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How will the new Home Oxygen Therapy Service work?
In June 2004 the Department of Health announced plans to modernise the domiciliary oxygen service in England and Wales.
The new service means that clinicians and patients will only have one supplier for all their oxygen needs – Vitalair, part of BOC Medical, will take full responsibility for patients’ oxygen supplies and will also provide and maintain all oxygen equipment. We will ensure that you and patients have round-the-clock access to expert advice and support in making the best use of the latest oxygen equipment.
How much does the service cost?
If clinicians wish to discuss pricing levels they should approach their local PCT.
What is Vitalair?
Vitalair is part of BOC Medical; a leading global supplier of medical. BOC used to be called “British Oxygen” and has been supplying medical oxygen in the UK for over 100 years. Vitalair is the brand name under which we will provide our home oxygen therapy service.
When will the new service begin?
The new service started on February 1st 2006. There will be a transition period of 6 months. By the 1st August 2006 all patients will have tansfered onto the new arrangements.
Which areas will Vitalair cover?
Vitalair is contracted to provide this service across the following regions:
How will the new service work?
If your patients currently use a concentrator, then you will not need raise a new oxygen order form, as we already have your patient’s details. We will visit your patient in the near future to either service the existing concentrator or replace it with a new one.
If your patient currently uses cylinders then the GP or hospital doctor will need to order oxygen from Vitalair, using a Home Oxygen Order Form. When Vitalair has received the order form we will advise you and the patient of the planned date of installation and deliver the oxygen equipment directly to your patient’s home. This may take a few weeks fduring which you should continue to get cylinders from your local pharmacist as normal. Clinicians should continue to write repeat FP10 prescriptions until the patient has been supplied by Vitalair. At this point the patient will no longer need to present. You will not need to write repeat order forms each time your patient needs a new cylinder. Vitalair will continue to deliver your patient’s oxygen requirements until we are notified otherwise.
Will pharmacies still be able to deliver oxygen?
Yes, the old FP10 system continues in force during this transition period. During this transition period it will still be possible for cylinders to be delivered from the local pharmacy. When the new service has bedded in, pharmacists will cease to supply oxygen.
It is still important that you ask your patients to return their empty cylinders back to the pharmacist who originally delivered them.
Who is authorised to sign the Home Oxygen Order Form?
Oxygen can be ordered by a registered healthcare professional, not just qualified prescribers.
Will GPs be required to fill out the Home Oxygen Order Form?
Yes, although GPs will mainly place oxygen orders for SBOT and emergency supplies. NHS has issued guidelines to all GPs to assist them with the completion of the new forms.
Please visit the ‘Place an Order’ page of this website for more information.
Where can I get copies of the Home Oxygen Order Form and the Home Oxygen Consent Form?
Forms will be supplied through the same sourcing as FP10s.
You can download both forms from the primary care contracting website:
Primary Care Contracting Website - HOOF
Primary Care Contracting - HOCF
You can also download copies of these from the ‘Place an Order’ section of this website.
When should I complete a HOCF form?
The HOCF should be completed at the same time as the HOOF and is used to obtain consent for the release of personally identifiable information to BOC. A copy should be retained in the patient’s records.
If a patient is not under secondary care, does the GP need to complete details of a hospital contact too?
If the patient does not need to be referred to secondary care, there is no need to input the hospital contact details. If the patient has been seen under secondary care, then details need to be added.
Section 4 of the HOOF asks for telephone, fax and email details. Is this for the PCT, hospital or GP?
Section 4 requires the contact details of the hospital. The GP should put their details in section 5.
Section 5 on the HOOF requires GP practice details and PCT name. Many secondary care clinicians will not have this information available at the time of completing the form. Is this mandatory?
Yes. Secondary care will have a referral form from GP or have access to GP name via their PAS system.
In Section 7 and 9, is there a default position for the supply of masks or cannulae?
There is no default. We cannot and will not make clinical decisions in the absence of full information. We cannot proceed with the delivery unless we are told whether a patient requires a mask or a cannula.
In section 8, please could you clarify the “initial 2 months supply option?”
The initial two months supply box is to highlight the need for an assessment and alerts the supplier to the fact that it may be inappropriate in the first two months to install a concentrator.
Section 10 requests the clinician to state the duration of emergency order up to a maximum of 3 days. Will the order only last for 3 days?
No.We will continue to supply until we receive a new HOOF. The 3 day supply box is to highlight the need for an assessment or review after 3 days.
How quickly can Vitalair install a concentrator?
Our standard response time is 3 days.
How quickly can Vitalair deliver oxygen cylinders?
Our standard response time is 3 days. Vitalair has introduced the latest scheduling software which will predict patients’ usage patterns. We will therefore be able to deliver oxygen to patients in a regular, set pattern such as every Wednesday or every Friday. Until we have built up patient’s usage patterns, we are asking patients to check how much gas they are using and to contact us to order a replenishment cylinder well in advance.
If patients find that they need oxygen urgently (ie an emergency) then we can respond within 4 hours.
When should I correctly use the emergency category?
The emergency category should only be used for patients who need an urgent supply of oxygen. On the reverse side of the HOOF, advisory notes clearly state a 4 hour response order should only be requested if a patient has no oxygen supply at home. It should not be used to help discharge patients from hospital.
Can any of the services be ordered on an emergency basis? (The notes under
Sections 10 & 11 seem to suggest that ambulatory could not be ordered in these Circumstances)
Yes, all services can be ordered under an emergency. The emergency category will last for a minimum of 3 days and will continue until we are notified otherwise.
If a hospital requests a next day delivery for a patient, would a GP need to follow this up after 3 days with an ongoing HOOF?
Our standard response times are 3 working days for a delivery/installation. If the hospital wishes for the patient to receive oxygen by the next day, then the hospital (not the GP) will need to follow this up after 4-5 weeks to re-assess.
We are asking hospitals to plan their discharges! The spirit of the contract is based around a service level agreement of 3 days –if all respiratory departments and/or all GPs request oxygen on a next day basis, then this may cause delivery issues.
We can respond next day, if required, but it is anticipated that this request is the exception rather than the rule.
A PIN field has been included at the bottom of the HOOF. Does this field refer to a prescribing identidier? Is it mandatory?
Yes. The PIN field should be the registration number of the orderer (GP number, UKCC number etc. It is a mandatory field, necessary for audit purposes.
What if the patient is using more oxygen than their ‘prescribed’ amount?
Vitalair will contact the ‘clinical contact for enquiries’ detailed in section 3. If this contact is the GP, then the GP should consider referring the patient to secondary care for an LTOT assessment or ambulatory re-assessment.
Are we correct in thinking that each PCT needs to appoint a person who will be the named contact for receiving copies of all HOOFs?
Trusts have been advised that the new service gives an opportunity to get an overview for the first time of who is ordering oxygen, and this is why the clinical advisory group asked that a clinical lead for Oxygen should receive a copy of all orders primarily for research purposes. The BTS has a list of clinical oxygen leads in all Trusts.
Will I need to complete a new HOOF every time my patient needs a new cylinder?
No. Only one HOOF is required for each request for a new service. Continuing service requirements (eg cylinder replenishments) will be provided against the initial order. The Service will continue until no longer required or until we are instructed to stop.
What if my patient wants to go on holiday?
If your patient wishes to travel anywhere within England & Wales, Vitalair will require a new HOOF. We will fax this form to the relevant contractor who will supply similar equipment to the patient’s usual modality. The cost of this service will be funded by the NHS. If your patient wishes to travel abroad, then your patient will have to pay for their oxygen. Our customer advisors have a wealth of experience and can assist patients with their travel arrangements. There is also a plethora of information available on the Holiday and Travel Section on this website.
What if my patient wants to go on holiday in Scotland?
If the patient wishes to travel to Scotland or Northern Ireland, then the patient will require a FP10 form to obtain oxygen. This is because the new home oxygen arrangements only affect England and Wales. Patients can travel with their concentrator (secured upright), but cylinders of oxygen will continue to be supplied through the pharmacy channel in Scotland. For more information on holidays, visit the ‘Holiday & Travel’ section of this site.
What if my patient wants requires oxygen at school or at a hospice
If oxygen is required at another address, the GP or hospital doctor will need to fill out a second HOOF, providing details of the location, flow-rates and duration. The orderer should mark on the HOOF (we suggest box 13) “SECOND ADDRESS”. BOC will continue to supply (an hence bill against this HOOF) until notified otherwise. If the hospice wants to consider arranging strategic stocks (if they have storage facilities) then BOC can also arrange this. If the hospice or school falls into another area which is not contracted to BOC then will send a copy of the form to the contractor who covers this area.
What if my patients’ needs change –Will a new HOOF need to incorporate both the old and new requirements?
If your patient has up until now been managed in primary care, then you will need to refer your patient to secondary care to carry out an LTOT or ambulatory assessment. This team will arrange for a new home oxygen order form to be sent to Vitalair. This will cancel out the previous HOOF. There is no need to write the old requirements as this will be confusing. It is good practice to write in box 13 ‘Change to patient’s original requirements’.When we have received the new order form we will advise the orderer and the patient of the planned date of installation of your new oxygen equipment.
What should we advise our patients to do with their old cylinders which were delivered by the pharmacist?
We are asking patients to return their empty cylinders to the pharmacy which supplied them or to contact the pharmacy directly, who should collect them from the patients’ home. Cylinders supplied by pharmacies MUST find their way back to the original pharmacy that supplied them in order to reconcile their cylinder holdings with their supplier. This will enable pharmacies to settle their accounts.
What is equipment is available for low flows?
We can provide two different types of low flow meter (0.1 to 1 l/min and 0.02 – 0.2 l/min) which can easily be attached to our standard portable and high capacity cylinders as well as our concentrators. Simply complete the HOOF, detailing the patient’s flow rates and we will deliver the necessary equipment.
Do you provide humidification?
Due to the lack of research in this area, Vitalair will not provide humidification for patients who are on flow rates of lower than 4 l/min. If you feel that your patients strongly benefits from humidification, please contact our customer advisors on 0800 136 603 to discuss.
How light is the lightweight cylinder?
The lightweight cylinder weighs just 2.7kg when full. We also provide a carry bag free of charge to help patients go out more easily.
Will you provide equipment for assessment?
Each respiratory department will receive 4 portable cylinders, a conserving device and a concentrator with which to carry out assessments. Please contact our respiratory advisor, Tracey Milligan for more information.
Can you define a typical liquid patient?
Liquid oxygen is suitable for a wide variety of patients. Patients who are most comfortable with this modality typically lead a more active lifestyle and/or require very high flow rates.
What risk assessments are carried out prior to installing liquid oxygen?
Prior to installing liquid oxygen in the home, one of our patient service representatives will ensure that there are easily accessible, well ventilated storage facilities. Patients should be able to understand the risks associated with liquid oxygen and be comfortable with the necessary filling procedures. We have a duty of care to our employees and will not deliver liquid oxygen systems to patients who continue to smoke in the close vicinity of oxygen.
Will you be able to provide reports on our patients?
Yes. In the future, as the technology becomes available we hope to provide a wide variety of reporting on patient usage and compliance. This will become available in the password protected area of the site, under ‘Reporting’.
Until this becomes available, please contact our customer service advisors on 0800 136 603, who should be able to provide hard copy reports.
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