Covid-19 - Covid Oximetry @ Home and Covid Virtual Wards (CVW)
Why do we need this service?
A hallmark of COVID illness was the late and sometimes unsalvageable presentation of patients to hospitals, often with very low oxygen sats without accompanying severe symptoms of breathlessness. This was termed ‘silent hypoxia’, and this can only be picked up if oxygen saturation levels are checked. We can do this very easily through pulse oximeters that are readily available. Early assessment of patient oxygen levels ensures that deteriorating patients are detected early and admitted urgently for life saving treatments.
NHSE have published a SOP for COVID Oximetry @ home and this model should now be implemented by all CCGs across England.
This is a pathway that should be available to people who are:
i. Diagnosed with COVID-19: either clinically or positive test result AND
ii. Symptomatic AND EITHER
iii. Aged 65 years or older OR
iv. Under 65 years and clinically extremely vulnerable (CEV) to COVID. (The CEV to COVID list should be used as the primary guide. Clinical judgement can apply and take into account multiple additional COVID risk factors; for the most part, it is anticipated that this will already have led to inclusion on the CEV list. National criteria for inclusion on the CEV list are set and updated by the Government.)
The national support offer, including oximeter supply, is targeted at this defined cohort.
Patients who meet the criteria for the COVID Oximetry @home pathway will be supported by a range of Registered Professionals and others to self-monitor their oxygen saturation levels, report symptoms and themselves act upon deterioration using either a recognised App or paper-based system.
There is also a very helpful video on YouTube, produced by the NHS, that explains for patients how pulse oximetry works.
|The NHS Futures Platform hosts a wealth of documents,resources and contact details to support the Covid Oximetry @ Home programme.|
Dr Matt Inada-Kim, (National Clinical Director- Infection, Antimicrobial Resistance & Deterioration) gave a presentation on the PC Webinar of 14th January 2021 for Covid Oximetry @ Home.
His slides from this webinar are informative and infographical and can be downloaded here. The slides also feature the Covid Virtual Ward set up and also a follow on presentation on Post Covid (Long Covid) Syndrome by Dr Kiren Collison, Interim Deputy Medical Director for Primary Care.
Safety Netting Leaflets and Patient Diaries
NHS England and NHS Improvement’s national Patient Safety Improvement Programme have published a safety netting leaflet designed for patients with coronavirus who have not been admitted to hospital and will be isolating at home. This leaflet contains key information about when and where to seek medical advice, including information on blood oxygen levels and pulse oximeters.
There is also an easy read version of the patient diary, "Using a pulse oximeter to check you are OK". This has been codesigned and created with people with a learning disability. The latest published diary and alternative translated versions are available via this NHSE landing page.
NHS Digital support
NHS Digital is supporting the data and digital architecture for the Oximetry @home programme. New SNOMED codes have been created which can already be used by colleagues using TPP SystmOne and colleagues are continuing to work with other GP IT system providers to set these up on their systems.
NHS Digital is also now sending providers daily lists of coronavirus patients in their areas who have tested positive, highlighting those who meet the recommended eligibility criteria for onboarding onto Oximetry @home. If you are not yet receiving these and want to, please email email@example.com
Covid Virtual Wards (CVW)
This is separate but complementary to COVID Oximetry @home (CO@h). Key differences between these pathways are set out in the table below.
An SOP for this service sets out the details in full.
Key concepts of The COVID Virtual Ward (CVW)
- Normally operated by secondary care
- Led by a named consultant or ST3+ doctor with relevant COVID experience (usually an acute or respiratory physician) some are nurse led
- Both competent registered and non-registered staff will be involved in the monitoring process
- The methods of monitoring and recording will vary across the regions
There is still some national work yet to be agreed and finalised on this piece of work, completion is expected at the beginning of February 2021.
For more information and to access a webinar recording about COVID virtual wards, visit the NHS @home on FutureNHS platform. Any questions and requests for additional oximeters from CCGs or acute trusts can be sent to: firstname.lastname@example.org.