Salisbury Foundation Trust

FOI_5639

Internal Reference Number: FOI_5639

Date Request Received: 15/04/2020 10:48:11

Date Request Replied To: 02/06/2020 14:14:35

This response was sent via: By Email

Request Summary: Clinical Pathways atrial fibrillation, DVT, Pulmonary Embolism

Request Category: Private Individuals

 
Question Number 1:
I would like to know what happens to patients referred by their GPs to the hospital suspected with atrial fibrillation. Is there a patient clinical pathway?

a. how many patients are diagnosed with AF in the hospital?
b. which departments do these patients go to get diagnosed?
c. who deals with their treatment?
 
Answer To Question 1:
Q1. If referred by GP, patients are referred using ERS as normal. The referrals are vetted by one of the cardiology consultants. If appropriate, they are triaged to electrophysiology clinic or combined cardiology clinic.
AF is a very heterogenous condition, on occasion requiring expert management but it can frequently be managed in the community without referral to secondary care.
a) we do not keep this information
b) Cardiology generally in outpatient setting
c) Either GP, arrhythmia nurse with discussion with electrophysiologist, general cardiologist, electrophysiologist
 
Question Number 2:
I would like to know what happens to patients referred by their GPs to the hospital suspected with DVT. Is there a patient clinical pathway?

a. how many patients are diagnosed with DVT in the hospital?
b. which departments do these patients go to get diagnosed?
c. who deals with their treatment?
 
Answer To Question 2:
Q2. All patients referred from GP get referred directly to the vascular unit for scanning. There is a protocol and if the GP ticks that they want to manage any condition diagnosed then the patient is discharged back to GP. If they say they want hospital management then anticoagulation team see them directly from the scan.
a) Average of 18 DVTs seen in the outpatient DVT each month.
b) Scan is performed in vascular department, all positive scans are then directly referred to be seen by the thrombosis nurse for treatment, based in pathology outpatients.
c) Specialist Anticoagulation and Thrombosis Nurse
 
Question Number 3:
I would like to know what happens to patients referred by their GPs to the hospital suspected with Pulmonary Embolism. Is there a patient clinical pathway?

a. how many patients are diagnosed with Pulmonary Embolism in the hospital?
b. which departments do these patients go to get diagnosed?
c. who deals with their treatment?
 
Answer To Question 3:
Q3. Suspected PEs come to AMU. We have a clinical pathway under development based on the NICE guidance. We follow NICE guidance as a unit anyway but with the ANPs starting we had to develop a pathway to facilitate their management. If they have confirmed PE they will currently be followed up by anticoagulation and referred to respiratory OPD.
a) We see on average 16 PEs each month.
b) Most patients who are admitted with symptoms of PE would be diagnosed in ED or AMU. But diagnosis could be made on any ward if they had symptoms whilst admitted. Diagnosis is made following patient history, NICE guidance and utilising risk assessment scores (PE Rule out criteria and Wells score) if high risk they will have a CT or VQ scan to confirm diagnosis.
c) Treatment Is initiated by the clinician looking after the patient. They will then be seen by the anticoagulation team and be followed up by the respiratory team if required. The Trust is currently creating a regular follow up clinic for all patients diagnosed with PE's.
 
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