Note that the following FAQs are intended as a guide. In many cases the local implementation will vary from this. If in doubt, contact your local GP or NHS pharmacy lead for more details.
Where can I find more information?
A leaflet with basic patient information is available to download Home Oxygen Service Patient Leaflet
To contact Dolby Vivisol about oxygen equipment and supplies, call 0800 833531 or for immediate medical attention, contact NHS 24 on 0845 24 24 24 .
For more information on the national service, contact Health Facilities Scotland on 0131 275 6860.
Information and factsheets about living with your condition and things like holidays are available from:
British Lung Foundation 03000 030 555 www.lunguk.org
Chest Heart & Stroke Scotland 0845 077 6000 www.chss.org.uk
Professionals seeking more information about local arrangements should contact their local NHS lead. This information is available here: 2012-03-12 Home Oxygen Prof Contacts
Home oxygen services are currently delivered from local Community Pharmacies. Now Health Facilities Scotland (HFS), a division of NHS National Services Scotland, are setting up a nationally coordinated service which will offer patients a more efficient service. HFS are working closely with local NHS Boards to implement a smooth transition for patients.
Supporting effective patient services is our highest priority. Moving to an integrated home oxygen service will offer a more efficient service and improved value for money. The handover will allow access to a new generation of lighter portable equipment and more oxygen concentrators.
Each NHS Board is creating its own transition timetable. Before patients can be transferred to the new service, they need to be assessed to find out which equipment, if any, is most appropriate for them. For some patients, assessment will be in person. For others it may be done from patient records without the patient needing to be present. Some patients may not need to continue on oxygen therapy. Assessments will focus on patients with high-use first, and then patients with low-use later. NHS Boards hope to have the new service fully operational by the end of 2012.
In 2010-11, over 7,000 people in Scotland received home oxygen services overall. Of those around 2,000 need to be assessed.
High use patients are those who use 5 or more cylinders per month. Low use patients are those using fewer than 5 cylinders per month. This is regardless of the size or type of cylinder that is used.
There will be a contract between HFS and Dolby Vivisol to provide home oxygen. Patients should not notice any change in the level of service they receive, although home deliveries will be available where previously patients might have had to go to their local pharmacist.
Each Regional NHS Board is responsible for setting local transition timescales. They will identify patients and assess their oxygen requirements. They will communicate with local GPs, Community Pharmacists and other local healthcare providers about the changes.
Local timescales will be created in partnership with each Health Board. These will vary according to the work involved. HFS will remain in close contact with each Health Board. The overall intention is to have the service up and running by March 2013.
Is there any central funding to cover costs incurred as part of the handover, e.g. additional staff time?
Each Board is required to manage the handover within existing resources. In the longer term, the change should be more cost-effective for Boards.
Is it possible to change patients over to Homefill concentrators as soon as possible in order to reduce the need for cylinder supplies?
Yes, Homefill systems are available now, and patients can be transferred now. Patients who receive new Homefill systems are being advised to return portable cylinders to their community pharmacy.
There is mention of Hospital Based Concentrators – are these portable concentrators available within the managed service for temporary loan to patients for home use?
Not necessarily – there will need to be available a mix of regular concentrators and portable concentrators that cover the range of flowrates. Regular concentrators are moveable and can be transported. However, portable concentrators can be more easily lifted and can be supported by a respiratory nurse if required.
There will need to be a local discussion to agree this. HFS can provide advice and support on how these devices can be made available and maintained as part of the national service
Discussions have revolved around patients with a respiratory indication, although there are patients with other indications – such as cardiac, neurology and palliative care services. Will there be a register of oxygen prescribers in these areas developed and shared with NSS?
Yes, Boards will need to draw up their own lists of approved prescribers and will include individuals in the above specialities as well as paediatric, neonatal. These may also include GPs, i.e. where they have hospital at home prevention of admission, or others already involved. The register could also include Respiratory Nurse Specialists or Respiratory Physiotherapists etc.
How can we be sure that Dolby Vivisol will have sufficient contingency arrangements in place to meet challenges such as bad weather, power outages and concentrator breakdowns?
The National Advisory Group for Respiratory Managed Clinical Networks has drawn up prescribing guidance containing a list of revised performance standards which are improved from previous arrangements Dolby Vivisol are working with NHS Boards and HFS to ensure that required standards can be met. The expectation is that Dolby Vivisol will be able to manage most situations but it would be prudent to have robust contingency plans in place for incidents such as prolonged power outages.
No, however we can assist in discussions on the level of planning that would be appropriate and what is realistic. Unfortunately, we do not have resources available to deliver workshops, although this could be reviewed if the situation were to change. Boards will already have developed Business Continuity Plans for other scenarios and this work could build on existing plans.
Your local NHS Board will communicate with you and keep you informed. They will identify who is responsible for making the arrangements for assessing patients. Assessment will typically begin with high-use patients and progress towards low-use patients. Your local NHS Board will need your help in contacting patients and will be in contact with you about this.
Your local NHS Board will be in contact with you to get your assistance in identifying and referring patients.
You should continue to assess and refer new patients. The National Advisory Group for Respiratory Managed Clinical Networks has made available new guidelines for appropriate prescribing
Yes if required. The revised performance standards will enable same-day supply of oxygen if requested during office hours. Out of hours arrangements will also be put in place. Each Board is developing its own plans.
Part of the arrangements negotiated with the central supplier will ensure urgent supply of oxygen within an agreed timeframe. In addition there may be local arrangements including those made with your out-of-hours service, many of which already hold portable concentrators, to address this.
See ‘Community Pharmacists’ section for details of the reconciliation arrangements.
These cylinders are probably rented from your supplier. It is essential that all practices have an oxygen supply for emergencies and continue to maintain their own equipment as provided by your supplier.
You should advise the patient to contact the pharmacy that currently supplies them with oxygen to have all cylinders and equipment collected.
Health Boards will inform you when the transition to the new service is complete. GPs will still be able to prescribe oxygen, however, local pharmacies are unlikely to be able to provide the cylinders. Only prescribers identified by local Health Boards will be able to obtain oxygen from Dolby Vivisol through the HFS service.
As independent contractors, you need to ensure that you have an oxygen supply contract for GP surgeries in place and may wish to contact BOC, Air Liquide or Air Products (other suppliers are also available). Supply of Oxygen cylinders for the BASICS service should continue to be obtained through Scottish Ambulance Service as before.
Until the handover is complete, you should continue to deal with new patients in the same way as you have always done and dispense oxygen as normal. If you have enough stock, it would be possible to dispense the prescription as before. The local relevant speciality (e.g. respiratory team or other) should follow up with the patient.
You should provide the patient or representative with the names and addresses of two alternative contractors who may supply oxygen. Your NHS Board will be setting up longer term arrangements including an out of hours contact. The detail of this is still being agreed.
There are national negotiations ongoing to consider both reconciliation of cylinders and compensation for headsets. Once these national discussions have progressed, local NHS Boards will be in contact with you regarding local arrangements. In the meantime, you are strongly advised to ask your supplier to provide details of what stock they consider you hold. This will help both you and your supplier ensure your records are accurate and all cylinders can be reconciled.
Local arrangements will be made by each NHS Board for their areas. As a general guide, prescribing of oxygen will often be handled by the relevant speciality (e.g. neurology, cardiology etc) following a full respiratory assessment and that supply will be managed centrally, however local arrangements may vary. Community Pharmacists should continue to provide patients with support/advice about their oxygen in the same way as they would provide support/advice about other prescribed drugs.
This process is outlined in a joint letter from Community Pharmacy Scotland (CPS) and British Oxygen Company (BOC) that will be distributed in your area as part of the scheduled changes.
This process is outlined in the joint letter from CPS/BOC. As part of the national agreement, any headsets post-transfer should be destroyed in line with current practice.
Patients should contact their local fire service that they are using oxygen supplies in their home.
Should a patient require replacement oxygen, they should contact Dolby Vivisol, using the phone number provided (0800 833 531). Ongoing usage of oxygen will be monitored by HFS and the patient’s prescriber. If the requirement is outwith the limits of the prescribed oxygen allowance then Dolby Vivisol will contact HFS for advice.
What happens if a pharmacist gets a prescription for oxygen after the Health Board has completed the transition?
Refer the patient on to your local NHS Board key contact, listed on this website, so that the local respiratory team can contact the patient, review their requirements and establish an appropriate oxygen supply.
Patients with cluster headaches must be assessed and diagnosed by a Neurologist.
We want to make sure that every patient is getting the right treatment for their condition. The move to a national supplier provides the opportunity to ensure that each patient is receiving the most appropriate care. It will ensure that future prescribing is safe and effective and support a more appropriate and efficient service. These changes will also enable access to a new generation of lighter portable equipment.
Yes, in most cases. Some patients may be able to move on to lighter equipment, or use an oxygen concentrator instead of cylinders. Some patients may no longer need oxygen, or may be better suited to a different treatment altogether.
A concentrator is a machine which you keep at home that provides you with oxygen, taken from the open air around the machine.
No. If you need to be assessed in person, you will be contacted for this. If you have any questions in the meantime, speak to your local GP.
Assessments are to check to see what kind of treatment patients need. Some patients may be able to move on to lighter equipment, or use an oxygen concentrator instead of cylinders. Some patients may no longer need oxygen, or be better suited to a different treatment altogether.
Everyone will have their need for oxygen therapy reviewed. Some patients will not need any changes to their therapy while others may need special tests to check the oxygen levels. All assessments will include a discussion about the most appropriate treatment for the future.
Assessments will determine how much oxygen you need and how it can best be delivered. Some patients may be able to move on to lighter equipment, or use oxygen concentrators instead of cylinders. Some patients may no longer need oxygen therapy, or may be better suited to a different treatment altogether.
No. Supporting effective patient care is our highest priority. Moving to an integrated home oxygen service will offer value for money, but more importantly a better, safer and more consistent service for patients across the country. The new service will also allow access to a new generation of lighter portable equipment.
We want to ensure that every patient gets the treatment they need, and the assessment will identify what is best for each patient. Using oxygen if not needed can sometimes be harmful. Talk to your GP about your concerns, and they may be able to identify other treatments which will suit you better.
It is unlikely you will need a full assessment but you may still be reviewed at your next clinic appointment to ensure that you are using the most appropriate equipment to get the best from your oxygen therapy.
What if I use my supply more quickly than normal? Will the new service be as quick as my local pharmacy?
Safe effective and timely patient care is the most important consideration. The new service will be required to provide oxygen within an agreed safe timeframe. If you need assistance, contact Dolby Vivisol on 0800 833531.
Patients going on holiday elsewhere in the UK should contact Health Facilities Scotland (HFS) for initial advice at least 4 weeks before their holiday. Please note that it may be necessary to contact the local respiratory team if special arrangements need to be made – HFS will advise if this is the case. Patients travelling abroad will continue to be responsible for organising their own oxygen supply.