Deep Vein Thrombosis (DVT) and Pulmonary Embolism (PE) Care
GPPC has successfully tendered to provide assessment services for suspected DVT or PE in NE Essex. This service has been provided in general practices in the past either through individual contracts with the local Clinical Commissioning Group (CCG) or by direct referral to hospital. From 1/7/16, GPPC has been contracted by the CCG to provide a community based service which GPPC will do through it's member practices. This is part of the general move for patient services to be "closer to home", providing quicker and easier access in a safe, well organised system.
A patient with a suspected DVT or PE will be assessed within the GP practice. This will include clinical assessment, the use of a validated risk assessment questionnaire (the 2 level Wells DVT Probability Score) and a near-patient D-dimer test. Following this, by linking the service to the community Ultrasound service, a high proportion of patients with suspected DVT can be diagnosed and treated within a primary care setting, avoiding referral onto secondary care.
The aim of the PE pathway is to quickly rule out a PE and therefore consider alternative diagnosis, and for a positive PE diagnosis, patients can commence treatment immediately and then be referred onto secondary care for the second stage of their pathway. Liaison with the telephone consultation service “Urgent Connect” will provide specialist support to the clinicians delivering the service. By enabling primary care to undertake the first stage of a PE diagnosis it is expected to improve patient care both through access and patient experience.