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Yet the Government’s decision to contract out the service in an attempt to improve quality and save money has brought unforeseen chaos to the system that may last several months.
Poor communication between health trusts and family doctors, underestimates of user numbers and misunderstandings by GPs and patients have been blamed for failures that have been implicated in deaths and risked the lives of thousands of other patients.
The changes, designed to offer patients requiring oxygen for breathing difficulties a more efficient and cheaper service, were announced by the Government in July last year.
Announcing the multimillion-pound contract with Air Products, Allied Oxycare/Medigas, BOC and Linde Gas, Jane Kennedy, the Public Health Minister, claimed that it would pull together a fragmented service. The reform was intended to allow patients more mobility with lighter NHS-subsidised equipment, keeping them close to home and out of hospital — in line with government efforts to steer patients away from secondary care.
Previously, GPs prescribed oxygen for pharmacies to provide cylinders through a local gas supplier, in a contract worth £18 million. The new arrangements are meant to allow GPs to send oxygen requests for patients directly to suppliers.
Many of the patients receiving the service suffer from chronic cbstructive pulmonary disease (COPD), which accounts for more than 10 per cent of all acute hospital admissions each year, costing the NHS about £600 million. The new contracts would also make substantial savings, the Government suggested.
The four companies, which have long track records of gas supply, were chosen after competitive tendering, which was promoted as the answer to providing a modernised service across the country. Yet it emerged last night that the NHS estimate of 60,000 people requiring the service may have been much lower than the reality. There is no official figure for the total.
Within days of the new system starting on February 1, thousands of calls were made to Air Products and Allied Oxycare, the two largest providers. Allied, which was expecting to serve 5,000 customers, received more than 20,000 calls in three days, while Air Products also received requests from most of its 49,000 expected clients. Patients who receive home oxygen therapy include those with lung disease (such as COPD and lung cancer), heart disease and cystic fibrosis. Doctors confused by the system also called in large numbers.
A spokesman for Air Products, which supplies Wales and much of England, said that it had been inundated with requests from GPs. Demand was such that many have been unable to reach the companies.
Dame Helena Shovelton, of the British Lung Foundation, said that the system would bring great advantages to patients, but was suffering teething problems. She suggested that some of these related to too many requests for oxygen being processed as urgent.
The NHS’s Home Oxygen Therapy Service said that patients could always use pharmacies to get their oxygen. It said that all channels of communication were being looked at. An inquiry is expected to begin next week.
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