1. Home Oxygen Service A/R Rosemary Steel Highly Specialist Respiratory Physiologist Respiratory Centre New Cross Hospital. September 2012 WITH THANKS TO AIR PRODUCTS FOR SPECIFIC SLIDES USED.

2. HOME OXYGEN SERVICE CARE PATHWAY - REFERRAL

4. New Specification Clinician chooses equipment and quantity at install HOOF A (non specialist static supply only) HOOF B (specialist HOS-AR) A new HOOF supersedes an old HOOF Minimum One weeks supply Activity based cost model – Daily equipment rental price (per diem) – Each activity charged (installations/refill visits/services etc) Quantity can be varied later – if patient request is reasonable and in line with HOOF NHS Spine (DBS) access allows Deceased & COA checks. Rental Billing Stops on removal request

5. Part A HOOF Non Specialist Temporary Orders Out of Hours Providers Hospital Discharge [where there is no access to HOS- AR] Completed by health professional

6. The New HOOF Live from 1 st day of New contract HOOF A: Before Assessment- Non Specialist or Temporary Order HOOF A :Available on the NHS PCC website Any HOOF received SUPERCEDES any previous HOOF Revised Consent Form

7. HOOF A  For a temporary order or non specialist, pending assessment, use PART A  Write clearly in bold with black ink  Ensure all sections are completed  Any section marked * is Mandatory  Provide as much information as possible to ensure smooth delivery

8. HOOF A Static oxygen for use in the home. Static concentrator – back up cylinder supplied. Static cylinder – B10 ORDER = L/min and Hours per day. QUANTITY = 1

9. Oxygen Equipment

10. HOOF A order

11. CHARGES Daily (per) equipment charges. ie: possible 2 concentrators.( Risk assessment and H/S issues) B10 – SBOT Ambulatory (where prescribed by HOS A/R)

12. CHARGES Each activity charged. ie: Installation – walk in – plumb in. Re-charge for full installation. Ambulatory cylinders, Refill visits, servicing.

13. CHARGES Delivery charges by Air products Within 3 working days – standard. Next calender day – order sent before 5pm. – standard charge. 4 hour – charged at higher rate.

14. Delivery Options

15. HOOF SUPERSEDENCE

16. HOOF Supersedence HOOF Received New PatientExisting HOOF 2.3 Existing HOOF A Existing HOOF B A * B v2.3 ** ** Process Process as HOOF A, subject to DBRA checks Reject * Unless 4 hr HOOF A - where we will process changes to static order ** If v2.3 received for Paediatric AP will process as HOOF B

17. NEW PATIENT CONSENT FORM

19. Revised consent includes : Exchange of data across NHS team involved in Oxygen Services Exchange of more detailed data with Fire Rescue Service Exchange of data with electricity supplier Agreement to be contacted with patient satisfaction Survey/ Audit Agreement to allow reasonable access to supplier to install service and remove equipment Consent MUST be obtained for all new patients Air Products will obtain updated consent from all existing patients

20. Next Steps – Once HOOF A completed, referral should be made to HOS-AR service by the prescribing clinician, this includes GPOOH UNLESS PATIENT END OF LIFE

21. Palliative Patients Access to same quality assessment. Oxygen prescribed when appropriate and correct flow rate. Type 2 Respiratory Failure – Oxygen Alert cards. Regular assessments to change / increase flow rates – Patients on 15 l/min managing home oxygen.

22. Information Sharing Team W RHW – open invitation to sessions. Community Matrons. Heart Failure Team. Lung Cancer Nurse Specialists. Palliative Care Team. Compton Hospice Consultant and Nurse Specialist

23. No Change Holiday Order or COA