We recognise the importance of tackling blood clots in pregnancy, also referred to as venous thromboembolism (VTE), as the leading cause of maternal death in England. The rate of maternal deaths from thrombosis and thromboembolism rose substantially between 2009 to 2011 and 2021 to 2023, from 1.26 to 2.13 per 100,000, in maternity, with rising rates of maternal obesity, advanced maternal age, and births by caesarean section likely contributing factors.

VTE is thought to occur in approximately one of 500 pregnancies, and the approach to minimising risk has therefore focused on universal risk assessment, targeted information, and preventative treatment for those considered to be at high risk. Last year, Mothers and Babies: Reducing Risk through Audits and Confidential Enquiries across the UK identified the need for improved VTE risk assessment, better pathways for rapid access to thromboprophylaxis in early pregnancy, and more robust training for clinicians.

NHS England published the Maternal Care Bundle in January 2026, with the aim to reduce maternal mortality and morbidity and reduce inequalities in these adverse outcomes. Element 1 requires the National Health Service to implement a new, simplified, national self-assessment questionnaire on VTE risk, for all women at their first NHS care contact with a positive pregnancy test, and ensure that those considered at highest risk have a discussion with a prescriber, and are offered low molecular weight heparin within 72 hours. Services have been asked through Element 1 of the Maternal Care Bundle to adopt Thrombosis UK’s early pregnancy blood clot risk questionnaire, which has information on the risk of VTE in pregnancy. All NHS trusts providing maternity services are responsible for fully implementing the Maternal Care Bundle by March 2027. This includes providing regular reports to the trust board on implementation.

All midwives are trained to discuss VTE symptoms with all women at the first contact in pregnancy and through to postnatal contacts, as part of the standard assessment process. Clinical guidance that directs their training includes the National Institute for Health and Care Excellence’s postnatal care guidance, reference code NG194, and Venous thromboembolism in over 16s: reducing the risk of hospital-acquired deep vein thrombosis or pulmonary embolism, reference code NG89.

Baroness Amos’ final report of her independent National Investigation into Maternity and Neonatal Services in England has recommended that the NHS commissions and delivers ‘antenatal education that reflects the realities of pregnancy and birth today’. The Government will work with the national Maternity and Neonatal Taskforce on the response to this recommendation, including on information women require regarding the risk of VTE.

Locally, some individual trusts also produce additional information for women and their families about reducing the risk of blood clots and VTE in pregnancy.

The Department has not made a specific assessment. The following table shows a count of Finished Admission Episodes in hospitals in England where there was a primary diagnosis, or any diagnosis, of 'deep vein thrombosis' for activity between 2015/16 and 2025/26:

Source: Hospital Episode Statistics, NHS England.

Note: data from April 2025 are currently provisional. This data may be subject to change as further updates are carried out during the financial year.

This data collection was established to support the work of the Medicines and Healthcare products Regulatory Agency. Whilst information on reported cases of COVID-19 vaccine induced thrombosis and thrombocytopaenia was collected by Public Health England, reporting was not mandatory or part of an official surveillance system and the data are not centrally validated.

NHS England and NHS Improvement are preparing guidance on the full restoration of deep vein thrombosis and post thrombotic syndrome services which will be issued to the National Health Service shortly.

Responsibility for deep vein thrombosis (DVT) lies with NHS England.

DVT is extremely rare in children. The Department is aware of an existing national guideline on investigation, management and prevention of venous thrombosis in children produced by the British Committee for Standards in Haematology. This is an area which would benefit from further study and sharing of experience and exemplar practice.

The Royal Blackburn hospital's protocol on dealing with children with DVT has been brought to the attention of those responsible for delivery of the National Venous Thromboembolism Prevention Programme. It is the responsibility of NHS England to make decisions on whether to adopt the Royal Blackburn hospital's protocol on dealing with children with DVT.

The Department does not hold this data centrally, but it has been provided by the National Health Service Litigation Authority (NHS LA), and is shown in the tables.

The following points in relation to the data should be noted. The data shows the position at 31 March 2012; the data for 2012-13 is not yet available. The year refers to the year when the claim was made. Relevant claims were selected by searching for the keywords in the incident details on the NHS LA database. However a particular claim's data could possibly be duplicated, i.e. the incident could be identified by one or more referenced words. The amounts paid in a given year may include payments on settlements made in that year as well as payments made against settlements agreed in earlier years, for example where there are on-going annual payments.

The information in the following table shows how many successful clinical negligence compensation claims against the NHS were made which referenced

(a) anticoagulation, (b) warfarin, (c) heparin, (d) deep vein thrombosis, (e) pulmonary embolism in each of the last five years for which figures are available.

The information in the following table shows the number of compensation cases brought against the NHS which referenced (a) anticoagulation, (b) warfarin, (c) heparin, (d) deep vein thrombosis, (e) pulmonary embolism in each of the last five years for which figures are available.

The information in the following table shows the cost of successful claims made against the NHS which referenced (a) anticoagulation, (b) warfarin, (c) heparin, (d) deep vein thrombosis, (e) pulmonary embolism in each of the last five years for. which figures are available.

The Department does not hold this data centrally, but it has been provided by the National Health Service Litigation Authority (NHS LA), and is shown in the tables.

The following points in relation to the data should be noted. The data shows the position at 31 March 2012; the data for 2012-13 is not yet available. The year refers to the year when the claim was made. Relevant claims were selected by searching for the keywords in the incident details on the NHS LA database. However a particular claim's data could possibly be duplicated, i.e. the incident could be identified by one or more referenced words. The amounts paid in a given year may include payments on settlements made in that year as well as payments made against settlements agreed in earlier years, for example where there are on-going annual payments.

The information in the following table shows how many successful clinical negligence compensation claims against the NHS were made which referenced

(a) anticoagulation, (b) warfarin, (c) heparin, (d) deep vein thrombosis, (e) pulmonary embolism in each of the last five years for which figures are available.

The information in the following table shows the number of compensation cases brought against the NHS which referenced (a) anticoagulation, (b) warfarin, (c) heparin, (d) deep vein thrombosis, (e) pulmonary embolism in each of the last five years for which figures are available.

The information in the following table shows the cost of successful claims made against the NHS which referenced (a) anticoagulation, (b) warfarin, (c) heparin, (d) deep vein thrombosis, (e) pulmonary embolism in each of the last five years for. which figures are available.

The Department does not hold this data centrally, but it has been provided by the National Health Service Litigation Authority (NHS LA), and is shown in the tables.

The following points in relation to the data should be noted. The data shows the position at 31 March 2012; the data for 2012-13 is not yet available. The year refers to the year when the claim was made. Relevant claims were selected by searching for the keywords in the incident details on the NHS LA database. However a particular claim's data could possibly be duplicated, i.e. the incident could be identified by one or more referenced words. The amounts paid in a given year may include payments on settlements made in that year as well as payments made against settlements agreed in earlier years, for example where there are on-going annual payments.

The information in the following table shows how many successful clinical negligence compensation claims against the NHS were made which referenced

(a) anticoagulation, (b) warfarin, (c) heparin, (d) deep vein thrombosis, (e) pulmonary embolism in each of the last five years for which figures are available.

The information in the following table shows the number of compensation cases brought against the NHS which referenced (a) anticoagulation, (b) warfarin, (c) heparin, (d) deep vein thrombosis, (e) pulmonary embolism in each of the last five years for which figures are available.

The information in the following table shows the cost of successful claims made against the NHS which referenced (a) anticoagulation, (b) warfarin, (c) heparin, (d) deep vein thrombosis, (e) pulmonary embolism in each of the last five years for. which figures are available.

Further to my reply of 12 March 2013, Official Report, columns 178-9W, giving a breakdown of primary care prescribing of rivaroxaban, a breakdown of the use of rivaroxaban in secondary care by strategic health authority is shown in the table.

Prescribing data do not include the indication for which the medicine has been given. It is therefore not possible to separate out prescribing for the treatment of deep vein thrombosis and prevention of recurrent deep vein thrombosis and pulmonary embolism from other uses such as prevention of stroke arid systemic embolism.

We are not aware of any such reports. The National Institute for Health and Clinical Excellence (NICE) has published technology appraisal guidance recommending rivaroxaban as an option for treating deep vein thrombosis and preventing recurrent deep vein thrombosis and pulmonary embolism after a diagnosis of acute deep vein thrombosis in adults. National health service organisations are legally obliged to fund drugs and treatments recommended in NICE technology appraisal guidance. Decisions on the prescribing of medicines are a matter for clinicians in discussion with their patients.

Information has been placed in the Library.

A table is provided for each of the last available three financial years 2009-10 through to 2011-12, together with April to September 2012, giving the total number of prescription items dispensed in the community, in England, by primary care trust, for rivaroxaban. The net ingredient cost of these dispensed prescription items is provided in a further table.

Prescription data does not include the indication for which the medicine has been given. It is therefore not possible to separate out any prescribing for rivaroxaban for the treatment of deep vein thrombosis and prevention

of recurrent deep vein thrombosis and pulmonary embolism from any other use such as prevention of stroke and systemic embolism.

In terms of cost, the main usage of rivaroxaban is in secondary care. In the calendar year 2011 the estimated cost in hospitals in England was £3.4 million. This figure is taken from the Hospital Prescribing 2011 report published by the Health and Social Care Information Centre.

The National Institute for Health and Clinical Excellence's (NICE) technology appraisal guidance, published in July 2012, recommends rivaroxaban as an option for treating deep vein thrombosis and preventing recurrent deep vein thrombosis and pulmonary embolism after a diagnosis of acute deep vein thrombosis in adults.

Primary care trusts are legally obliged to fund drugs and treatments recommended in NICE technology appraisal guidance, within three months of guidance being published, unless the requirement is waived in a specific case.

The NHS chief executive's report, “Innovation Health and Wealth”, committed the NHS to establishing a compliance regime to promote rapid and consistent implementation of NICE technology appraisal guidance.

As “Creating Change: Innovation Health and Wealth one year on” sets out, this compliance regime is already reducing variation.

It is for primary care professionals to ensure their own professional competence in regard to venous thrombroembolism (VTE), and to have regard to the clinical guidelines and Quality Standards on VTE published by the National Institute for Health and Clinical Excellence (NICE). The national VTE prevention programme encourages all clinicians to familiarise themselves with NICE guidance on the diagnosis and management of VTE and recommends use of the VTE Prevention e-Learning module which has been endorsed by a wide cross section of the United Kingdom medical community.

This information is not available.