Sharon Henshall
20 Aug 2015 · Coroner Claire Hammond · Preston and West Lancashire
The coroner's concerns
1. lack of VTE risk assessment model for patients with lower limb immobilisation
“The evidence of Cl aun Consultant in Emergency Medicine, an Consultant [name redacted], was that there is currently no venothromboembolism risk assessment model in place in the Emergency Department to assess the risk of VTE in patients discharged with tower limb immobilisation”
2. absence of interim VTE risk assessment tool
“To have no assessment in place at all and to offer nothing in an area of known risks on the basis that the evidence base is varied, as opposed to having a tool in place, even one that recognises only the highest and obviously known/understood risk factors, seems unlikely to be adequate”
3. lack of LMWH prophylaxis for immobilised patients
“Dr McDowell's evidence was that other European countries routinely give LMWH to patients with lower limb immobilisation, yet this is not something that is done at LTHTR, or uniformly across Trusts in England and Wales”
4. absence of NICE-compliant risk discussion tool
“According Ss caanuam the NICE guidance in this area, which was updated in June 2015, states that clinicians should have a discussion about risks and benefits with each individual, which necessarily requires having some form of tool or model in place to facilitate that discussion, yet there is no such tool in place within LTHTR”