Anticoagulation Monitoring Level 4

Under Review — this page was due to be reviewed by Tuesday, 31 August 2021. The information shown here may be outdated.

Anticoagulation Monitoring Level 4

This specification requires anticoagulation monitoring service providers in primary care to provide a level 4 service. This means providers would be responsible for sampling, testing and dosing patients on vitamin-K antagonists according to locally agreed protocols approved by ICCG. Clinical support and advice will be provided by the Haematology Departments at the respective hospitals. 

The overall aim is to provide an integrated anticoagulation service across primary and secondary care for patients on vitamin-k antagonist therapy.  In particular, the enhanced service will:

  • Provide increased capacity in the community to meet the rising demand for anticoagulation monitoring.
  • Shift some of the burden of anticoagulation monitoring from the Whittington, UCLH, Homerton and St Bartholomew’s Hospital into the community, allowing the Haematology Department to focus on new and complex patients.
  • Provide more services that are nearer to patients and are easily accessible.
  • Ensure the same high quality of service to patients whether accessed in primary or secondary care.
  • Ensure a consistent approach to testing, sampling and dosing between primary and secondary services.
  • Ensure that maintenance of patients is properly controlled and the need for continuation of therapy is reviewed regularly and therapy is discontinued where appropriate.
  • Enhance the confidence and develop the skills of GPs and community pharmacists and staff who have an interest in anticoagulation monitoring.
  • Improve the primary/secondary care interface resulting in a streamlined service that benefits patients.

Specification Document

Anticoagulation Monitoring Level 4 Service Specification 2020-21

PDF, 495.15 KB


LCS Covid-19 guidance (and Q2 payment update)

PDF, 425.23 KB


Thursday, 21 January 2021

Thursday, 21 January 2021

Review date: Tuesday, 31 August 2021