When I calculated, for The Welfare State We're In, how many people a year die prematurely because Britain has the National Health Service rather than an averagely good system for an advanced country, I did not include deaths from Deep Vein Thrombosis (DVT). There is now plenty of reason to think that if these deaths were added, the toll of unnecessary deaths Britain endures would be even higher.

Today most papers have a report of the high death rate from DVT. However what is lacking, as far as I know, is any comparison with how other countries perform. If anyone knows of an international comparison, I would be grateful to hear of it. It is hard to believe they do worse.

I have personal experience of how much of the British medical establishment has got into the habit of not giving the risk of DVT proper attention (as with hospital acquired infections). A close relative broke her hip and afterwards, I came to learn, being elderly and not very mobile, she was at considerable risk of developing DVT. But she was not monitored. I, as the main person responsible for her, was not told of the risk. And although she was visited by a district nurse and developed symptoms, no effort was made to check whether she had the problem. It was only when I rang the consultant who did the operation to ask about her inflated leg that a check was ordered. She did indeed have DVT and might well have died as a result if I - not the district nurse - had not seen that there was a problem that should be checked out.

I suspect it is true that the failure of the National Health Service in general and, in truth, large parts of the private medical service in Britain, too, to take DVT seriously has caused tens of thousands of unnecessary deaths.

Here is some of the coverage of the story in the Daily Mail:

Nearly 11,000 patients have died during the past seven months because of a failure by NHS hospitals to prevent them developing blood clots, a report claims.

Guidelines introduced in April mean every patient at risk should be assessed for treatment to cut the toll of deep vein thrombosis, or DVT.

But only one in three trusts is taking action, according to the damning report from the All Party Parliamentary Thrombosis Group.

It estimates that the failure to implement the guidance has cost 10,700 lives from DVT in the past seven months - nearly three times the number of deaths from the MRSA superbug and C Difficile infections.

The death toll in a year is greater than that from breast cancer, Aids and traffic accidents combined.

DVT is caused by blood clots forming in the deep veins of the legs. If they travel to the lungs it may trigger a pulmonary embolism that can cause them to collapse, and heart failure.

The blood clots often form as a result of immobility during and after surgery. If part or all of the clot breaks off and lodges in the lung, 30 per cent of those affected will die without treatment.

A substantial number of patients are struck by a surgical DVT - whose medical name is Venous Thromboembolism, or VTE - after they have been discharged from hospital.

The report says it is a "public health emergency" yet preventive drugs given at the time of surgery cost just £1 a day, while compression stockings can help others.

Altogether, 99 per cent of 140 NHS Trusts surveyed in the report are fully aware of the guidelines, but only 32 per cent are taking steps to assess patients at risk.

These include patients in hospital for longer than four days with reduced mobility, severe heart failure, respiratory failure, acute infection, inflammatory illness or cancer.

John Smith, chairman of the parliamentary thrombosis group, said: "The stark realisation is that while nearly all hospitals are now aware of what best practice looks like, and the steps they should be taking on a daily basis to protect their patients, over two-thirds of NHS Trusts admit to not having in place a mandatory risk assessment for every hospital patient on admission.

"DVT causes more than 25,000 deaths each year. It is worrying

that some NHS Trusts are still failing to adhere to these guidelines, which could reduce deaths by over 40 per cent."

Campaigners say DVT causes 10 per cent of all hospital deaths.

Dr Beverley Hunt, medical director of Lifeblood: The Thrombosis Charity, said: "The total costs of managing DVT within the NHS are estimated to be £640million and it's deeply concerning that the simple step of risk-assessing patients is not being taken.

"Any unwell adult entering a hospital bed has a 17 per cent risk of DVT but this risk rises considerably if they are over 40, are having surgery or have a predisposing condition such as cancer."

In March 2005, a report from the Health Select Committee warned the NHS was systematically and dangerously underestimating the threat from bloodclotting.

It found preventive drugs were cheaply and easily available but not widely administered.

The full article is here.http://www.dailymail.co.uk/pages/live/articles/news/news.html?in_article_id=495064&in_page_id=1770

Posted by James Bartholomew • Indexed in NHS

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