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Originator: National Patient Safety Alert - NHS England & NHS Improvement

Issue date: 14-Jul-2021 10:01:26

This alert has been issued to:
  • Care Trusts
  • Mental Health Trusts
  • Specialists Trusts
  • Learning Disabilities Trusts
  • Mental Health & Social Care Trusts
  • Ambulance Trusts
  • Mental Health & Learning Disabilities Trusts
  • Acute Trusts
  • Community Trusts

  • Other contacts
  • Independent Healthcare Providers (registered with CAS)
  • Clinical Commissioning Groups
  • NHS Regional Offices
  • Special Health Authorities
  • GP - Locum
  • GP Practices
  • Community Pharmacy
  • Primary Care Networks
  • GP Practices 1

Action category: Action

Title: Inappropriate anticoagulation of patients with a mechanical heart valve

Broadcast content:

Early in the Covid-19 pandemic, published guidance supported clinical teams to review patients treated with a vitamin K antagonist (VKA) and where appropriate change their medication to an alternative anticoagulant (eg a low molecular weight heparin (LMWH) or a direct oral anticoagulant (DOAC)). This was partly to reduce the frequency of clinic attendance for monitoring, and thus reduce the risk to patients. The guidance listed exceptions where specific patients should not be switched from a VKA, including patients with a mechanical heart valve.

However, incidents have been reported of patients with a mechanical heart valve being switched to a LMWH or a DOAC. This alert asks GPs and other NHS providers of anticoagulation services to identify any patients who have a record of a mechanical heart valve and are receiving a DOAC, and to urgently review these patients to ensure they are on the most appropriate anticoagulation therapy and monitoring.

Additional information: NHS England and NHS Improvement Regional Offices: please cascade this alert to Community Pharmacy.

Alert reference: NatPSA/2021/006/NHSPS

Action underway deadline: 16-Jul-2021

Action complete deadline: 28-Jul-2021


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