Ignoring the fact that NICE doesn’t licence, (it only provides guidance and makes recommendations) they have not yet released their guidelines on dabigatran AFAIK, although the release is imminent.

The answer to your question, according to the experts at many meetings this year, is ‘No, there is no need to change’. A stable patient, well controlled on warfarin, with no other factors of concern, could and should be allowed to continue the status quo. The key parameter is ‘time in therapeutic range’ – those patients with a TTR of less than 60% should probably be offered the change, as and when it becomes available. It’s also worth noting that a patient on warfarin with a TTR of <40% is at greater risk of a thrombotic stroke than if they weren’t on any  anticoagulation at all.