Anticoagulant management service



The Haematology Department is responsible for the provision of the UHNM anticoagulation management service, (AMS), which initiates and monitors patients on oral anticoagulants. The most commonly used drug is warfarin.


The AMS provides oral ant​icoagulation management for approximately 6,500 patients. The majority of these patients are managed in one of 38 designated INR clinics. These clinics are run by the Trust's Biomedical Scientists or Phlebotomy staff. The anticoagulation service also provides telephone warfarin dose advice to housebound patients once the INR samples are received into the laboratory via District Nurses or nursing home staff.


Patients requiring oral anticoagulant therapy can be referred to the AMS. This includes patients who have to restart warfarin after temporary discontinuation and patients already taking warfarin on admission.


The AMS employs four Anticoagulation Nurse Specialists (ANS) who provide anticoagulation management advice 365 days a year in various hospital based clinics and ward visits. As a patient this means that if you are admitted to hospital, your warfarin treatment will continue to be managed by the AMS if authorised by your clinician. The ANS will ensure the patient or relative or carer has a full understanding of warfarin dose advice on discharge.




The AMS can be contacted for appointments or queries via: email at ​or telephone on 01782 674252.


General ​​Practitioner Infor​mation


ANS provides a Community Anticoagulation Service in accordance with the Service Specification.


GPs can refer patients directly to the AMS for initiation of warfarin by completing and signing a ​ Patient Specific Directive (PSD) for warfarin. AMS will also administer LMW​H once prescribed under a further Patient Specific Directive (PSD) for LMWH​​​ for those patients starting w​arfarin following diagnosis of a venous thromboembolism and those who have a recent VTE (in the preceding six weeks) and have a sub ​therapeutic INR. 


The PSDs should preferably be printed using the links above to ensure the current version is submitted. Once fully completed and signed the PSD(s) should then be scanned and emailed to the AMS using the secure address:​. Alternatively completed  and signed PSDs can be forwarded to the AMS via the secure FAX number 0844 2448577.


The PSDs should only be submitted by the GP, Consultant, or Non-medical prescriber who is responsible for patient care and capable of taking these decisions.