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Last Updated: Friday, 17 February 2006, 18:08 GMT
Patients hit by oxygen shortage
Nasal tubes
Four companies took over the service at the start of February
Patients dependent on oxygen at home face a shortage of supplies after private firms took over the contract.

The four companies only took control of the NHS service this month, but delays in home deliveries have already begun.

A Cumbrian woman died after reportedly waiting hours for oxygen, prompting the NHS trust and firm responsible for the contract to launch inquiries.

Patients in most of England and Wales are being told to use the NHS not the firms if oxygen is needed urgently.

According to reports, Alice Broderick, 63, died last Saturday after oxygen, which had been ordered by an out-of-hours doctor, took more than eight hours to arrive at her home in Carlisle.

Jim Broderick, 61, said his wife was poorly and he does not know if the wait for oxygen contributed to her death.

We apologise to patients for these short-term difficulties
Air Products spokeswoman

But he told The Times: "I feel let down. I can't say for definite if she would have survived if she had got the oxygen sooner, but I'll never know now."

North Cumbria Primary Care Trust said it has not received a complaint from the Broderick family but that it is launching an investigation.

Acting chief executive Patrick McGahon said: "We are aware that there are some transitional difficulties with the new home oxygen service and we have been assured by the supplier, Air Products, that the problems will be ironed out shortly."

About 60,000 people require oxygen at home for pulmonary, heart and cancer problems. Many are elderly patients, but some premature babies are also on oxygen.

Before the new arrangements came in at the start of February, GPs prescribed oxygen for pharmacies to provide cylinders through local gas suppliers.

The contract with the four major suppliers - Air Products, Allied Respiratory, BOC Medical and Linde Gas - was designed to save money and allow patients quicker and easier access to gas supplies.

Urgent

The Department of Health said it was aware of difficulties in the service but that it has been assured patients who urgently need oxygen will get it.

A spokesman said pharmacies would still be able to supply oxygen as part of transitional arrangement which have been put in place.

He said the problem had been caused by the "high number of orders" which had been received.

Patients in Wales and in the south west, south east, north west, Midlands, London, and Yorkshire and Humber areas of England are being asked to use pharmacies if oxygen is needed urgently.

Air Products, which supplies seven of the 11 regions in England and Wales including North Cumbria, said "We apologise to patients for these short-term difficulties."

And the spokeswoman added the company was "very sorry" to hear about Mrs Broderick's death and was launching an investigation to find out what happened.

'Inherent' problems

Allied Respiratory was also experiencing supply problems, according to reports, but the firm was unavailable for comment.

Its helpline advises patients who need oxygen urgently to contact their GP to get oxygen from a pharmacy.

BOC Medical, which has the contract for eastern England, and Linde Gas, the supplier's for the north east, said they were coping with demand.

Liberal Democrat health spokesman Steve Webb said the new system was failing and called for a full investigation into the "shambles".

The National Pharmacy Association, which represents 11,000 community pharmacies, said it had always been concerned about "possible 'worst case scenario' implications".

"This highlights the difficulties and problems inherent in the new system, when patients have to reply solely on one supplier, covering a large geographic area," it said in a statement.


Have you or anyone you know been affected by the issues raised in this story?

My daughter, who is in her 30s, is a mum to two children and lives in West Dorset with her husband and is on 24 hour oxygen therapy with back up for a bipap machine and a nebulizer was told on Saturday morning that she would not be getting her oxygen delivery on the Monday when her current supply runs out. When she told them she would die as a result of this they did not want to know, it was not their problem. I have been in communication with four MPs two of which have replied and promised an investigation.
Mrs Wendy Dibdin MBE, London SE

I am a community pharmacist and have been supplying oxygen to my patients for the last 20 years. Besides the home delivery we build up a social network with housebound patients which has now been dismantled and will be difficult to replicate. We were advised that as of 1 February we would not be paid for any oxygen supplied, and that BOC would charge a rental for all cylinders we held back and would charge an exorbitant price for any not returned. When the new suppliers could not cope we were told to continue supplying to bail them out but without any interim support for pharmacies. I look forward to an enquiry and hope it is a full one which takes into account what community pharmacists have to say about these changes to a system they have maintained flawlessly for over 50 years and is now a complete shambles, putting their patient's lives at risk.
Riaz Esmail, Harrow, Middlesex

As a community pharmacist I would like to take issue with Richard Radford - the six month transition was to enable us to supply oxygen for patients with prescriptions dated before February, not now. However, like most pharmacists we are continuing to supply our existing and new patients to make up for this worrying but predictable situation - if a pharmacy wont supply it is most likely due to them having run down their stock - something we have been told to for some time now.
Phil, Harlow, Essex

In the few days after the change of oxygen suppliers, my staff spent around ten man-hours trying to organise on-going supplies for just two patients. One of them was due to run out that weekend, so I had to authorise an emergency order. According to the form I had to fill in, that oxygen would cost nine times as much as a routine order. As it happened, the delivery was never made, so that saved a little money for the NHS. Fortunately the patient survived. I gather that our suppliers (Air Supplies) received about five times as many requests as they had expected, suggesting that there was a complete failure of the hand-over process. This was undoubtedly someone's fault, but I am quite sure no blame will ever be apportioned. The word "shambles" is far too mild a word for what was a life-threatening mess. Incidentally, retail pharmacists no longer need to stock oxygen (because someone else now "supplies" it), so it can be a very long-winded process finding a local supply.
Dr Harry F Hill, Stockport, Cheshire

My stepfather has delivered oxygen for 9 years for our local chemist. There were no transitional arrangements made in our area - Doctors reverted to issuing prescriptions out of desperation. Oxygen was stored locally and now it has to come from Gravesend. My stepfather's customers have said that the helpline doesn't answer/fails to call back. If you take the cheapest tender and underestimate the job, this is what you get.
Alison Judge, Guildford, UK

I suffer from COPD, and have to use Oxygen at home. I was informed weeks ago that the system was changing, but the changeover has been a fiasco. Last week (7th) I had run out of Oxygen and could not get any anywhere, even though I had a prescription. I kept trying to get through to Air Products, who insisted they did not have my details, even though my GP had sent them. My argument at that time was that regardless of whether they had my details or not, I needed Oxygen. I would not be contacting them for the pure fun of it. None of the Pharmacies I spoke to could help, and I was told that they would not be carrying oxygen any longer. In the end I had to contact NHS Direct, who arranged for an on-call Doctor to visit. He then advised me that he could fax a request to Air Products for an emergency fix, which they had to respond to within 4 hours. They did turn up, with a machine that extracts the oxygen out of the Air, so no more Bottles. This could so easily have turned into to an emergency situation, and I was getting increasingly anxious, which only made my situation worse.
Leslie Fraser, Enfield

As the Managing Director of a supplier to all of the 4 new supply companies concerned, I am in a position to understand a little of what is happening under the new arrangements. Whilst clearly there are problems with the new system, the medium term impact of the new oxygen service will be to deliver a significantly better and safer service to a wider group of patients at a considerably lower cost to the taxpayer. What a shame the BBC didn't do its homework before publishing this article.

Why did the journalist not ask why a patient needing oxygen that urgently wasn't admitted to hospital? Why have pharmacists ignored the 6 month transition period and refused to deliver oxygen from day one? How can the journalist possibly justify describing the new arrangements as "private firms took over"? Home Oxygen has always been delivered by private companies: oxygen concentrators by companies like BOC and Air Products, cylinders by independent pharmacies.

The major hold up is the lack of clarity on the initial prescribing and I know for a fact that there are people in these organisations (and companies like ours supporting them) working incredible hours to make this system work. Isn't it time you supported their efforts to improve the lives of so many? Feed us the journalist concerned!
Richard Radford, Mansfield, Notts

We had to put my step father into a hospice because there was a shortage of oxygen for home use in this area. He later died (he had lung cancer) in that hospice, his last wishes had been to pass away at his home. We were all so regretful that we couldn't carry out his last wishes.
Cherry, Doncaster UK

My mother has oxygen 16 hours a day, and needs small bottles (which she carries in a backpack) to allow her to go out, drive her car, shop and so on. She needed new bottles on 1st Feb, which when she found out that her doctor and pharmacist were no longer responsible, and the new supplier, Air Product's telephone number was simply not answered (the doctor, the chemist and three of her children all trying to get through). She was facing being confined to her home for as many days as it took to get in touch with Air Products. Fortunately her doctor did a postdated prescription (bit naughty) and the chemist tracked down the last bottles available in the area, and the delivery man who had just been sacked as a result of the change - made the delivery. The letter informing my mother of the change in arrangements arrived on 3rd Feb, so she did not receive notice of the change until after it had happened - and by the way - we have still to get through to Air Products by phone.
Glenys, Bradford, Yorkshire

The change in supply is only part of the problem. My mother has just died. She had started having serious breathing difficulties at home. But we could not even get oxygen at home prescribed through her GP. The GP said the specialist at the hospital (10 miles away) would have to prescribe it. But my mother was too ill to attend the hospital. So, Catch 22. I don't blame the GP - but the system of prescribing oxygen is at fault.
Peter Barnes, Bridgwater, UK

My father-in-law has chronic emphysema and had oxygen ordered by his GP at the beginning of the month. He is still to receive the delivery. He ran out of oxygen over the weekend and I had to use a repeat order (not prescription) at a Sunday pharmacy, which they kindly accepted, although did not have to, as they now have to request the prescription from the GP, who could refuse. If this incident related to a person without relatives, they would have had to attend A&E. For this to occur is not just the supplier's fault, but also the DOH, as they have a duty of care to patients to transfer this service to a competent company, which has not occurred.
Alan Hickox, Tamworth, Staffordshire




VIDEO AND AUDIO NEWS
Hear the problems one man faced over his oxygen supply



SEE ALSO
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01 Feb 06 |  North West Wales

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