J Haem Pract 2014; 1(2):J Haem Pract 2014; 1(2): 24-29. doi: 10.17225/jhp00021

Authors: Christine Harrington, Charles RM Hay, Vicky Vidler, Rashesh Dattani, Katherine Heygate

Christine Harrington
Nurse Consultant (Haemophilia)
Katharine Dormandy Haemophilia Centre and Thrombosis Unit, Royal Free Hospital, London NW3 2QG, UK.

Professor Charles RM Hay
Professor of Haemostasis and Thrombosis, Consultant Haematologist and Director
Manchester Haemophilia Comprehensive Care Centre, Manchester Royal Infirmary, Oxford Road, Manchester M13 9WL, UK.

Vicky Vidler
Nurse Consultant (Paediatric Haematology)
Sheffield Children's Foundation NHS Trust, Western Bank, Sheffield S10 2TH, UK.

Rashesh Dattani
Clinical Nurse Specialist/Centre Manager
Haemostasis and Thrombosis Centre, Leicester Royal Infirmary, Infirmary Square, Leicester LE1 5WW, UK.

Katherine Heygate
Senior Medical Adviser
Novo Nordisk UK, City Place, Beehive Ring Rd, Crawley, Gatwick, West Sussex RH6 0PA, UK.


Clotting factor concentrates used in the treatment of haemophilia are now procured centrally in the UK by nationally organised competitive tendering to obtain the best product price while still preserving some degree of prescribing freedom. Inevitably, however, some patients are required to switch from one brand of factor VIII to another to fulfil contractual requirements. This process of switching patients from one product to another falls to staff at individual haemophilia centres, with haemophilia nurses in particular playing a key role. This article outlines the national procurement process and discusses how the switch can be managed quickly and smoothly, as well as providing practical guidance on selecting which patients may be asked to switch. Issues such as patient communication, managing potential patient anxiety and efficient stock management are also discussed.


This paper is based on a roundtable discussion meeting funded by Novo Nordisk. The authors wish to thank: Jemma Efford, Clinical Nurse Specialist, Great Ormond Street Hospital, London; Emma Franklin, Haemophilia Clinical Nurse Specialist, Bristol Haemophilia Comprehensive Care Centre; Lisa Grainger, Advanced Nurse Practitioner, Oxford Haemophilia & Thrombosis Centre, Churchill Hospital, Oxford; Kingsley Lawrence, Specialist Haemophilia Nurse, Cambridge Haemophilia Centre, Addenbrooke's Hospital, Cambridge; Barbara Subel, Clinical Nurse Specialist, Haemophilia, Katharine Dormandy Haemophilia Centre & Thrombosis Unit, Royal Free Hospital, London; Julie Vowles, Nurse Specialist, Haemophilia Centre, Royal Victoria Infirmary, Newcastle Upon Tyne.
Editorial support for production of this paper was provided by Jane Smalls, Meritus Communications, Kent and funded by Novo Nordisk.


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