In line with national guidance, and in response to increasing Covid numbers and pressures in Primary Care, we have made some important updates to the Covid Oximetry @ Home (CO@h) service. 

• We now know pregnancy is an important risk factor for more serious disease, especially when unvaccinated, so referrals are encouraged for women who are pregnant and meet the criteria (ie. 18 years+ with symptomatic Covid-19). Women who are pregnant will not be advised to contact primary care at any point in their pathway, but instead will escalate straight to 999/ED at 94% saturations in line with the national SOP. All Trust maternity units are engaged in this process.
• We are also making some updates to the daily lists of people testing positive for Covid-19, to make these easier to manage each day. We will be highlighting and moving all those who are eligible for Co@h to the top of the list and are awaiting an update from the national team which will ‘flag’ those who are particularly vulnerable due to a range of factors including: pregnancy, obesity, diabetes, homelessness, ethnicity, deprivation, mental health and those with a learning disability or caring responsibilities.

Practices are asked to ensure they have a system in place for reviewing their lists and referring eligible patients. If felt to be beneficial, practices can work together at PCN level and we can provide support to set this up if required. We will shortly be issuing some PCN-level data packs around the uptake and effectiveness of CO@h, but for now you can see a table of uptake across PCNs here

• We are implementing a light touch pathway, also in line with the national guidance. This pathway will be for those who are of lower risk (under 65s who are double vaccinated) but would still benefit from additional monitoring. The triage and referral process remains the same, however the person will be given the option to minimise their contact with the CO@h team during their time on the service and to fully self-manage. If a person opts for this, they will be offered the full safety netting advice and issued with an oximeter but will only make contact in the event of deterioration. This is to enable increased capacity in CO@h teams delivering the service.

The Devon CO@h service has now supported over 1100 people and 85% of referrals have come from Primary Care. Just 10% have needed to contact their practice during this time.

Recently published national evidence shows that for those who do need to be admitted, there are a number of improved outcomes for those who have been on CO@h (data November 20 to March 21):

All documentation has been updated to reflect the above changes and can be found on the formulary websites by searching ‘Oximetry’