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CQC-Agreed principles for defibrillators, oxygen and oximeters

For those of you who haven’t seen it, copied below from CQC’s website is a blog from Dr Nigel Sparrow, CQC medical adviser.

Whilst the guidance doesn’t go as far as to say that the availability of such equipment in all surgeries is compulsory, clearly it would be farharder for practices to demonstrate the safety and quality of care for emergencieswithout it, and any practice that does not have such equipment must be in a position to demonstrate that they have carried out adequate risk assessments and be able to justify their decisions and the adequacy of their treatment. It also goes without saying that all equipment must be in good working order and properly maintained and appropriate staff properly trained in its use.

Nigel Sparrow's myth buster - Agreed principles for defibrillators, oxygen and oximeters

We need to be assured that practices are able to immediately respond to meet the needs of a person who becomes seriously ill. Since we do not have explicit guidance around emergency equipment such as pulse oximeters, defibrillators and oxygen, having reviewed external guidance and national standards, we agreed the following with the BMA, RCGP, NCAS and MDU:
We need to consider the individual circumstances of the practice such as the practice's knowledge and assessment of the emergency services available to them.
With regard to defibrillators: current external guidance and national standards around this issue sees defibrillators as best practice and that practices should be encouraged to have them.
With regard to oxygen, the National Resuscitation Council has the following views: "Oxygen: Current resuscitation guidelines emphasise the use of oxygen, and this should be available whenever possible."
Oxygen is considered essential in dealing with certain medical emergencies e.g. acute exacerbation of asthma and other causes of hypoxaemia; if the practice does not have oxygen they are unlikely to be able to demonstrate they are equipped for dealing with emergencies.
With regard to pulse oximeters: the 2009 British Thoracic Society (BTS) guideline on the management of asthma recommend SpO2 monitoring by pulse oximetry as an objective measure of acute asthma severity, particularly in children. In addition the Primary Care Respiratory Society states that it should be used to assess all acutely breathless patients in primary care. The need for pulse oximeters and paediatric pulse oximeters should be risk assessed within a GP practice. In light of the above recommendations, it would be unlikely that a practice would be able to demonstrate that they are equipped for dealing with emergencies without a pulse oximeter.
With regard to training in CPR: this is mandatory. If a practice has not trained its staff that are working while the practice is open, they would have no evidence that their staff would be able to immediately respond to a person who becomes seriously ill requiring resuscitation. The above guidance relates to Regulation 9, which states that: "The planning and delivery of care and, where appropriate, treatment in such a way as to…ensure the welfare and safety of the service user."

Dr. Robert Morley
Executive Secretary
Birmingham Local Medical Committee

36 Harborne Road, Edgbaston, Birmingham B15 3AF

Tel. 0121-454 5008, Fax. 0121-455 0758
Office email:
Birmingham Local Medical Committee
Supporting the Business of General Practice


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