NEWS

PHILIPS CPAP UPDATE

Recent media coverage about Philips Respironics CPAP machines may have caused some concerns if you use one to treat your sleep apnoea.

PLEASE NOTE THAT THE MEDIA INFORMATION WAS ONLY ABOUT PHILIPS RESPIRONICS PRODUCTS SOLD IN THE USA AND NOT THE UK.

The situation here in the UK is still proceeding as per the original communications by Philips Respironics on 26th April 2021 (announcing a repair and replace programme), and on 21st June 2021, the UK Government Medical & Healthcare Products Regulatory Agency (MHRA) (announcing the risks).

The situation in Europe is still in progress and you can find out more by visiting the Philips website, as follows: https://www.philips.co.uk/healthcare/e/sleep/communications/src-update

The MHRA advice to UK Clinicians is:
“Do not advise patients to stop using the devices unless a risk assessment has concluded that the risks outweigh the benefits”.

The MHRA advice to UK patients is:
“CPAP devices are primarily used by patients with Obstructive Sleep Apnoea (OSA), enabling them to carry out activities of normal daily living e.g. driving a vehicle, that they would be unable to do if they were to stop treatment. Withholding treatment could increase their risk of stroke, heart disease and high blood pressure. This could require hospital admission and a more invasive method of treatment and have long-term health consequences”.

By now, all Philips Respironics CPAP patients in the UK should have been contacted and told what is happening. Additionally many will have had their CPAP machines either repaired or replaced.

If you have a Philips Respironics CPAP machine in the UK that has been repaired or replaced, you should have no further need for concern.
If you have a CPAP supplied by the NHS from another manufacturer there should be no current or future cause for concern, provided the machine, masks and tubing are regularly cleaned in line with the manufacturer’s instructions.

If you have any questions please email SATA on info@sleep-apnoea-trust.org and we will do our best to advise.

This special 75th edition carries a full report of October’s SATAday Conference & AGM, plus a look back at the 30 years of the charity’s amazing progress and influence on behalf of patients.

It is currently only available to members, but will be made public in the New Year.

Not a Member? Join and support the Sleep Apnoea Trust charity

Energy Companies’ Priority Service Register – What might we get from them?

There has been much debate among sleep apnoea patients as to what exact benefits might be provided to them as members of the Priority Services Register, and SATA is now able to be more precise on what you might get, and more importantly what you won’t get if the system has a problem. Energy Networks Association (ENA – the voice of the networks) have published a range of documents on their plans to cope with the current fuel crisis, and how it might worsen. Here are links to two documents on their website to help you –

What happens during an energy shortage – Energy Networks Association (ENA)

Getting extra help from your energy network operator – Energy Networks Association (ENA)

All companies have their own detailed policies, but are broadly in line with the Associations view.

SATA has received postings from Scottish and Southern (SSEN) on how they will be approaching any likely scenario, with a range of helpful Frequently Asked Questions and replies.

How will planned and emergency disconnections work, and how will I be notified?
Planned rota disconnections – the National Grid Electricity System Operator (ESO) will give advanced warning to the DNO of a next-day outage by 5.30 p.m.; if it occurs in your rota area, you will be advised by text at around 6.00 p.m. Each outage is expected to last around 3 hours.

Emergency disconnections – caused by a fault, a failure or weather event, will be of uneven length dependant on circumstances, and no notice time is possible. When information becomes available, the DNO will text it to your mobile number if they have it.

What is a block letter, and why is it important?
Each electricity meter is assigned an alphabetical ‘block letter’. In the event of a planned power cut different block letters are timetabled to be without power for a 3-hour period. Depending on the severity of the situation, power may be interrupted multiple times over the period of the event which may last several days. You can also find your rota block and see what areas are affected around you at myrotablock.ssen.co.uk .

How can I find the power cut timetable (rota)?
If a planned rota disconnection is initiated, a timetable will be available at powercut105.com and on our website ssen.co.uk . The timetable will tell you when you will be without power, and when there is a risk you may be without power. Your power might be switched off or reconnected around 30 minutes before or after the published time depending on national electricity use at that time. This is because of the need to phase disconnections and reconnections, creating a short overlap.

How long will my power be off for?
As stated above, this is a worst-case scenario, and it is likely that National Grid ESO will not need to implement planned power cuts this winter. However, if they do, a robust plan has been established to minimise the length of time you would be without power – typically around 3 hours at a time. You do not need to do anything – the power will be turned off and back on automatically.

How will I know I’m affected by one of these power cuts?
We have plans in place to be able to communicate to our customers quickly if this situation evolves. If you have provided us with a mobile phone number you’ll receive a text message from us, , and we’ll provide as much notice as possible. You’ll also hear about it on the news and announcements from National Grid ESO and Government, where advice will also be provided.

Can I be excluded from the power cuts?
A very limited number of sites are protected from emergency power cuts. These are typically locations which are deemed to be critical national infrastructure, such as air traffic control centres and major hospital facilities with accident and emergency departments. Domestic properties are not eligible for this as there is a very specific set of requirements which include providing national or regional services.

There are some specific suggestions for customers with medical conditions –

Oxygen dependency?
If you use an oxygen tank, please make sure you have a backup oxygen tank. Replacements can be obtained from Dolby Vivisol or Air Liquide, the companies that provide oxygen on behalf of the NHS. Your oxygen provider can help you with reducing your oxygen flow if required.

Use of nebuliser or apnoea monitor?
Experts recommend that you purchase a backup battery for your sleep apnoea machine. These can sometimes be provided by the NHS if your medical condition means you may be a serious health risk without the equipment. You can speak to your GP or health specialist for further advice on what to do and what risks a power cut may have for you.

Stairlift, hoist or electric bed?
Some customers may wish to purchase a backup battery if they heavily depend on a stair lift, hoist or electric bed. The situation referred to in this letter would mean your power would be off for around three hours and you should consider how you will manage during that time. You should however review the instruction manual for your stair lift, hoist and electric bed so you know how to switch to a manual override. Where you receive advance warning of these power cuts, you should avoid using the equipment in the 15 minutes leading up to the time your power is expected to be turned off.

Medication in the fridge?
Most fridge/freezers will last several hours without power and retain their temperature which for most medication will suffice. However, there are some medications that require a specific temperature to be set. A battery backup should be suitable for this, but you should consult your GP or pharmacist for further advice.

There is also some general advice for all customers where power cuts may be a problem –

  • Make sure your electrical provider has your mobile number, and you’re on the Priority Service Register. Landline digital phones need mains power to work, so your mobile may be your lifeline
  • Keep your mobile charged , when the power is back on. If you have a backup battery, make sure it gets recharged when power is available
  • Have a plan for getting in touch with friends or relatives if there’s a cut – and see if there’s a place to go near you with a different rota block letter
  • Have an emergency kit in easy reach in the event of a cut – as well as the mobile, a torch with spare batteries, a battery radio for information, and some candles (use with care)

Sleep Apnoea Trust – best advice
Every sleep apnoea patient is different – degree of severity of the condition, other conditions as co-morbidities, mental attitude towards a CPAP, and background worries and concerns. However most of us have a CPAP and that joins us together. You must make your own decisions on how much you need your CPAP on a daily basis, how happy or fearful you would be without it, and what you feel you can afford to keep your CPAP going 24-7, when you need it. Medical advice is that missing one sleep period will make little difference to your condition in most cases; missing several nights in a row could have an impact on your well-being and your health, and possibly on your fitness to drive. However, you might not want to sleep without your machine, or even dread not having it available, however accurate your fears might be. Remember that all sleep is sleep, whenever in the 24 hour day you take it, but if the main danger time for cuts is the peak power period 4-7.00p.m. you probably won’t be affected much.

Our best advice is to buy a backup battery if you can afford it, and decide on how much battery you can afford to buy

  • A useful minimum size is a 100 Watt hour lithium-ion battery. This will give 4-8 hours of CPAP (without humidifier) and can legally be used on long-haul aircraft for holiday use (see the Airline Guide on our website). Try to get one with a standard 3-pin socket giving 220 volts – the CPAP will plug straight in without extra cables, and the battery will take over if the mains is halted. Cost should be between £100-200 on Amazon, but check that it meets UK standards and has a local dealer for spares and technical help
  • A 200-300 Watt hour battery will give at least one, maybe 2 nights sleep from £250-350. Most will also charge your phone while you sleep, and power a bedside light without compromising the CPAP, which is after all the primary item
  • A 500+ Watt hour battery is better if you also take camping holidays, for £500-600. Such a unit will run several items as well as your CPAP at up to 150 watts per item, so a camp fridge, lighting and entertainment

AND FINALLY – If there are cuts, what are the chances for compensation?

You might be entitled to compensation if your gas or electricity supply goes off. What you can claim depends on:

  • if it is due to planned works
  • how long you don’t have gas or electricity
  • if a network operator has not met standards set by Ofgem, the GB energy regulator.

Network operators are regulated by Ofgem. Ofgem sets service standards network operators must meet. These include rules on how quickly operators must restore supply in normal and severe weather conditions, and compensation consumers get if standards aren’t met.

What you can claim

Compensation for power cuts in normal weather

Network companies have 24 hours to restore your power if more than 5,000 homes are affected by a single fault. If you are without power for 12 hours or more, you can claim:

  • £75 as a domestic customer
  • £150 as a non-domestic customer.
  • You can get a further £35 for each additional 12 hours of being without power, up to a total of £300.

If you are without power more than four times in a year, for at least three hours each time, you can claim an extra:

  • £75 as a domestic customer
  • £75 as a non-domestic customer.

The year runs from 1 April to 31 March.

Compensation for power cuts in severe weather

When you can claim depends on how Ofgem categorise storms in severe weather.

You can claim:

  • £70 as a domestic customer
  • £70 as a non-domestic customer
  • if the power was off for 24 hours (Storm Category 1) or 48 hours (Storm Category 2). Ofgem checks and verifies storm categories.

You can get a further £70 for each additional 12 hours of being off supply, up to a total of £700.

  • Additional payments and provisions are available for households on the Priority Services Register. This includes, for example, alternative heating and cooking facilities.

If you are off supply for more than 24 hours you can claim more. The amount will rise depending on how long you are without gas.

How to claim

You need to make compensation claims for supply issues to you network operator within:

  • three months for unplanned supply cuts.
  • one month for planned supply cuts.
  • Make a claim through your local network operator

Further help

Citizens Advice and Advice Direct Scotland can help if you need support.

Citizens Advice

  • Call on 0808 223 1133 or use their online webchat.
  • For textphone, dial 18001 followed by the helpline number.

Advice Direct Scotland

Published by the Sleep Apnoea Trust 3rd March 2023

Sleep Matters  –  Summer 2023

Page 1                  SATAday 2023 – Preparing the Conference Agenda for Saturday 14th October 2023

Pages 2, 3           Semaglutide – The Story So Far Siobhan Harris reports for Medscape

Page 4                  The Swindon Volunteers

Page 5                  From the Chairman

Pages 6-10          The Liverpool Critical Survey-the ‘Gold Standard’ and how to make it better

Page 11               Liverpool’s new approach to CPAP delivery and first usage

Page 12               INTEGRATED CARE BOARDS LAUNCHED

Page 13               TENS machine provides cheaper and non-invasive treatment for sleep apnoea

Pages 14-15        Perioperative Management of Obstructive Sleep Apnoea in Adults

Page 16               Tale End – are CPAP patients given adequate training? Your thoughts, please!              

Excellent News For Patients from the DVLA – SATA says it drastically reduce the administration workload for Sleep Clinics in dealing with the DVLA medical enquiries and speed up the whole process.

DVLA announces change in the law to enable more healthcare professionals to complete DVLA medical questionnaires

  • From today, 20 July, the law has changed to enable healthcare professionals other than doctors to complete DVLA medical questionnaires following notification of a medical condition that may affect an individual’s driving, DVLA has announced.
  • The change to the Road Traffic Act 1988 will now allow doctors to refer medical questionnaires to colleagues such as specialist nurses and opticians from other professional bodies
  • This change is a result of extensive work by DVLA including a public consultation where 82% of respondents were supportive of the change
  • This forms part of an approach by DVLA to speed up elements of the medical licencing process while reducing the burden on doctors to complete DVLA medical questionnaires

Specialist nurses and opticians are among the healthcare professionals now able to complete DVLA medical questionnaires, as part of an approach by DVLA to improve and speed up the medical licensing process. An amendment to the Road Traffic Act 1988, which comes into force today, means a wider pool of registered healthcare professionals, other than doctors, can now be authorised to provide information where a driver has declared a medical condition.

By law, all drivers must meet the medical standards for fitness to drive. Often, other healthcare professionals such as nurses or opticians will be involved in patient care and this change in the law now allows these and others to complete DVLA medical forms following deferment by a doctor. DVLA will continue to send questionnaires to GMC doctors and consultants, and it will then be up to individual GP practices and hospital teams as to which healthcare professional in practice is best placed to complete the questionnaire.

Roads Minister Baroness Vere said:

“Obtaining or renewing a driving licence should always be a quick, simple and efficient process.

“That’s why we’re allowing more healthcare professionals to complete DVLA medical questionnaires to speed up the medical licensing process and ease the burden on GPs”.

DVLA Chief Executive Julie Lennard said:

“Every year we are receiving an increasing number of medical licensing applications from drivers.

“This law change, which widens the pool of healthcare professionals who can complete DVLA questionnaires, improves the process for those notifying DVLA of medical conditions whilst reducing the administrative burden on doctors, benefitting drivers and the NHS alike”.

Previously, only doctors registered with the General Medical Council (GMC) could complete the questionnaires. Although there is no requirement for GP surgeries or hospital teams to make changes to their current processes, the change to the law will now allow medical professionals from the following Councils to complete medical questionnaires on behalf of doctors:

  • General Chiropractic Council
  • The General Optical Council
  • The General Osteopathic Council
  • The Nursing and Midwifery Council
  • Health and Care Professions Council

The change to the law does not apply to the D4 Medical Examination Report which will still need to be completed by a doctor or consultant who is registered with the GMC.

Regards

Corporate Services Team
Service Management | D14 | DVLA | Swansea | SA99 1ZZ

New Assessing Fitness to Drive published – Essential Reading for Medical Professionals

DVLA has updated its excellent and very clear “Assessing Fitness to Drive – A Guide for Medical Professionals” and page 110 refers to Excessive Sleepiness and Obstructive Sleep Apnoea (OSA).

Click here for a copy

DVLA to allow more healthcare professionals to complete DVLA Medical Questionnaires

After a public consultation the DVLA’s “Proposed legal change to support medical licensing applications”, measures have been brought forward to change the law to allow more healthcare professionals like specialist nurses to complete DVLA medical questionnaires. The Legislative Reform Order, that is required to change the law, having also now been laid in Parliament. It is hoped that the change in the law will come into effect in July, subject to parliamentary approval.

For more information read the following link:

https://www.gov.uk/government/news/proposed-legal-change-to-support-medical-licensing-applications

August 2021 – New NICE Guideline NG202, Obstructive sleep apnoea/hypopnoea syndrome and obesity hypoventilation syndrome in over 16s

This new guideline covers the diagnosis and management of obstructive sleep apnoea/hypopnoea syndrome (OSAHS), obesity hypoventilation syndrome (OHS) and chronic obstructive pulmonary disease with OSAHS (COPD–OSAHS overlap syndrome) in people over 16. It aims to improve recognition, investigation and treatment of these related conditions.

Click on this link to view it: https://www.nice.org.uk/guidance/ng202

“NICE TA139, which as been in place since Mar 2008 has also been modified to allow for changes contained in NG202”
https://www.nice.org.uk/Guidance/TA139

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