Community Deep Vein Thrombosis (DVT) Service: Castle Point & Rochford CCG

Description

Castle Point & Rochford Clinical Commissioning Group is seeking providers who can provide high quality initial DVT Testing services to improve patient experience/access to community services, patient’s choice and to avoid unnecessary referrals to secondary care. The service shall be provided to adults registered with a GP in Castle Point and Rochford CCG, including temporary residents, and unregistered patients residing within the Castle Point and Rochford area. Patients who are pregnant are not eligible for this service and shall be referred directly to secondary care. A venous thrombus most often occurs in the deep veins of the legs or pelvis and is then called a deep vein thrombosis (DVT). The clot may dislodge and travel to the lungs to cause a pulmonary embolism. A DVT can be very difficult to diagnose but early recognition and appropriate treatment can save many lives. A specialised blood test, known as the D-dimer test, is used to detect pieces of blood clot that have been broken down and are loose in the bloodstream. The larger the number of fragments found, the more likely it is that there is a blood clot in the vein. If the D-dimer test is negative, it rules out the possibility of a DVT in 95% of cases. However, the D-dimer test is not always reliable. Consequently, several diagnostic scoring systems have been validated whereby patients are classified as having a high, intermediate or low probability of developing DVT, based on history and clinical examination, including Wells Scores. Wells scores are a clinical prediction rule for estimating the probability of DVT and PE. There are a number of versions of Wells scores available. The NICE clinical guideline 144 recommends the use of the two-level DVT and PE Wells Scores to aid diagnosis of PE or DVT.