• Healthcare Safety Investigation Branch starts new investigation
  • Incident at acute trust triggers the review
  • Trusts grappling with oxygen infrastructure problems

A national investigation has been launched into the robustness of hospital oxygen supply systems after the need to care for a rapildy increasing number of covid-19 cases caused problems which saw one trust struggling to treat critically ill patients.

The Healthcare Safety Investigation Branch today announced an investigation into the provision of piped oxygen gas supplies.

The move comes after HSJ revealed national NHS estates chiefs have warned of “very high demand” for oxygen across the health service. The problem is not one of supply, but rather the capacity to flow enough oxygen through hospitals’ pipes and infrastructure, as many NHS hospitals are old and require upgrading

All trusts have been told to involve gas engineers in their clinical decision-making as they open new covid-19 wards within their estate.

According to NHS England/Improvement data, as of 14 January, hospitals across England are treating 32,925 covid-19 patients, of which 3,351 – 10.2 per cent – are in mechanical ventilation beds.

HSIB’s investigation was triggered after an acute trust had to divert patients to different hospitals, and transfer patients between clinical environments, due to demands on its oxygen supply.

The trust - which HSIB has not named - had sufficient supplies of liquid oxygen available, but its piped system was unable to deliver the volume of oxygen gas required to meet all patient needs.

During its investigation, HSIB will examine the incident at the trust to “better understand issues highlighted about limitations in piped oxygen supply to hospitals”, according to its statement.

The watchdog will also look at the role of engineering specialists and medical gasses committees in piped oxygen supply across the NHS.

HSIB hopes this will help identify “any safety action or learning that can assist in mitigating the risk to piped oxygen supplies”, and highlight actions that can assist NHS organisations both during and after the pandemic.

In its statement, the watchdog said: “Covid-19 can cause severe inflammation of the lungs affecting a patient’s ability to breathe.

“As a result, an increased number of patients have required oxygen therapy within hospitals. Insufficient oxygen supply to seriously ill patients can have very severe consequences, including death.”

HSIB plans to release several interim reports before publishing its final report.

Earlier today, HSJ reported incidents of ambulances crews in the East of England working with less oxygen supplies due to shortages, while the Care Quality Commission is “monitoring” a hospital in Essex after it was forced to lower patients’ oxygen-intake due to capacity issues with the infrastructure.