Venous thromboembolism (VTE) is a major cause of death in hospital patients, and there are considerable costs associated with non-fatal symptomatic VTE and related comorbidities. The first step in preventing death and disability is to identify those who are at risk so that preventative treatments can be used. The VTE risk assessment was formally a national Commissioning for Quality and Innovation (CQUIN) indicator and is a National Quality Requirement in the NHS Standard Contract for 2016/17. It sets a threshold rate that acute providers must undertake risk assessments for at least 95% of inpatients each month.
We also examine how deep vein thrombosis (DVT) rates after hip or knee replacement surgery compare internationally over time.
Adherence to national guidance around VTE risk assessment has the potential to save many lives each year.
The data presented here relates to the proportion of adult hospital admissions admitted during the analysis period who are risk assessed for VTE on admission to hospital according to the Department of Health/NICE National VTE Risk Assessment Tool.
All providers of NHS-funded acute hospital care (including foundation and non-foundation trusts and independent sector providers) are required to complete the data collection, which was mandated in June 2010.
Definitions and comparability for the international indicator are taken directly from the OECD report Health at a Glance 2017: OECD indicators. Detailed information about the definitions and the source and methods for each country can be found here. The surgical admission-based method uses unlinked data to calculate the number of discharges with ICD codes for deep vein thrombosis in any secondary diagnosis field, divided by the total number of discharges of patients aged 15 and older.
A fundamental challenge in international comparison of patient safety indicators centres on differences in the underlying data. Variations in how countries record diagnoses and procedures and define hospital admissions can affect calculation of rates. In some cases, higher adverse event rates may signal more developed patient safety monitoring systems and a stronger patient safety culture rather than worse care. There is a need for greater consistency in reporting of patient safety across countries and significant scope exists for improved data capture within national patient safety programmes.