Community Home Oxygen, Assessment and Review Service – Portsmouth City

Referrals can be completed via SystmOne e-referrals (please ensure you task recipient 1 Home Oxygen eReferral). Any referrals that do not have the required clinical information to appropriately triage or meet criteria will be rejected. We do not accept referrals via SPA.

If a patient is already on oxygen you do not need to complete a formal referral but please contact us directly, ideally by telephone, to discuss

Referrals to the Home Oxygen Service can only be made by a registered clinician.

Oxygen is not a treatment for breathlessness in the absence of chronic hypoxia.                                                     

Oxygen should only be considered once patients have a confirmed diagnosis, optimally controlled and clinically stable.

Reference: BTS Guidelines for Home Oxygen Use in Adults (2015)

Long Term Oxygen Therapy (LTOT):

• Indicated for chronic hypoxic patients with a confirmed diagnosis and who are optimally managed.
• Patients with a pulse oximetry of SpO₂ ≤92% on air (or ≤94% with known Polycythaemia, Cor Pulmonale or Pulmonary Hypertension) when stable should be considered for referral for LTOT.
• Minimum of eight weeks post exacerbation (or as long as possible if frequently exacerbates).
• LTOT is to be worn for a minimum of 15 hours a day in order to derive the intended clinical benefit.

Ambulatory Oxygen Therapy (AOT):

• Patients who desaturate by 4% or more to below SpO₂ 90% when mobilising when stable.
• AOT is advised for use on exertion only when mobilising outdoors.

Short Burst Oxygen Therapy (SBOT):

• SBOT is not evidence based in the absence of hypoxia.
• SBOT is recognised as a treatment for Cluster Headaches if provides symptomatic relief.

Palliative Oxygen Therapy (POT):

• POT is not evidenced in absence of hypoxia and alternative treatments, both pharmacological and non-pharmacological, should be considered and suitably trailed before commencing POT.

If a patient is end of life, it may be suitable for a clinician, rather than refer to the HOSAR team, to commence oxygen therapy based on individual assessment considering an improvement to oxygenation, reducing dyspnoea and improving quality of life. We are happy to provide advice regarding the Home Oxygen Order Form (HOOF) completion in these circumstances.

• When assessed or reviewed for a current supply the patients safety, and that of others, will be considered and assessed. If the risk, despite appropriate and feasible steps to mitigate, is deemed to remain high by the Home Oxygen Service oxygen therapy may not be commenced or if required may be removed.
• Serious consideration should be given to current or relapsing smokers regarding commencement or continuation of oxygen therapy. Risk or compliance should be considered and Oxygen may not be commenced or may be removed.

• Serious consideration must be given to those who do not adhere to minimal requirements of use of oxygen therapy to achieve clinical benefit. (as per guidelines) This needs to be considered prior to referral and will also be considered on assessment and review.