Treatment of blood clots: our anticoagulation and thrombosis service
What we do
We look after people who have had blood clots, also known as deep vein thromboses. These are common but can make people very unwell. They usually occur in the veins of the lungs (known as a pulmonary embolism) , legs, arms, brain or abdomen. Occasionally we will also look after people who have had blood clots in other places, for example in the heart, where we would work alongside the cardiology team.
We help the teams on the ward and in A&E decide what treatment to start, then we see patients in clinic and help decide how long treatment is needed, whether any tests are needed for an underlying cause, and what the best treatment is from that point onwards. We help educate and counsel patients about how to use their medicine for blood clots (anticoagulants) safely, and how to lower their risk of further clots in future. Sometimes you will speak to a doctor, and sometimes a nurse or pharmacist, depending on the type of decision or counselling that you need.
- We also help patients who have an irregular heart rhythm (atrial fibrillation) to start anticoagulants safely, after the decision to start this treatment has been made, usually by a GP, cardiologist or stroke doctor.
- If a decision is made to start you on warfarin you will be seen in the warfarin clinic.
- Our team is made up of doctors, nurses, pharmacists and scientists, and together we look after patients at the Royal London, St Bartholomew's, Newham and Whipps Cross hospitals, with lots of us working at more than one hospital.
What to expect in our warfarin clinic
You will receive a letter to invite you to a face-to-face clinic at either The Royal London, Whipps Cross, St Bartholomew's or Newham, depending on where you live.
We will explain how to take warfarin safely. You will have your first blood test and be told how much warfarin to take. This will be written in your yellow warfarin record. You will need regular blood tests in this clinic to determine what dose of warfarin you need. If you are housebound, we will try to arrange someone to come to your house to do the blood tests. If you are on dialysis we can do this through the dialysis unit. Some people prefer to buy self-testing kits at home, in which case we can use the blood tests you do yourself to dose your warfarin. Your GP will give you prescriptions for the warfarin tablets but the warfarin clinic will keep letting you know how much to take.
How to cancel or rearrange an appointment or contact the warfarin clinic
- Royal London/St Bartholomew's: phone 020 3594 1885 or email the team
- Whipps Cross: phone 020 8535 6815 or email the team
- Newham: phone 020 7363 8730 or email the team
What to expect in our thrombosis clinic
If you have been diagnosed with a blood clot, also known as a deep vein thrombosis or pulmonary embolism, you will be given medicine called an anticoagulant to help your body heal and prevent another clot from forming. Unless advised specifically otherwise, please keep taking your medication until you are seen in thrombosis clinic, with extra prescriptions from your GP if needed.
You will receive a letter informing you of your appointment in the thrombosis clinic , which may be by phone or face-to-face the first time . This is usu ally scheduled around 6 to 12 weeks after the clot happened. Please make sure your GP has your correct telephone number and address as we use your GP record to contact you. Phone calls will be from a withheld number so please check you can receive those. Interpreters are available if you need one .
The doctor in clinic will go over your history and help you decide how long to take the anticoagulant, what the best type of anticoagulant is for you going forwards, whether there was an underlying cause for the blood clot that needs treatment, and what you can do to try to prevent another blood clot in future.
After an appointment you and your GP will receive a letter summarising the appointment and any changes to your treatment plan by post . This letter can also be found on the NHS app , or via a we b site called Patients Know Best . N ew prescriptions will be issued from the hospital pharmacy with a request to your GP to continue them if needed by post . Sometimes you may need further tests like scans or blood tests.
If you need another appointment you will be notified by post, and you can also find this information on the NHS app or Patients Know Best .
Contact us to cancel or rearrange an appointment for thrombosis clinics, including if you would like to request a change to the format of the clinic (phone/ face-to-face).
Contact us for other issues
- Royal London/St Bartholomew’s: phone 020 3594 1885 or email the team
- Whipps Cross: phone 020 8535 6815 or email the team
- Newham: phone 020 7363 8730 or email the team
Further information
- Deep Vein Thrombosis Barts Health patient information leaflet
- Pulmonary embolism Barts Health patient information leaflet
- Thrombosis UK: excellent patient information, videos, events and webinars
- Rivaroxaban: a medicine to help prevent blood clots - NHS
- Apixaban: NHS
- Edoxaban : NHS
- Dabigatran: NHS
- Warfarin: NHS
- Patient video: how to inject anticoagulants (tinzaparin, dalteparin , enoxaparin, fondaparinux, This video is designed for women in pregnancy but the principles of good injection technique apply to everyone : How to inject low molecular weight heparin (LMWH).