Urgent and important! NHS Consultation on future of HBOT chambers

[Tunicates]

NHS consultation on removal of HBOT provision - this affects YOU, so read on, and complete the on-line consultation.
The below is from the website of the London Hyperbaric Chamber - so I assume it's real.


Public Consultation on a new Policy for Hyperbaric Oxygen Therapy

URGENT / IMPORTANT NEWS FOR DIVERS!

Dear Divers,
NHS-England have started a public consultation on a new policy for Hyperbaric Oxygen Therapy (HBOT), and we would like to suggest you respond to the Online Survey.
This new policy represents the closure / withdrawal of a long-standing NHS-funded service, which, on the face of it, doesn’t appear to affect your access to emergency treatment for decompression illness or Gas embolism.

However, everyone else, including those suffering from severe carbon monoxide poisoning, radiation tissue damage, problem wounds and other previously funded conditions will be denied access to NHS-funded Hyperbaric therapy.

We feel that this is UNFAIR and DISCRIMINATORY, particularly as most of these often elderly and vulnerable patients come from predominantly ethnic minority or disadvantaged backgrounds.

Public Health England has produced no evidence of any financial, clinical or other benefit, either to patients or the NHS itself, but appears to accept the risk of the destruction of the national emergency service, that this policy presents.

Without a viable and appropriate caseload, the IMPACT of the new policy will have if that staff will de-skill, become unsafe and de-motivated. The knock-on effect will be a race to the bottom in quality of care standards if centres are only allowed to treat divers and no one else.

If you feel that HBOT should not just be available to the diving community but to the community as a whole then please support us and our clinicians to preserve the service for the future.

The consultation is accessible here:

https://www.engage.england.nhs.uk/consultation/clinical-commissioning-wave11

The consultation closes on 4th June, so time is of the essence!

Thank you for your support.

[MarkP]

There's also another, knock-on effect; if the chambers aren't in regular use they will be considered even less cost efficient and some will close completely.

[notdeadyet]

That's what happens when a bunch of millionaire shitbags in the pockets of the banks get voted in by muppets who only care about their house value going up and their pensions growing and get to pretend it's still 1953. Personally, I'd rather pay a few quid a year for DAN insurance and see the people that actually need it for more than their hobby get it for free than the other way around but it is what it is.

[MarkP]

I started to fill in the survey, but it seems it's aimed squarely at clinicians and members of health management.

It doesn't seem to be for the likes of us.

[BTS]

Have the bods at the governing body for SCUBA in the UK been informed? This is something positive they could put their efforts into...

[iain/hsm]

That's what happens when a bunch of millionaire shitbags in the pockets of the banks get voted in by muppets who only care about their house value going up and their pensions growing and get to pretend it's still 1953. Personally, I'd rather pay a few quid a year for DAN insurance and see the people that actually need it for more than their hobby get it for free than the other way around but it is what it is.

No get your facts right. That’s what happens when a bunch of millionaire private hyperbaric centres get to vote out the little diver $500 a treatment chambers and screw the NHS out of millions for an overpriced seat in a chamber breathing oxygen that cost £6 quid a bottle for two hours

DDRC Plymouth for example with £2,000,000 of NHS payments in the bank by charging £18,000 per diver treatment.

Further as a result even your DAN insurance won’t touch them for treatments because they charge too much.

As to the OP the sooner they close these chambers the better, The NHS has been bleed dry enough with these overblown overpriced care professionals. Better is to follow cheaper. :rolleyes: Iain

[BTS]

I bet you took a healthy profit for fitting the chambers out Iain. ...

I think maybe you fail to understand the true costs of offering treatment

[Ken]

I think maybe you fail to understand the true costs of offering treatment

Could you explain those costs?

My guess is that the one or two divers per week that a chamber might get (total guess) has to cover the fixed overheads. Rent, on call staff, receptionist etc.

Say 1000sq at 100/sq ft, 100k for staff and 100k for a doctor (assume mostly paid from full time work next door in the hospital). Another 100k for Iain's servicing, gas and pizza.

400k/100 divers a year or 4K/ diver.

Anyone got a better back of the envelope number?

[BTS]

Could you explain those costs?



No, that is commercially sensitive information...

You may need a cigar pack as there are several fixed costs missing from your guesstimate...

[Ken]

Go on then, add them.

[GLOC]

Bear in mind the number of divers treated for DCS per chamber is pretty small compared to other treatments that are undertaken.

The only figures I have for divers treated for DCS was 2009 where 354 divers were treated by BHA chambers - that isn't all the chambers in the UK. This was compared to just over a 100 reported incidents to BSAC for DCS.

I do not have the breakdown per chamber...

Regards

[Ken]

How many chambers is that?

[GLOC]

Google is your friend

http://www.ukhyperbaric.com/members.htm

Regards

[Ken]

17 then, so 354/17 is approx 20, so 20k/diver assuming no medical use.

Makes the ddrc seem cheap.

[gobfish1]

17 then, so 354/17 is approx 20, so 20k/diver assuming no medical use.

Makes the ddrc seem cheap.

do you think so , the 354 wont be getting spread around, some will have lots ie by the sea side or a few close to the odd inland pond , other,s will get feek all , the 2mill at 18k a pop is 111 ish rides , a 3rd or your 354 number

i dont have a clue on running cost , but im sure iain will have a good story or 3

[OutOfTest]

Mind if I copy your post to another forum Tunicates?


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[Paulo]

My concern would be that they would only do the emergency part of treatment and not the rehab part

[iain/hsm]

My concern would be that they would only do the emergency part of treatment and not the rehab part
Paulo

Welcome back what the heck did you do to get banned? criticise the BSAC? or their control over the forum mod’s :hi:

Two parts to the reply, first don’t be concerned this has nothing to do with divers, treatment for divers is recognised and fully funded. But the NHS has concerns:

1. The level of high treatment costs for NHS funded divers compared to what say DAN chambers charge.
2, The number of expensive Type II treatments charged for compared to the average Type 1/Type II profile hits
3. The number of repeat treatments given to double of even quadruple the treatment charges
4. Divers that can eat Pizza inside and drive home after may not have required such expensive treatment
5. Chambers outright fraud against the NHS for fictious treatments.
6. Overseas chambers once paid for the emergency treatment by DAN then stuffing said diver on the next flight back with instructions to present himself to the London Heathrow/Gatwick area chambers to follow up treatment on the NHS with tacit agreement of both chambers profit but against the best interest of the diver having to forgo treatment and incur a flight.

So in a nutshell its the piling up the treatment charges against the NHS for what in effect is a mild bend with some muscle strain,

The second part is the other NHS problem in so far that you have a situation where private chambers are stuffing the NHS with bills for a wider and varied list of “possible valid treatments” for an ever increasing list of ailments and conditions.

I could go on its much deeper than you think.

[PhilPage]

The second part is the other NHS problem in so far that you have a situation where private chambers are stuffing the NHS with bills for a wider and varied list of “possible valid treatments” for an ever increasing list of ailments and conditions.
HBOT treatment of chronic wounds is well established as effective...

[MarkP]

Two parts to the reply, first don’t be concerned this has nothing to do with divers, treatment for divers is recognised and fully funded. But the NHS has concerns:

1. The level of high treatment costs for NHS funded divers compared to what say DAN chambers charge.
2, The number of expensive Type II treatments charged for compared to the average Type 1/Type II profile hits
3. The number of repeat treatments given to double of even quadruple the treatment charges
4. Divers that can eat Pizza inside and drive home after may not have required such expensive treatment
5. Chambers outright fraud against the NHS for fictious treatments.
6. Overseas chambers once paid for the emergency treatment by DAN then stuffing said diver on the next flight back with instructions to present himself to the London Heathrow/Gatwick area chambers to follow up treatment on the NHS with tacit agreement of both chambers profit but against the best interest of the diver having to forgo treatment and incur a flight.

So in a nutshell its the piling up the treatment charges against the NHS for what in effect is a mild bend with some muscle strain,

The second part is the other NHS problem in so far that you have a situation where private chambers are stuffing the NHS with bills for a wider and varied list of “possible valid treatments” for an ever increasing list of ailments and conditions.

I could go on its much deeper than you think.I think you've missed the point.

Though the NHS may well have concerns re. your points 1-6, the consultation is all about your "second part".

My concern is that if chambers don't get enough throughput from, say, hyper-oxygenating burns victims' tissues, then chambers will close and no longer be available to anybody. This is why it's a concern to us.

As I pointed out in my earlier post, the consultation doesn't seem to be for the likes of us. It seems to be aimed at clinicians or other health industry professionals with hyperbaric medical experience and access to outcome data.

I started to fill it in before realising it wasn't aimed at me. I don't see what value divers can add to the consultation.

[Paulo]

Paulo

Welcome back what the heck did you do to get banned? criticise the BSAC? or their control over the forum mod’s :hi:

Two parts to the reply, first don’t be concerned this has nothing to do with divers, treatment for divers is recognised and fully funded. But the NHS has concerns:

1. The level of high treatment costs for NHS funded divers compared to what say DAN chambers charge.
2, The number of expensive Type II treatments charged for compared to the average Type 1/Type II profile hits
3. The number of repeat treatments given to double of even quadruple the treatment charges
4. Divers that can eat Pizza inside and drive home after may not have required such expensive treatment
5. Chambers outright fraud against the NHS for fictious treatments.
6. Overseas chambers once paid for the emergency treatment by DAN then stuffing said diver on the next flight back with instructions to present himself to the London Heathrow/Gatwick area chambers to follow up treatment on the NHS with tacit agreement of both chambers profit but against the best interest of the diver having to forgo treatment and incur a flight.

So in a nutshell its the piling up the treatment charges against the NHS for what in effect is a mild bend with some muscle strain,

The second part is the other NHS problem in so far that you have a situation where private chambers are stuffing the NHS with bills for a wider and varied list of “possible valid treatments” for an ever increasing list of ailments and conditions.

I could go on its much deeper than you think.

Yes but what happens when they have treated the diver emergency? Are they going to pay out for the course of treatments that might be needed to get the diver back to normal?

[Tunicates]

...

[Tunicates]

Mind if I copy your post to another forum Tunicates?


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Fill your boots mate, I only copied it from LHB's website.

[matt]

I started to fill in the survey, but it seems it's aimed squarely at clinicians and members of health management.

It doesn't seem to be for the likes of us.

I didn't even understand the questions.

[iain/hsm]

Yes but what happens when they have treated the diver emergency? Are they going to pay out for the course of treatments that might be needed to get the diver back to normal?

Nothing, Like I said in my first post: "This has nothing to do with divers". We are not affected its business as usual, you get treated exactly as before, free at point of contact, with re runs, follow ups and physio all included free to you with and all the bills paid by your own local area health authority. As I said divers are not affected in this. Its much deeper than us.

[Paulo]

Fair enough so. Crack on lol

[drysuitdiver]

Nothing, Like I said in my first post: "This has nothing to do with divers". We are not affected its business as usual, you get treated exactly as before, free at point of contact, with re runs, follow ups and physio all included free to you with and all the bills paid by your own local area health authority. As I said divers are not affected in this. Its much deeper than us.

Unless the chamber suddenly isn't there. Which " might" happen .

They could always get some slat wall ( Autocrect changed to slate all , how fuggin apt) and sell stuff to divers. Could even service your regs while you are in there, would be a fairly clean environment being as its in hospital ....

[iain/hsm]

I think you've missed the point.

Though the NHS may well have concerns re. your points 1-6, the consultation is all about your "second part".

My concern is that if chambers don't get enough throughput from, say, hyper-oxygenating burns victims' tissues, then chambers will close and no longer be available to anybody. This is why it's a concern to us.

As I pointed out in my earlier post, the consultation doesn't seem to be for the likes of us. It seems to be aimed at clinicians or other health industry professionals with hyperbaric medical experience and access to outcome data.

I started to fill it in before realising it wasn't aimed at me. I don't see what value divers can add to the consultation.


No, Mark you haven’t read the first paragraph properly. As a diving forum I’m more concerned with points 1-6 as each of these are areas of great concern to divers and should be discussed fully the implications

Now as to your concern of throughput

Here’s my concern and as a diver what should be all of our concerns. My local Divers chamber closed down. It was working well, saved many divers, had a competent staff, internal tenders diver medics and a diving doctor at the local hospital.

It was a small Webster twin lock divers decompression chamber installed by a old diver college of mine Alan King. The location Stoney Cove.

Now instead of reaching the surface and being in the chamber under pressure and beginning your treatment within 3 minutes you now have to wait for a chopper and look forward to a helicopter ride to a hyperbaric chamber in Hull or some such. The result being sadly that more than one diver has died as a result on more than one occasion.

Further the treatment cost used to be free at Stoney Alan King didn’t charge the NHS a penny it was all part of the service and his duty of care to his divers at Stony

Now you are flown to Hull/ Rugby and its an £18,000 bill for the treatment and another £18,000 for the helicopter running maintenance and service

So at £36,000 it now costs the NHS more money to treat one single diver at the private hyperbaric centres than installing a brand new chamber back at Stoney Cove. Go figure.

That is the concern manifold with the well understood deterioration of a divers condition by delaying treatment while these private hyperbaric chambers fly you in.

Follow ups, phyisio and clinical care and assessment can all be done at your local NHS hospital but as a diver you need to be inside the chamber under pressure breathing oxygen or 50/50 on one of the many treatment tables offered ASAP, and not waiting for the jolly green giant or a free ambulance ride past suitable chambers to eventually end up on the south coast of Devon.

Now you may ask who got the chamber at Stoney closed down and all the others originally on the UK available chamber list. Iain

[iain/hsm]

Unless the chamber suddenly isn't there. Which " might" happen .

They could always get some slat wall ( Autocrect changed to slate all , how fuggin apt) and sell stuff to divers. Could even service your regs while you are in there, would be a fairly clean environment being as its in hospital ....

Yeh sure you could even do a line on the side of dead divers kit selling off the unwanted YBOD's off the widow, I guess like one chamber I know:rolleyes:

[drysuitdiver]

Yeh sure you could even do a line on the side of dead divers kit selling off the unwanted YBOD's off the widow, I guess like one chamber I know:rolleyes:

Even that's low and bang out of order based on my standards

Really a chamber did that .

[MarkP]

No, Mark you haven’t read the first paragraph properly. As a diving forum I’m more concerned with points 1-6 as each of these are areas of great concern to divers and should be discussed fully the implicationsI don't think I did.

The problem is the survey linked to by the OP. Divers don't get a mention; it's all about the efficacy and value for money of hyperbaric oxygen therapy for other problems.

The NHS may well have a problem with the costs of recompression for bent divers, but it's not the subject of this bit of research. Unless I missed something. Which is possible.

[matt]

Now you may ask who got the chamber at Stoney closed down and all the others originally on the UK available chamber list. Iain

Go on then?

[Tewdric]

Go on then?

Seems like a long time ago now but I seem to recall an NHS edict that all recrompression facilities should have a primary care facility colocated, which Stoney clearly didn't have.

It was probably the wrong decision IMHO but, given the age and lifestyle profiles of a lot of divers these days, possibly more defensible than it was? Stoney wouldnt be much good at dealing with cardiac conditions or failing livers or kidneys For example, that may have been the precursor to the problem or incident.

I'd be interested in any insider knowledge on this one.

[iain/hsm]

Seems like a long time ago now but I seem to recall an NHS edict that all recrompression facilities should have a primary care facility colocated, which Stoney clearly didn't have.

It was probably the wrong decision IMHO but, given the age and lifestyle profiles of a lot of divers these days, possibly more defensible than it was? Stoney wouldnt be much good at dealing with cardiac conditions or failing livers or kidneys For example, that may have been the precursor to the problem or incident.

I'd be interested in any insider knowledge on this one.

Enclosed is the NHS contract with hyperbaric providers
For divers treatment its a pretty simple twin lock category 3 chamber.

https://www.england.nhs.uk/.../wp.../d11-hyper-oxy-thera-0414.pdf

[GLOC]

https://www.england.nhs.uk/commissioning/wp-content/uploads/sites/12/2014/04/d11-hyper-oxy-thera-0414.pdf

[Hellenic Diver]

No, Mark you haven’t read the first paragraph properly. As a diving forum I’m more concerned with points 1-6 as each of these are areas of great concern to divers and should be discussed fully the implications

Now as to your concern of throughput

Here’s my concern and as a diver what should be all of our concerns. My local Divers chamber closed down. It was working well, saved many divers, had a competent staff, internal tenders diver medics and a diving doctor at the local hospital.

It was a small Webster twin lock divers decompression chamber installed by a old diver college of mine Alan King. The location Stoney Cove.

Now instead of reaching the surface and being in the chamber under pressure and beginning your treatment within 3 minutes you now have to wait for a chopper and look forward to a helicopter ride to a hyperbaric chamber in Hull or some such. The result being sadly that more than one diver has died as a result on more than one occasion.

Further the treatment cost used to be free at Stoney Alan King didn’t charge the NHS a penny it was all part of the service and his duty of care to his divers at Stony

Now you are flown to Hull/ Rugby and its an £18,000 bill for the treatment and another £18,000 for the helicopter running maintenance and service

So at £36,000 it now costs the NHS more money to treat one single diver at the private hyperbaric centres than installing a brand new chamber back at Stoney Cove. Go figure.

That is the concern manifold with the well understood deterioration of a divers condition by delaying treatment while these private hyperbaric chambers fly you in.

Follow ups, phyisio and clinical care and assessment can all be done at your local NHS hospital but as a diver you need to be inside the chamber under pressure breathing oxygen or 50/50 on one of the many treatment tables offered ASAP, and not waiting for the jolly green giant or a free ambulance ride past suitable chambers to eventually end up on the south coast of Devon.

Now you may ask who got the chamber at Stoney closed down and all the others originally on the UK available chamber list. Iain
I had a bend at stoney in 2011, I ended up on o2, looking back, they were very reluctant (ie didn't) call an ambulance, and left my mate to drive me to rugby.

And when asked said no you can't take the o2, as we don't have a spare.

This is after a vestibular bend, and collapsing in the shop...

Other than that I was the 7th diver potted that year (as although number 8 turned up, just as I was getting out). That was at the end of April, so off season though.

I think you've missed the point.

Though the NHS may well have concerns re. your points 1-6, the consultation is all about your "second part".

My concern is that if chambers don't get enough throughput from, say, hyper-oxygenating burns victims' tissues, then chambers will close and no longer be available to anybody. This is why it's a concern to us.

As I pointed out in my earlier post, the consultation doesn't seem to be for the likes of us. It seems to be aimed at clinicians or other health industry professionals with hyperbaric medical experience and access to outcome data.

I started to fill it in before realising it wasn't aimed at me. I don't see what value divers can add to the consultation.


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