Incomplete clinical guidance for venous thromboembolism assessment and management
First to latest report 18 Feb 2016 — 12 Aug 2024
Reports that mention this concern
8
Times this concern has been raised
11
Stated actions linked to this concern
10
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.
What is 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.
Trends
Reports over time
Reports mentioning this concern, 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
Reports and published responses 8 reports
See individual reports that have raised this concern, and the actions taken in response
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.
Linked response
East London NHS Foundation Trust
Stated actions An action is something a respondent says it has done, is doing, or plans to do in response to the concern raised.1
East London NHS Foundation Trust
Remove unclear VTE assessment information from the Physical Healthcare Policy and publish an update directing staff to the VTE policy.
Respondent positions A position is what a respondent says about the concern when they do not describe a specific action.1
East London NHS Foundation Trust
The separate VTE policy is unambiguous and aligned with NICE guidelines, although VTE information in the Physical Healthcare Policy is unclear.
Disputes 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.
Linked responses
National Institute for Health and Care Excellence
Royal College of Paediatrics and Child Health
Stated actions An action is something a respondent says it has done, is doing, or plans to do in response to the concern raised.1
National Institute for Health and Care Excellence
Ask the prioritisation board to consider whether guidance should be developed on venous thromboembolism in children.
Respondent positions A position is what a respondent says about the concern when they do not describe a specific action.2
Royal College of Paediatrics and Child Health
NICE should take the lead in developing paediatric pulmonary thromboembolism screening tools and specific national guidance.
Redirects responsibilityThe respondent said that another organisation was responsible for deciding or taking action.
National Institute for Health and Care Excellence
NICE cannot recommend a paediatric VTE screening tool because evaluated adult scores perform poorly and no suitable tool is known.
Unable 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.
Linked responses
Barts Health NHS Trust
Department of Health and Social Care
Respondent positions A position is what a respondent says about the concern when they do not describe a specific action.2
Barts Health NHS Trust
Insufficient evidence exists to justify changing the national VTE risk assessment tool for tranexamic acid use or pelvic fibroids.
Unable to actThe respondent said that a constraint prevented them from taking the relevant action.
Department of Health and Social Care
The established VTE risk assessment tool remains appropriate, with insufficient evidence to adapt or change it.
Existing 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.
Linked response
Department of Health and Social Care
Respondent positions A position is what a respondent says about the concern when they do not describe a specific action.1
Department of Health and Social Care
Issues concerning Pennine Care NHS Foundation Trust should be addressed in the Trust’s response.
Redirects 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.
Linked response
Royal Cornwall Hospitals NHS Trust
Stated actions An action is something a respondent says it has done, is doing, or plans to do in response to the concern raised.3
Royal Cornwall Hospitals NHS Trust
Scrutinise and ratify the Thrombosis Prevention and Anticoagulation Policy in its current form through the steering group.
Royal Cornwall Hospitals NHS Trust
Review the Thrombosis and Anticoagulation policy arrangements through a larger workstream to improve accessibility and remove ambiguity.
Royal Cornwall Hospitals NHS Trust
Audit the ten most recently uploaded document-library policies within three months to verify that the correct approval process was followed.
Respondent positions A position is what a respondent says about the concern when they do not describe a specific action.1
Royal Cornwall Hospitals NHS Trust
TPAS considered the policy’s acknowledged ambiguity insufficiently risky to warrant removal and ratified the current policy pending broader review.
Existing 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.
Linked response
Medicines and Healthcare products Regulatory Agency
Stated actions An action is something a respondent says it has done, is doing, or plans to do in response to the concern raised.5
Medicines and Healthcare products Regulatory Agency
Maintain warnings in combined hormonal contraceptive product information about venous thromboembolism risks, surgery and immobilisation.
Medicines and Healthcare products Regulatory Agency
Review combined hormonal contraceptive venous thromboembolism risks and update product information with revised risk estimates and antithrombotic-treatment advice.
Medicines and Healthcare products Regulatory Agency
Introduce user cards and prescriber checklists covering clot risks, warning symptoms, and alerts about planned or recent surgery or immobilisation.
Medicines and Healthcare products Regulatory Agency
Communicate revised venous thromboembolism risk estimates and risk-reduction measures to prescribers through Drug Safety Update.
Medicines and Healthcare products Regulatory Agency
Request updates to the product information for the small number of combined hormonal contraceptive products missing information from the venous thromboembolism review.
Respondent positions A position is what a respondent says about the concern when they do not describe a specific action.2
Medicines and Healthcare products Regulatory Agency
Existing product warnings, risk estimates, antithrombotic advice, user materials and prescriber tools provide risk-minimisation measures for combined hormonal contraceptives.
Existing arrangements considered sufficientThe respondent said that existing arrangements were sufficient, so no further action was needed.
Medicines and Healthcare products Regulatory Agency
Clinical guidance addresses DVT prevention, diagnosis and management, including VTE risk assessment and antithrombotic prevention for surgery and trauma.
Redirects 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.
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
No linked response statements
No respondent-stated action or position is linked to these concerns in the published data.
Actions and positions describe what organisations say in published responses. Implementation is not independently verified.
Actions and positions describe what organisations say in published responses. Implementation is not independently verified.