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Expert GP-led sleep apnoea clinic cut as ICB tightens budgets

Expert GP-led sleep apnoea clinic cut as ICB tightens budgets

Exclusive A GP-led sleep apnoea clinic has been decommissioned despite a lengthy waiting list, Pulse has learned.

Dr Robert Koefman, a GP at the Binfield Surgery in Bracknell, was asked 13 years ago to set up the service to avoid patients in East Berkshire having to travel to Oxford for specialist assessment.

Since then, he has seen more than 3,000 patients with suspected sleep apnoea, doing sleep studies and referring for CPAP where necessary.

But he has now received an email from NHS Frimley ICB with no prior discussion to say they were decommissioning the service with the 160 patients on his waiting list to be sent back to secondary care from next month.

Dr Koefman, a GP with special interest in ENT who was a committee member on the NICE guidance on obstructive sleep apnoea says doctors in local hospital services have told him they are already swamped and have long waits that will now just get longer.

‘I just had an email to say we’re decommissioning your service, no phone call, no discussion. People at the ICB making the decision don’t know the history or what you do, you’re just a number on a spreadsheet.

‘There’s no recognition of the work you have done, or loyalty and patients aren’t even thought about, it’s purely the money’, he added.

He added his clinic, which runs twice a month had kept going throughout Covid when hospital sleep clinics stopped. He fears a separate weekly ENT clinic he runs which has funding for this year, may also be at risk in the future.

‘The Government says it wants to provide more services in the community but at the same time everything in the community is being cut.

‘Sleep apnoea is a public health issue, there are more and more people being diagnosed with it or being told to go see their doctor about it. This is a backward step.’

Dr Koefman also has concerns about what it will mean for equality of access to services for patients.

Under the NICE guidance on obstructive sleep apnoea published in 2021, patients with two or more symptoms which include snoring, unexplained sleepiness and witnessed apnoeas should be referred for assessment through sleep studies.

Obesity and overweight, type 2 diabetes, and treatment-resistant hypertension among other conditions are linked with a higher prevalence of the condition and patients should be prioritised for assessment if they have a driving job or a job that requires vigilance for safety or unstable cardiovascular disease.

The All-Party Parliamentary Group for Sleep recently warned that improvements are needed in the diagnosis of sleep disorders, particularly sleep apnoea as well as access to treatment.

Pulse has asked NHS Frimley ICB for a comment.


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Please note, only GPs are permitted to add comments to articles

Michael Mullineux 20 July, 2023 11:01 am

Makes no sense joining the litany of often opaque descision making with patients now having to join a long queue for assessment at said trust with waiting times for OSA assessment in the region of 18/12 minimum

Monica Stevens 26 July, 2023 9:33 am

It will cost he NHS a lot more than it saves due to the increase in hypertension and type 2 diabetes in all those suffering sleep apnoea.