Introduction

In the UK there is a shift towards moving services from hospitals into the community. It is important to understand how these pathways work for management of OSA.

Aims

This project aims to describe and evaluate a pilot healthcare scientist (HCS) led OSA clinic in Swansea Bay Health Board to evaluate whether a HCS was able to make appropriate clinical decisions in the referral and management of patients.

Methods

In this pathway general practitioners (GP?s) made direct referrals to the HCS who made triage, clinical assessment and management decisions, with independent review by a secondary care Consultant Physician (CP). The pilot clinic was funded by the Welsh Government Health and Social Services Transformation Fund. The service evaluation was approved by the Swansea Joint Study Review Committee.

Results

48 patients were referred. At triage, 4 were redirected to secondary care and 3 were returned to the GP. 36 patients attended a HCS remote assessment. After a sleep study 19 were offered CPAP, 4 offered lifestyle advice and 1 was referred to the GP. The HCS and CP agreed in 96% of the referral decisions and 97% of the management decisions. We are not aware of other studies of decision making by a HCS in primary care. While referral decisions by the HCS and CP were made independently, this was a real-life service evaluation, care should be taken extrapolating the outcomes elsewhere. The pilot was limited in scale by disruptions due to the covid pandemic and CPAP machine supply.

Conclusion

The evaluation indicates that the HCS-led pilot-clinic was able to provide safe and effective clinical decision-making in referral and management. This HCS-led model may be of interest to other services.