New and improved pathway for patients with deep vein thrombosis (DVT)

Hundreds of people with deep vein thrombosis (DVT) living in Bradford can now receive care closer to home thanks to the development of a new diagnostic and treatment pathway.

Clinical leaders from the two Bradford clinical commissioning groups (CCGs): Bradford City and Bradford Districts, developed the innovative pathway to improve patient care and deliver better health outcomes.

Historically, most people with suspected DVT were admitted to hospital for diagnosis and, if confirmed, treatment.

However, evidence suggested that most non-complex DVT patients could be cared for by their GP, which in turn would be more convenient and help patients to manage their condition better.

Following a review of DVT services provided across the district, CCG clinical leaders identified poor health outcomes for people living with DVT.

By actively engaging hospital clinicians, particularly staff from radiology, haematology and acute medicine departments, the CCG looked at how services could be transformed to help improve the patient experience.

The new pathway will see GPs assessing patient’s symptoms and medical history; and using a blood test to gauge the likelihood of DVT. If DVT is suspected, patients would receive treatment from the GP and a prompt scan at the hospital.

If a DVT is confirmed, patients will receive expert advice on the length of treatment and how to avoid future problems at Bradford Teaching Hospitals’ specialist thrombosis clinic. The new care pathway means that the majority of people avoid hospital admission, receiving expert advice from the most appropriate person at the most appropriate time in their treatment.

Anticoagulation Europe, a patient information group, acted as a critical friend to help provide a patient’s perspective and offer advice about the new pathway.

Dr Matthew Fay, a GP and a key figure in developing the new pathway, said: “Improving the health of all our patients is at the heart of everything we do and this is a great example of how community clinicians and hospital clinicians can work together to improve local health services.

“This development represents an important shift in the way we traditionally deliver health services.

“It means that hundreds of patients are receiving the care and treatment they need to manage their condition without hospital treatment. With the help of their GP, patients are aware of the importance of their medicine and the positive impact this has on their health and well being. We believe this will help them to keep up with their treatment plan.”

In the first 18 weeks of piloting the new pathway, 263 patients avoided treatment in hospital, saving £51,000. By delivering services in this way, the CCGs expect to save up to £250,000 a year.

The success of the pathway has led to many requests from other CCGs across the country to learn from the CCGs’ experience. Clinical leaders believe this pathway can easily be replicated and lead to improvements in other health services.