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British Thoracic Society publishes first quality standards for adult home oxygen

British Thoracic Society publishes first quality standards for adult home oxygen

All patients who are being considered for long-term oxygen treatment (LTOT) at home should have a thorough risk assessment undertaken by trained staff, according to new national standards.

The assessment should include a review of the risk of fire, trips and falls from using oxygen within the home. As part of the process, the smoking status of patients and other household members should be recorded – with safety advice and smoking cessation support supplied as appropriate. 

The British Thoracic Society (BTS) is encouraging widespread use of its new set of Quality Standards for Home Oxygen Use in Adults by NHS commissioners, healthcare practitioners and patients to ensure the best possible clinical care. PCRS-UK has been involved in the development of the Quality standards and believes they should be implemented in order to improve standards. 

Vikki Knowles, Respiratory Nurse Consultant in Guildford and Waverley CCG and Daryl Freeman, GP and Respiratory lead for North Norfolk CCG represented PCRS-UK in developing these quality standards and commend them to you as follows:

‘Oxygen is an important treatment for patients who are hypoxic but hasn't always been used appropriately. These quality standards offer a really useful framework to check that your local oxygen assessment service is providing oxygen to patients at home in a way that maximises safety and the benefits for the patient. Proper initial assessment and ongoing monitoring is really important and these quality standards will help to ensure that the right patients benefit and go on benefitting.’ Vikki Knowles.

‘These quality standards indicate clearly what best practice looks like, and should give you an opportunity to initiate discussions locally about what needs to be in place to provide home oxygen in an efficient and effective way. Misuse of oxygen is not good for patients and poor value for the NHS, and putting these quality standards in place locally will improve this aspect of respiratory care.’ Daryl Freeman.

Recommended actions:

  1. Review patients in your practice/caseload who are currently receiving oxygen to see whether their care conforms to best practice as described in the quality standards. Make appropriate changes to improve their care.
  2. Initiate discussion with your CCG/Healthboard about the processes (e.g. assessment, education, review) which need to be provided at local level, in line with the quality standards.

Some of the key points from the Quality standards are as follows:

  • Patients with advanced stable cardiorespiratory disease who meet the blood oxygen saturation criteria should be referred for an LTOT assessment.
  • All patients being considered for LTOT should undergo serial blood gas assessments, by the home oxygen assessment service.
  • All patients should have home oxygen assessment, carried out by a home oxygen assessment service that includes appropriately trained staff and appropriate equipment.
  • All patients being assessed for home oxygen should undergo a risk assessment that includes risks from smoking, fire, trips and falls.
  • All patients initiated on home oxygen should have appropriate education and written information provided by a specialist home oxygen assessment team.
  • Review, reassessment and withdrawal: all patients started on LTOT should be followed up with blood gas assessment within three months of initiation of therapy. All patients who continue on LTOT should be monitored at least on an annual basis by a home oxygen assessment service. All patients who are identified as no longer requiring any form of home oxygen should have this withdrawn.

The full text is available HERE

Further resources:
PCRS-UK conference session: 11.30 Friday September 29, 2017
‘Experiencing oxygen therapy and non-invasive ventilation’ Facilitator: Chris Loveridge and a patient 

PCRS-UK Wallchart on home oxygen  

Full guideline from BTS on home oxygen

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