A recent incident involving treatment for decompression illness in Malta and reported on Divernet has drawn scuba divers’ attention to the possibility that even reaching a hyperbaric chamber might not necessarily draw a line under an emergency.
In England, the National Health Service is currently looking to boost its hyperbaric services, counter-intuitively by reducing the number of centres commissioned to offer treatment to bent divers.
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It is proposing to reduce the total from eight to six, as part of changes to its Hyperbaric Oxygen Therapy (HBOT) services specification and provider commissioning arrangements. Its network currently costs £8.2 million per year to maintain.
NHS England says that with the exception of the London and Midlands chambers the existing hyperbaric centres are all located close to the coast, and that good-practice guidelines set out the optimal time to treatment from the onset of symptoms as being within six hours, which is particularly important for patients with gas embolism.
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The proposal is said to still enable patients to be able to reach the nearest centre in no more than four hours by road.
Keeping in practice
Some providers are currently treating comparatively low numbers of patients, says the NHS, meaning that it could be challenging for each staff-member to complete the minimum number of genuine (as opposed to simulated) treatments needed to maintain their clinical competence. Neither are all of the current providers equipped to treat critically ill patients, it says.
NHS England has launched a consultation, seeking the views of patients and the wider public regarding the proposed changes, which it says will have the effect of improving timeliness of access to treatment for patients, reduce variation in access to care for critically ill patients and, through new follow-up procedures, ensure that long-term outcomes for patients are monitored and reviewed.
As diving’s governing body, the British Sub-Aqua Club says it has been invited to represent the views and interests of divers and will be formally responding to the consultation. “We are talking to other parties involved with this consultation in order to get the best results we can on behalf of our members,” says BSAC CEO Mary Tetley.
Any individual divers or groups wishing to submit their own feedback can do so, though the submission needs to be completed by 13 October. NHS England recommends reading the public consultation guidance, the Equalities Health Impact Assessment and the revised service specification before completing its consultation survey.
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