Detecting the early signs of deterioration in patients with confirmed or suspected Covid-19 is vital for reducing mortality and morbidity, and ensuring that patients get appropriate care. One effective way of detecting a decline in a patient’s condition, which might mean they need to be admitted to hospital, is by picking up early decreases in blood oxygen levels. 

As part of the national NHS Covid-19 response, the Health Innovation Network, one of NIHR ARC South London’s partners, has supported health and care systems in south London to offer the Covid Oximetry @home service. This service enables patients at risk from Covid-19 to safely monitor their own blood oxygen levels at home using pulse oximeters.

Using informatics to understand the impact of the pandemic on service users and to inform care 

During the pandemic, applied informatics researchers at ARC South London have been analysing clinical records and service data to investigate the impact of the pandemic on mental health service users in south London. Through this work, they have contributed to emerging research evidence showing high rates of mortality in people with severe mental illness (SMI). A recent paper has shown that, of the measures assessed, schizophrenia has the greatest effect on 45-day Covid-19 mortality, second only to age (Nemani et al, 2021)

Working closely with the Health Innovation Network and other key stakeholders including South London and the Maudsley NHS Foundation Trust, the ARC informatics research team has helped to secure agreement that people living with SMI should be considered an ‘at risk’ group under the Covid Oximetry @home service. 

During the pandemic, we have used informatics to improve our understanding of what is happening across health and social care systems in near real-time. In this case, we have used this information to inform care and service delivery with the aim of improving outcomes for patients in south London with serious mental illness who contract Covid-19.

Professor Fiona Gaughran, who leads applied informatics research at the ARC

Recommendations for health and care services in south London 

The work has led to a number of recommendations for health and care services in south London to support those with a diagnosis of SMI who get Covid-19. These include:

  • Expand Covid Oximetry @Home referral criteria to include SMI. Enable mental health teams to refer patients with SMI into the Covid Oximetry @Home service
  • Consider the psychosocial needs of the patient and their current situation. Consider alerting mental health services if a patient under their care has been admitted onto the Covid Oximetry @Home service
  • When providing suspected or confirmed Covid patients with SMI with oximeters, assess whether they may need extra support to help take and record readings 
  • Assess whether Covid Oximetry @ Home staff need further support (eg training, updated scripts or telephone number to access local mental health teams).

Advice for patients

Health Education England has produced an animation (below) which explains how to use pulse oximeters at home and keep a Covid-19 diary. 

General advice for anyone experiencing the symptoms of Covid-19 is available on the NHS website.