Provincial warfarin

It so happened that I needed a warfarin INR test (see reference 1) on or about the first Thursday of our stay here in Brading, something that has happened at least once in the past, although I can find no trace now.

So I telephone the surgery at Brading from Epsom and they invite me to visit them when we arrive to sort something out. So we call in on the Friday afternoon to find that nothing much is doing after lunch on Friday; come back Monday with some forms filled out.

Which we do, and after a friendly exchange, both old style face to face and new style mobile phone, I have an appointment for 0905 on the Thursday.

Turn up on Thursday to be attended to by a friendly nurse from up north, Southport to be precise, a place I used to know as the home of the National Health Service Central Register, then a massive collection of large ledgers, card indexes and such like, and of the Bold Hotel, an establishment which did not serve beer in anything more than half pints for fear of attracting the wrong sort of trade. I learned that the hotel only does the wrong sort of trade these days, more than forty years later.

I also learned that warfarin testing is managed by a central database, perhaps run by the National Warfarin Testing Service, a bit of critical national infrastructure which the Tories forgot to privatise. This meant that the friendly nurse was able to plug into my warfarin record and generally know what was going on without my needing to tell her. She was also able to enter my new result so that the nurse at Epsom could see it. And should adjustment of dose have been necessary, the computer would have given the nurse at Brading the same steer as it would have given the nurse at Epsom. All very clever. Rather more clever than the last occasion - so clearly all that money spent on NHS IT is doing at least some good!

And much more clever than what I had to do in Ottawa, noticed at reference 2.

Reference 1: https://bpac.org.nz/BT/2010/November/inr.aspx. '... International Normalised Ratio (INR) testing is well established as an integral part of warfarin treatment. INR has a critical role in maintaining the warfarin response within a therapeutic range, to provide the benefits of anti-coagulation, while avoiding the risks of haemorrhage ... Therapeutic monitoring of warfarin treatment requires two key elements to be undertaken if it is to be successful: the measurement of the INR and an interpretation of the result in order to advise on dosage of warfarin and when the next test should be performed...'. Plus some nice pictures. New Zealand is clearly on the case.

Reference 2: https://psmv2.blogspot.com/2014/10/warf-warf.html.