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If you are currently prescribed the drug warfarin and attend regular anticoagulation (INR) checks to assess how quickly your blood clots and adjust your dose, you may have heard about upcoming changes to your anticoagulation service. 

From Tuesday 1 October 2019, your care will transfer from Boots to the new Croydon Integrated Community Anticoagulation Service (CICAS). The new service will provide a seamless anticoagulation service for the people of Croydon, whether they are seen in hospital, at a community clinic, in general practice or at home.  

CICAS information leaflet 

This service will be delivered in partnership by:

Croydon Health Services NHS Trust which provides integrated NHS services to care for people at home, in schools, and health clinics across the Borough as well as at Croydon University Hospital and Purley War Memorial Hospital and The Croydon GP Collaborative, a healthcare provider formed by Croydon GPs to provide local healthcare services.
 
Care will be offered from a range of locations across the borough so that services remain local and easily accessible for all. CICAS will be working with people who use the service to make sure that clinic locations are accessible and as close to current Boots clinics as possible to and deliver the best service possible throughout the transition period and beyond.

What do I need to do?

Like Boots, CICAS will provide you with a choice of appointment location, time and day so you can select what works best for you.

It is important that you continue to attend your planned appointments with Boots. At or after your final appointment, the Boots team will book you into your first appointment with CICAS. Details of your next appointment will be written in your yellow book as normal. You will also be given a number to call if you want to check or change your appointment.
Your INR records will be transferred from Boots to CICAS electronically within 2 working days of your final appointment to make sure that there is no disruption to your care. 
If you unexpectedly need a further appointment with Boots after this transfer, the Boots team will be able access your records. 
You can opt out of the electronic transfer of your records, however, you must bring your yellow book with you to your next appointment so CICAS can start a new record and your treating clinician will not be able to see your previous blood test results.
 

Frequently Asked Questions

Why has there been a change to our anti-coagulation services service?

Boots’ contract to provide INR checks for people taking warfarin will end on 30 September. This provided an opportunity to develop an integrated anticoagulation service with primary care (GPs) and secondary care (hospital) working together to provide a more seamless service for the residents of Croydon.

Who will be delivering the new service?

This service will be delivered in partnership by: 

Croydon Health Services NHS Trust which provides integrated NHS services to care for people at home, in schools, and health clinics across the Borough as well as at Croydon University Hospital and Purley War Memorial Hospital.

The Croydon GP Collaborative which is a healthcare provider formed by Croydon GPs to provide local healthcare services.

Will there be continuity in my care?

Boots and the new integrated service use the same electronic dosing system, so your anticoagulation records can be safely and seamlessly transferred to the new service. We are lucky enough to have been able to employ staff who have previously worked in the Boots anticoagulation service. Therefore they will bring a wealth of experience to ensure continuity of your care.

Will I be able to stay at the same site of my existing clinic?

We have strived, along with patient representatives, to provide the new service at sites as close geographically to the current service, with good transport links and parking in order to ensure minimum inconvenience and disruption. Those people attending clinics at Parchmore, Queenhill and Old Coulsdon medical practices will be able continue to have their anticoagulation service provided at these sites. Those people who attend anticoagulation clinics based in a Boots’ pharmacy will need to move site as these clinics will no longer be available. You will find the full list of locations and clinic times at the end of this document.

Will I be able to attend a clinic at the weekend?

We will be providing a clinic every Saturday morning. These will be alternately at East Croydon medical practice and Purley War Memorial Hospital.

Who will lead the service?

The integrated service will be led by the consultants at Croydon hospital. There will be regular communication between the staff in the community clinics and those based at the hospital. There will be clinical leads both in the community and the hospital giving constant support and regular training to all clinical practitioners involved in running this integrated service.

Will I still need to go to the hospital based anticoagulation clinic if I have a procedure or surgery?

This will remain the same during the first year of this new integrated service, as you will still need to be seen temporarily at the hospital until your INR is back in therapeutic range. However, the clinical staff in the community clinics will be undergoing training to become non-medical prescribers. Once this is completed they will be able to provide this service safely within the community environment, minimising disruption to your anticoagulation care.

What will happen if I have a high INR (over 8)?

If this is highlighted during a morning clinic you will be asked to attend the anticoagulation clinic at Croydon University Hospital where a venous sample will be taken. If this reveals an INR over 8 you will be given oral vitamin K and given advice regarding ongoing anticoagulation treatment. If this is highlighted during an afternoon or Saturday clinic you will be asked to attend the Accident and Emergency department as is the case at present.

What will happen if I need/request to be switched from warfarin to one of the alternative anticoagulant drugs?

Within the first year you will need to be seen at the hospital anticoagulation clinic either at Croydon University Hospital or Purley War Memorial Hospital for this to be arranged. Once the community clinical practitioners are trained as non-medical prescribers, this service will be provided in the community based clinics.

Will there still be an anticoagulation service at Croydon University Hospital and Purley War Memorial Hospital?

The hospital team will continue to provide an anticoagulation service at these two sites working closely with our community colleagues. The hospital will look after people with more complex anticoagulation needs and continue to provide a service for patients with venous thromboses. The hospital team will triage all new referrals and arrange appointments in the most appropriate setting. The team will provide continuous support, training and educational events community colleagues.

What are the benefits of this new service for my GP?

This new service embraces the integration of primary care (GPs) and secondary care (hospital) services. It will enable us to provide more seamless care for the residents of Croydon and improving the communication between all the health professionals involved in your care.

How can I contact the service?

We have a central contact number (020 8401 3355) and e-mail address: ch-tr.cicas@nhs.net where staff will be available during normal working hours Monday-Friday. At any other time, it will still be necessary to contact 111 or 999 if it is an emergency.

Has the CHS Anticoagulation DXS form changed or GPs?

There has been a minor change to the current CHS Anticoagulation DXS form. Please find the updated version of the DXS form here for your reference. This has been uploaded onto DXS for use from 1st October.