New Home Oxygen Service

1
New Home Oxygen Service

• Anne Corkhill
• Prescribing Team
• Western Sussex PCT

2
New HOS

• New contract starts 1st February 2006
• The regional supplier is Allied Respiratory (AR)
• AR will provide a 24hour, 365 day service
• GPs will continue to order home oxygen for
  patients with short-term and emergency oxygen
  needs
• GPs will refer patients requiring long-term
  oxygen and/or ambulatory oxygen for specialist
  assessment

3
New HOS

• A Home Oxygen Order Form (HOOF) will replace
  FP10s
• Clinical staff no longer specify equipment
• Clinical staff need to specify patients
  requirements in terms of flow rate and hours per
  day
• AR will match patients needs with the most
  appropriate equipment (concentrator, cylinder
  etc)
• A Home Oxygen Consent Form (HOCF) must also be
  completed for new patients

4
HOOF

• Will be available from the same source as FP10s
  and on the AR website
• Printed version should be available third week in
  January
• A PDF version is available on the Primary Care
  Contracting website until the printers version is
  available
• Must be completed for all new patients AND all
  existing patients coming forward for requests for
  repeat prescriptions

5
HOOF

• Only one HOOF is required for each request of
  service
• Continuing service requirements will be provided
  against initial order
• Service will continue until AR is instructed to
  stop
• A new HOOF will be required for an additional
  service e.g. holiday
• A new HOOF will be required when there is a
  change in service requirements e.g. following an
  assessment

6
Example HOOF front
7
Example HOOF reverse
8
HOOF

• Must be completed in full omissions are likely
  to result in either delay in supply or a request
  for clarification
• Sections 1-5
• Mostly self explanatory
• Need to indicate whether paediatric order
• Confirm consent has been given and HOCF completed
• Indication of address to be supplied

9
HOOF

• Sections 6-15
• If holiday order, additional details are required
  e.g., duration of supply, address etc
• Equipment sufficient information (flow rate,
  hours of usage etc) should be given to allow AR
  to provide the most appropriate equipment
• Recommendation is NOT to order humidification for
  low oxygen flow rates
• Emergency supply expensive option. State
  duration (max 3 days). However, AR will continue
  to supply until a new HOOF is received or an
  instruction is given to stop

10
HOOF

• Sections 6-15 cont.
• Advice is to write a HOOF for continuing normal
  supply at the same time as the emergency order
  (see reverse of HOOF)
• Complete date of planned assessment etc
• Additional information complete for any
  specific information relating to the supply
• Oxygen conserving device this should only be
  ticked if a conserving device is NOT wanted

11
HOCF

• Will be available from the same source as FP10s
  and AR website
• Should be available third week in January
• A PDF version is available on the Primary Care
  Contracting website until the printers version is
  available
• Must be completed at the same time as the HOOF
• By completing the HOCF, the patient agrees to the
  sharing of personal information

12
Example HOCF front
13
Example HOCF reverse
14
Out-of-Hours

• OOH providers will still, on occasion, need to
  order emergency short-burst oxygen therapy (SBOT)
• All orders placed by OOH are likely to be for a 4
  hour response service
• All such events must be followed up to
• Establish continued need
• See whether referral is indicated
• Ensure a normal continuation supply, where
  appropriate, via a new HOOF as soon as possible

15
Admission to/Discharge from Hospital etc

• If a patient who currently receives oxygen is
  admitted to a community hospital, hospice etc, AR
  should be contacted and informed of this
• If a patient is discharged on oxygen, AR will
  again need to be notified
• If a patient is who has not previously been on
  oxygen is discharged on oxygen a HOOF and HOCF
  will need to be completed
• Long-term oxygen therapy (LTOT) should be avoided
  on hospital discharge

16
Allied Respiratory

• Will provide a 24-hour, 365 day service
• Emergency, short-burst, long-term and ambulatory
  services
• Equipment will be installed as follows
• Emergency 4 hours in the event of an emergency
  (any therapy)
• Urgent 8 hours between the hours of 9am and 5pm
  for short period oxygen therapy
• Normal 3 days between the hours of 9am and 5pm
  for long-term oxygen

17
Allied Respiratory

• Will provide the service and equipment that best
  meets individual patient needs
• Will have a dedicated customer helpline (for
  prescribers and patients)
• Will have trained patient service representatives
• Will manage all installation/de-installation
  activities
• Will provide regular reports concerning service
  use and provision

18
Allied Respiratory

• Has produced a patient information leaflet
  already distributed, via Primary Care Support
  Service (PCSS), to patients currently receiving
  home oxygen
• Has produced a clinician leaflet for distribution
  to GPs December 2005
• Has produced a clinician pack for distribution to
  GPs January 2006
• Prescribers are encouraged to contact AR if they
  require advice on completing the HOOF or if they
  have any service queries

19
Example Patient Information Leaflet
20
Example Patient information Leaflet cont.
21
Referral for Assessment

• Patients should be stable and on optimal therapy
• Pulse oximetry is an essential adjunct aid in
  determining whether to refer
• Patients who are hypoxic, or become hypoxic on
  exercise, should be referred
• Patients requiring oxygen purely for palliation
  of breathlessness (e.g. end stage disease) do NOT
  need formal assessment or referral
• Patients that are not desaturated should NOT be
  referred

22
Assessment

• The PCT is in the process of commissioning
  assessment services
• Patients requiring LTOT should be referred for
  specialist assessment
• Existing LTOT patients will be re-assessed over a
  period of time (may take up to 2 years)
• LTOT patients will receive periodic follow-up
  assessments
• Patients requiring ambulatory oxygen (alone or in
  combination with LTOT) will require ambulatory
  assessment

23
Assessment

• Details of the assessment service will be
  notified to practices once finalised
• Until assessment services are established,
  referral should be made via the normal route
  for respiratory services
• Details of the British Thoracic Society Clinical
  Component for the Home Oxygen Service in England
  and Wales can be found at
• www.brit-thoracic.org.uk/c2/oads/oxygenserviceaug
  05.pdf

24
Transition to the new HOS

• PCSS, on behalf of the PCT, has collected data
  for those patients known to be on oxygen therapy
• These patients have been written to and asked to
  provide consent to pass their details to AR
• New patients started on oxygen (after initial
  data collection and prior to 1st February 2006),
  should be asked to provide written consent to
  pass their details to AR
• Community pharmacies will provide oxygen against
  FP10s written before 1st February 2006

25
Handover Plan
26
Handover Plan

• In this circumstance, AR will create a HOOF
  and arrange for delivery of supplies. The FP10
  will be collected from the patient when supplies
  are delivered and kept by AR with ARs copy of
  the HOOF
• The supplier will check with the patients GP,
  and with his/her approval, arrange an emergency
  supply to the patient (within 4 hours if needed).
  HOOF to follow

27
FAQs

• The Primary Care Contracting website maintains
  lists of FAQs
• General FAQs can be found at www.pcc.nhs.uk/uplo
  ads/HOS/December20Uploads/FAQs.doc
• Patient specific FAQs can be found at
  www.primarycarecontracting.nhs.uk/uploads/HOS/Dece
  mber20Uploads/HOS20PATIENT20FAQs.doc

28
Contact Details

• PCT
• Anne Corkhill
• Tel. [phone]
• Email. Anne.corkhill_at_wsx-pct.nhs.uk
• Allied Respiratory
• Information, advice and emergency orders
• Tel. [phone]
• Completed HOOF
• Fax. [phone]
• Website www.alliedrespiratory.com
• Primary Care Contracting website
• www.primarycarecontracting.nhs.uk/118.php
•