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Research to Support the Evaluation of Scotland's Domiciliary Oxygen Therapy Service

DescriptionIn Scotland over 7,000 patients use oxygen at home through the domiciliary oxygen therapy (DOTS) service. This research aimed to evaluate current arrangements for the delivery of DOTS. It explored ways to improve current service provision taking account of the particular needs of patients, carers and clinicians, while ensuring supplies are maintained.
ISBN978 07559 77406
Official Print Publication DateMay 2010
Website Publication DateMay 19, 2010

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Dr Angus Ferguson, Roderick Ferguson, Dr Andrew Walker and Dr Allison Worth, Fortuno Consulting Limited
ISBN 978 0 7559 7740 6 (Web only publication)
This document is also available in pdf format (588k)
This Report is accompanied by a Research Findings

CONTENTS

ACKNOWLEDGEMENTS

GLOSSARY

EXECUTIVE SUMMARY
Background
Aims
Methods
Findings
Context
Costs
Patient views
Stakeholder views
Options for the future
Conclusion

1 INTRODUCTION
Background
The Study
Structure of the report

2 METHODOLOGY
Literature review methodology
Methodology for researching service user views
E-Delphi methodology used to gather stakeholder views
Methodology and assumptions for developing and costing future options
Ethical considerations
Summary

3 LITERATURE REVIEW
Introduction
Types of domiciliary oxygen therapy
Long-term Oxygen Therapy
Short-burst oxygen therapy
Portable and ambulatory oxygen therapy
Equipment
Equipment for providing oxygen to patients
Recent innovations
UK Models of Domiciliary oxygen therapy
Scotland
England and Wales
Northern Ireland
International examples
Australia and New Zealand
Canada
Denmark
Poland
Assessment and Support
Lessons learned from recent changes to DOTS in England and Wales
User views research
DOTS for children and infants
Summary

4 COSTS
Introduction
Current Costs
National contract costs
Community pharmacy costs
Potential areas for cost savings
Summary

5 PATIENT VIEWS
Introduction
Participant characteristics
Patients' experiences of DOTS
Patients' views on DOTS equipment
Cylinders
Concentrators
Portable and ambulatory oxygen
Masks, nasal cannulae and tubing
Assessment, monitoring and support
Summary

6 STAKEHOLDER VIEWS ON DOMICILIARY OXYGEN SERVICES
Introduction
Meeting patients' needs
Assessment, prescribing and monitoring
Assessment
Prescribing
Monitoring
Oxygen supply
Equipment
Safety
Summary

7 FUTURE OPTIONS FOR DELIVERING DOTS IN SCOTLAND
Introduction
Option 1: Maintain the status quo
Option 2: Separate the supply and support functions and make these more specialised
Support function
Supply function
Option 3: Introduce a national contract to improve the supply of cylinders
Introduce a national contract to deliver the cylinder service
Introduce a national contract including conservers
Option 4: Improve the supply of portable oxygen
Transfer concentrator patients who also use portable cylinders onto HomeFill
Increase the use of liquid oxygen for patients using portable oxygen
Option 5: Reduce costs by lowering the threshold for using concentrators
Reduce the threshold for using concentrators to four hours oxygen use per day
Reduce the threshold to 4 hours and increase the use of HomeFill
Remove any threshold and supply all patients with concentrators or HomeFill
Summary

8 CONCLUSION

REFERENCES

ANNEX 1: PATIENT INTERVIEW GUIDE
ANNEX 2: EUROPEAN QUALITY OF LIFE - 5D RESULTS
ANNEX 3: ONLINE SURVEY QUESTIONS
ANNEX 4: STAKEHOLDER SURVEY RESULTS
ANNEX 5: EXAMPLES OF DIFFERENT SERVICE MODELS
ANNEX 6: ANNUAL COSTS FOR SERVICES PROVIDED BY DOLBY
ANNEX 7: EXAMPLES OF POSSIBLE COST SAVINGS

The views expressed in this report are those of the researcher and
do not necessarily represent those of the Department or Scottish Ministers.

This report is available on the Scottish Government Social Research website only
www.scotland.gov.uk/socialresearch.