Recommendations from the British Committee for Standards in Haematology and National Patient Safety Agency

The British Committee for Standards in Haematology (BCSH) published its third edition of Guidelines on Oral Anticoagulation in 1998 (British Committee for Standards in Haematology, 1998) with an update in 2006 (Baglin et al, 2006). These recommendations on safety indicators compliment those guidelines. Risks and recommendations are accompanied by lists of safety indicators for patients starting oral anticoagulant therapy and for patients established on oral anticoagulant therapy. Not all indicators will necessarily be adopted by every service; rather a selection is provided from which to choose those considered most useful for local circumstances and needs. It is envisaged that indicators will be used to set standards for service development and for controls assurance, either by monitoring or audit (see section on Governance). As in the previous guidelines the term 'oral anticoagulant' refers to oral vitamin K antagonists (VKA), such as warfarin. Initial drafts of the guideline were produced by the writing group and modified in accordance with comments from a multidisciplinary sounding board, the BCSH and the British Society for Haematology (BSH) and comments incorporated where appropriate. Criteria used to quote levels and grades of evidence are as in appendix 3 of the Procedure for Guidelines Commissioned by the BCSH (http://Nvww.bcshguidelines.com). The target audience for this guideline is healthcare professionals involved in the management of patients receiving oral anticoagulant therapy.