2
Position
NICE should take the lead in developing paediatric pulmonary thromboembolism screening tools and specific national guidance.
Stated by Royal College of Paediatrics and Child HealthRedirects responsibilityThe respondent said that another organisation was responsible for deciding or taking action.
Position
NICE cannot recommend a paediatric VTE screening tool because evaluated adult scores perform poorly and no suitable tool is known.
Stated by National Institute for Health and Care ExcellenceUnable to actThe respondent said that a constraint prevented them from taking the relevant action.
East London
Concerns raised1
Failure of VTE risk assessment criteria to include relevant risk factors
This report raised 1 other concern. They are not shown here because they do not form part of this recurring concern.
Responses linked to these concerns
Each statement is shown once, even when linked to more than one concern.
Respondent positions A position is what a respondent says about the concern when they do not describe a specific action.2
Position
Insufficient evidence exists to justify changing the national VTE risk assessment tool for tranexamic acid use or pelvic fibroids.
Stated by Barts Health NHS TrustUnable to actThe respondent said that a constraint prevented them from taking the relevant action.
Position
The established VTE risk assessment tool remains appropriate, with insufficient evidence to adapt or change it.
Stated by Department of Health and Social CareExisting arrangements considered sufficientThe respondent said that existing arrangements were sufficient, so no further action was needed.
Manchester South
Concerns raised1
Lack of clear guidance for undertaking and repeating Venous Thromboembolism risk assessments
This report raised 3 other concerns. They are not shown here because they do not form part of this recurring concern.
Responses linked to these concerns
Each statement is shown once, even when linked to more than one concern.
Respondent positions A position is what a respondent says about the concern when they do not describe a specific action.1
Position
Issues concerning Pennine Care NHS Foundation Trust should be addressed in the Trust’s response.
Stated by Department of Health and Social CareRedirects responsibilityThe respondent said that another organisation was responsible for deciding or taking action.
Cornwall and Isles of Scilly
Concerns raised1
Failure to ensure clinicians access accurate thrombosis prophylaxis guidance
This report raised 3 other concerns. They are not shown here because they do not form part of this recurring concern.
Responses linked to these concerns
Each statement is shown once, even when linked to more than one concern.
Actions described in response An action is something a respondent says it has done, is doing, or plans to do in response to the concern raised.3
Action
Scrutinise and ratify the Thrombosis Prevention and Anticoagulation Policy in its current form through the steering group.
Stated by Royal Cornwall Hospitals NHS TrustStated completedThe respondent said that this action was complete when they made their response on 19 May 2023.
Action
Review the Thrombosis and Anticoagulation policy arrangements through a larger workstream to improve accessibility and remove ambiguity.
Stated by Royal Cornwall Hospitals NHS TrustStated plannedThe respondent said that this action was planned when they made their response on 19 May 2023.
Action
Audit the ten most recently uploaded document-library policies within three months to verify that the correct approval process was followed.
Stated by Royal Cornwall Hospitals NHS TrustStated plannedThe respondent said that this action was planned when they made their response on 19 May 2023.
Respondent positions A position is what a respondent says about the concern when they do not describe a specific action.1
Position
TPAS considered the policy’s acknowledged ambiguity insufficiently risky to warrant removal and ratified the current policy pending broader review.
Stated by Royal Cornwall Hospitals NHS TrustExisting arrangements considered sufficientThe respondent said that existing arrangements were sufficient, so no further action was needed.
Manchester South
Concerns raised1
Lack of clear guidance for clinicians on reducing DVT risk in immobilised surgical patients
This report raised 1 other concern. They are not shown here because they do not form part of this recurring concern.
Responses linked to these concerns
Each statement is shown once, even when linked to more than one concern.
Actions described in response An action is something a respondent says it has done, is doing, or plans to do in response to the concern raised.5
Action
Maintain warnings in combined hormonal contraceptive product information about venous thromboembolism risks, surgery and immobilisation.
Stated by Medicines and Healthcare products Regulatory AgencyStated completedThe respondent said that this action was complete when they made their response on 17 May 2023.
Action
Review combined hormonal contraceptive venous thromboembolism risks and update product information with revised risk estimates and antithrombotic-treatment advice.
Stated by Medicines and Healthcare products Regulatory AgencyStated completedThe respondent said that this action was complete when they made their response on 17 May 2023.
Action
Introduce user cards and prescriber checklists covering clot risks, warning symptoms, and alerts about planned or recent surgery or immobilisation.
Stated by Medicines and Healthcare products Regulatory AgencyStated completedThe respondent said that this action was complete when they made their response on 17 May 2023.
Action
Communicate revised venous thromboembolism risk estimates and risk-reduction measures to prescribers through Drug Safety Update.
Stated by Medicines and Healthcare products Regulatory AgencyStated completedThe respondent said that this action was complete when they made their response on 17 May 2023.
Action
Request updates to the product information for the small number of combined hormonal contraceptive products missing information from the venous thromboembolism review.
Stated by Medicines and Healthcare products Regulatory AgencyStated plannedThe respondent said that this action was planned when they made their response on 17 May 2023.
Respondent positions A position is what a respondent says about the concern when they do not describe a specific action.2
Position
Existing product warnings, risk estimates, antithrombotic advice, user materials and prescriber tools provide risk-minimisation measures for combined hormonal contraceptives.
Stated by Medicines and Healthcare products Regulatory AgencyExisting arrangements considered sufficientThe respondent said that existing arrangements were sufficient, so no further action was needed.
Position
Clinical guidance addresses DVT prevention, diagnosis and management, including VTE risk assessment and antithrombotic prevention for surgery and trauma.
Stated by Medicines and Healthcare products Regulatory AgencyRedirects responsibilityThe respondent said that another organisation was responsible for deciding or taking action.
Leicester City and South Leicestershire
Concerns raised2
Failure of VTE risk assessments to provide comprehensive and clear assessment criteria
Lack of national guidance on bilateral leg swelling in DVT diagnostic profiling
This report raised 2 other concerns. They are not shown here because they do not form part of this recurring concern.
Responses linked to these concerns
Each statement is shown once, even when linked to more than one concern.
No linked response statements
No respondent-stated action or position is linked to these concerns in the published data.
Blackburn, Hyndburn and Ribble Valley
Concerns raised1
Failure of the obstetric VTE prophylaxis and management policy to comply with NICE guidance
Responses linked to these concerns
Each statement is shown once, even when linked to more than one concern.
No linked response statements
No respondent-stated action or position is linked to these concerns in the published data.
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Includes failures in clinical guidance, policies or decision criteria specifically governing VTE diagnosis, risk assessment, repeat assessment and management, including gaps in guidance for children and unclear guidance for when inpatient VTE risk assessments should be undertaken or repeated.
