Post-operative anticoagulation practice

​Request ​795256833

:Post-operative anticoagulation practice at Jersey General Hospital. 

Provide the standard policy, protocol or clinical guideline in place in May 2023 governing venous thromboembolism (VTE) risk assessment and post-operative anticoagulation for patients undergoing hip fracture surgery, including discharge prescribing. Provide the standard practice in May 2023 for patients undergoing hip fracture surgery to be discharged with anticoagulant thromboprophylaxis Also share the typical duration. Provide the circumstances under which anticoagulant thromboprophylaxis would appropriately be withheld on discharge following hip fracture surgery and how such decisions should be documented. Provide any pharmacy review or sign-off of discharge medications was required or expected for orthopaedic patients during that period. Provide an audits, reviews, or incident investigations between 2020 and 2024 identified issues relating to missed, omitted, or withheld anticoagulant prescribing following surgery, particularly in orthopaedics.

Response

Documents relating to venous thromboembolism (including risk assessment) and regarding hip fracture surgery which were in use in May 2023 are attached below:

[Venous Thromboembolism (VTE) Risk Assessment Form]​

[Venous Thromboembolism (VTE) Checklist]

[Venous Thromboembolism (VTE) Patient Information Leaflet]​

[Your Anaesthetic for a Broken Hip]​

In the absence of ratified Department-specific policy for a particular diagnosis or circumstance, the guidelines provided by the National Institute for Health and Care Excellence (NICE) or Royal Colleges are considered in treatment decisions to provide evidence based best practice care.

In all circumstances, treatment is determined not only by the patient’s acute presentation, but in consideration of any co-existing medical conditions; care is then tailored to the individual as directed by best practice guidelines.

With respect to Pharmacy review or sign-off of discharge medications, all TTA (to-take-away) prescriptions must be clinically verified by a pharmacist prior to discharge. This includes anti-coagulants.

A Freedom of Information response published to www.gov.je in December 2025 includes information on recorded incidents for non-administration / non-prescription of anticoagulant or antiplatelet medications across the preceding five year period.

gov.je/government/freedomofinformation/pages/foi.aspx?ReportID=9068

Fewer than five of the incidents recorded relate to patients under the care of Trauma and Orthopaedics. As numbers are small, disclosure control is applied to protect individuals from identification, and Article 25 of the Freedom of Information (Jersey) Law 2011 has been applied to protect the privacy of individuals.

Health and Care Jersey (HCJ) report upon Serious Incidents in the annual HCJ Quality Account (Part 3: Review of our quality performance; Learning from Serious Incidents and Never Events).

Health and Care Jersey Quality Account 2024

Prior to the production and publication of the Quality Account, redacted versions of quarterly reports were shared through Freedom of Information:

gov.je/government/freedomofinformation/pages/foi.aspx?ReportID=6372​

As noted in a previous Freedom of Information response, Serious Incident reports are not made available in the public domain.

No audits have been identified for the period from 2020 to 2024 meeting the scope of this request.

Article applied 

Article 25 Personal information 

(1) Information is absolutely exempt information if it constitutes personal data of which the applicant is the data subject as defined in the Data Protection (Jersey) Law 2005. (2) Information is absolutely exempt information if – (a) it constitutes personal data of which the applicant is not the data subject as defined in the Data Protection (Jersey) Law 2018; and (b) its supply to a member of the public would contravene any of the data protection principles, as defined in that Law.​