When should I refer a patient with suspected inherited bleeding disorders to a specialist haematology service?

Refer a patient with suspected inherited bleeding disorders to a specialist haematology service when:

• There is unexplained bleeding or bruising suggestive of a bleeding disorder that requires specialist diagnostic evaluation.
• Women with known or suspected bleeding disorders require multidisciplinary care planning, especially in pregnancy and childbirth, involving a haematologist to manage bleeding risks and tailor intrapartum and postpartum care.
• There is a need for specialised diagnostic pathways and integrated reporting to confirm the diagnosis and subtype of the bleeding disorder, which can only be provided by a specialist haematology service.

Early referral is important to ensure appropriate diagnosis, management, and multidisciplinary planning, particularly in complex cases such as pregnancy or when invasive procedures are considered.

Specialist haematology services should have defined organisational structures, quality management, and protocols to provide accurate diagnosis and integrated reports for disease management.

In children and young people, unexplained bleeding or bruising should prompt urgent specialist assessment or investigation to exclude serious haematological conditions.

Therefore, any suspicion of inherited bleeding disorders based on clinical history, bleeding symptoms, or abnormal blood counts should prompt referral to specialist haematology for comprehensive assessment and management.

References: ¹,²,³