Oxygen supply problems ‘the new PPE’, warn hospital bosses

Senior managers across England warned supplies were running low and the number of engineers available was not sufficient to expand capacity.

While there is thought to be sufficient total medical oxygen in the UK, the concerns are about the regularity of deliveries which are needed to specific hospitals; and about the engineering expertise needed to ensure it is used safely and can be made available to a much-expanded set of patients requiring it.

One hospital director said “oxygen is the new PPE”, referring to the shortages of personal protective equipment for staff well-documented in recent weeks.

Others said widespread use of continuous positive airway pressure machines — a type of non-invasive ventilation — was proving effective for patients but used “massive” amounts of a hospital’s oxygen supply.

A senior leader at a trust outside London said they had been trying to get more engineering support for more than a week. She said: “It is crucial to how we align our oxygenated beds with the modelling that has been done for our region.”

Several others have reported similar concerns about getting engineering support for the much greater use of oxygen. 

HSJ reported yesterday (5 April) on six London trusts which have been prioritised for expanded oxygen supply, to increase bed capacity by 1,013.

In yesterday’s daily government press conference, health and social care secretary Matt Hancock said the “quantity and supply of oxygen is something we’ve been working very hard on and we have a very high degree of confidence in the supply”.

HSJ understands some initial problems with the oxygen supply to the new Nightingale Hospital at the Excel Centre in London have now been resolved.

On Saturday, West Hertfordshire Hospitals Trust urged the public not to attend Watford General Hospital’s emergency department due to a “technical issue” with its oxygen equipment.

The trust declared a critical incident that morning and told people to visit the next nearest hospital with an emergency department.

HSJ has approached BOC, which supplies much of the liquid oxygen and engineering support to England’s hospitals, for comment.

The German-owned company’s website said its supply to UK hospitals operated from 12 cylinder filling sites, “filling over 40,000 cylinders a day, with over 25 distribution sites strategically located to provide nationwide coverage throughout the UK. Our investment in this infrastructure ensures reliable and frequent deliveries to our customers.”

It said: “Even in an emergency or disaster situation, the contingency plans we have in place ensure that the delivery of medical gases receives the highest priority, and time and time again we have proven our ability to supply in any crisis.”

Senior national leaders said earlier in the outbreak they believe there is a reliable UK oxygen supply, but engineering to ensure it can be reliably used at much greater rates in old estate may be a challenge.

An NHS England spokesman indicated it disagreed with the accounts from hospital chief executives and directors, stating: ”This story is untrue as hospital oxygen tanks are fuller than normal, having been filled more frequently in recent weeks as part of comprehensive preparation for the expected surge in patients with coronavirus.

“So hospitals have sufficient oxygen for their patients, the government is continuing to increase supply and NHS trusts were sent guidance on how to manage supply in February and again last week, including how to make correct use of CPAP machines.”

The issue of availability of engineers was not directly addressed.

Updated on 6 April at 9.08pm to include NHSE comment