Pilot scheme helps NHS Hull save over £35,000 and improve patient care

NHS Hull has revolutionised the way patients receive oxygen therapy and saved £35,000, by rolling out a highly successful home oxygen assessment pilot.

The pilot, carried out over a one month period, aimed to rationalise oxygen prescribing by reviewing oxygen assessments at home. The PCT introduced an i-STAT® portable analyser for home based blood gas assessments, monitoring and treating patients at the point of care. A total of 50 patients* were referred over the pilot period, with 41 patients actually assessed.

After running the service for just three months the PCT saved £35,000 in equipment hire alone, by taking patients off oxygen who no longer required it.  In England and Wales, up until the first of February 2006, home oxygen could only be prescribed by primary care physicians. Unfortunately a number of patients were prescribed oxygen for relief of symptoms of breathlessness without ever having had a formal oxygen assessment, which is a costly provision.

The pilot revealed that of the 41 patients assessed by experienced respiratory specialist nurses, 90 per cent of these required treatment - either alterations to existing oxygen flow rates, initiating LTOT (Long Term Oxygen Therapy), ambulatory oxygen or complete removal of inappropriately prescribed oxygen therapy.

Julie Danby, Respiratory Nurse Specialist NHS Hull, said: “Through our very successful pilot we demonstrated that performing assessments and monitoring patients on existing oxygen delivery systems was effective and cost saving. A device such as the i-STAT® means a patient’s status can be monitored without sending them into hospital for sometimes lengthy, painful arterial blood gas tests. This can also risk potential ward based infections and prove costly in terms of transport, clinic and hospital bed costs.”

Continuing she said: “For the vast majority of PCT’s reducing hospital admissions it is not just about reducing costs. It’s about providing better patient care, reducing anxiety for patients with chronic conditions and making the lives of sufferers and those around them more manageable. Our home oxygen pilot has done just this. It has provided a structured, efficient, quality and cost effective service, which has revolutionised the way patients receive oxygen at home. The i-STAT® device has contributed to support this service with a total cost of £4.50 per patient for the consumables to assess the patient at home, compared to the higher financial impact of ward or hospital clinic based assessments, which include transport and bed costs.”

The handheld i-STAT®, from Axis-Shield UK, enables respiratory nurses to monitor the status of respiratory patients within minutes when conducting home visits, by measuring their blood gases. This means informed decisions on accurate oxygen prescribing, and helps prevent hospital admissions for further assessment. It also means less anxiety and inconvenience for patients who can find out their results on the spot.

The long term conditions team (LTCT) and the community physiotherapist were informed an i-STAT® machine would be available for use in the pilot on a months trial from 30.03.09 to 24.04.09. A referral form was given to the LTCT and patients who were identified as hypoxic (oxygen saturations <92%), had suspected hypercapnia, or were already on oxygen and needed a blood gas check, were referred.

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* It should be noted that the number of referrals were limited due to the number of cartridges, short term loan of the gas analyser and other work commitments.

About Axis-Shield:

Axis-Shield UK is part of the Axis-Shield Group which develops, manufactures and distributes high quality, in-vitro diagnostic testing technologies that help improve healthcare and patient management. The company has a range of proprietary technologies and runs an active programme of development for new products that can be utilised across clinical laboratories, in hospitals or by Primary Care Trusts (PCT). The organisation manufactures key devices including Afinion^™ and Thrombotrack^™ and works with medical company Abbott to distribute i-STAT^® - a unique handheld analyser.

At the point-of-care (in hospitals or in the community), Axis-Shield’s novel, branded products can be used for the early, rapid and differential diagnosis and treatment of patients while they are present – ultimately speeding treatment times and helping to improve lives.

In the laboratory sector, Axis-Shield specialises in proprietary markers for the diagnosis and management of critical illnesses such as cardiovascular and neurodegenerative diseases and rheumatoid arthritis.