Guidance for palliative care and respiratory services on decision-making for initiating and prescribing home oxygen therapy in the palliative phase of illness and long-term respiratory disease has been agreed and published by NCL Integrated Care System (ICS).

The document includes the following decision tools:

• long term oxygen therapy decision tool (LTOT) for long term respiratory disease (COPD, pulmonary fibrosis, sleep-related hypoventilation etc)
• clinical decision tool for use of oxygen in patients with hypoxia in palliative phase of illness whose prognosis likely to be short months or less (hospital and community).

These have been developed  in conjunction with clinicians across clinical care settings, including home oxygen services and palliative care teams, to support clinicians not specialising in caring for people requiring oxygen therapy. 

The guidance has been approved by the NCL Respiratory Network and palliative care services in NCL. Prescribing of oxygen should only be by respiratory services, home oxygen services or palliative care teams.