Rising demand for high-flow and portable oxygen therapy in the home is adding pressure to healthcare providers and increasing safety risks, according to UK-based Baywater Healthcare’s Claire Hole.
Speaking at the BCGA Conference 2025, Hole, a Clinical Manager at Baywater and former specialist nurse, said the company now supports more than 50,000 patients across the UK through National Health Service partnerships, with many requiring increasingly complex and individualised oxygen solutions.
“We’re now seeing patients needing up to 15 litres per minute,” she told delegates. “Ten years ago, that would have been unusual outside of a hospital.”
Medical oxygen must meet strict purity standards, typically at least 99.5% purity, and is classified as a medicinal product under UK regulations. While exact figures vary year to year, estimates suggest that around 10% to 15% of the UK’s total oxygen production is allocated for medical use, with demand spiking during winter months and during periods of respiratory illness outbreaks.
Baywater holds the home oxygen contract for Wales and the West Midlands and works alongside other suppliers to support patients nationwide. The service provides medical-grade oxygen to individuals with a wide range of conditions, including COPD, pulmonary fibrosis, severe asthma, heart failure, and cystic fibrosis.
Claire Hole speaking at the BCGA Conference 2025
But the profile of the average oxygen user is changing. Hole noted a rise in younger, more mobile patients who are trying to maintain normal working lives while managing their condition. “That brings very different considerations – from travel and portable supply options to managing fatigue at work,” she said.
One patient featured during the talk had to resign from teaching following a respiratory diagnosis and now uses two separate oxygen systems, one static and one portable, to manage daily life.
“She uses a concentrator at home and liquid oxygen when out and about. That’s the level of personalisation we’re working with,” said Hole.
However, Hole warned that the increased complexity of home care also brought heightened risks, particularly when it comes to fire safety. “Oxygen doesn’t burn on its own, but it’s an accelerant,” she said. “If a patient is smoking near it, the results can be fatal.”
She recounted a case in which a patient who hadn’t smoked in ten years started again after receiving oxygen therapy and tragically died in a fire.
“That’s why honest patient assessments are critical. We need to know the full picture to reduce risk,” she stressed.
Baywater’s clinical teams conduct in-home assessments and safety checks, considering factors such as living space, equipment placement, and ventilation. Patients and families are educated on the safe use of equipment, and regular servicing is carried out every six months.
To meet rising demand, the company delivers around 1.3 million cylinders annually, the equivalent of 1.6 billion litres of oxygen. This is increasingly supplemented with concentrators, including portable backup units, to support continuity of care.
Hole stressed the importance of ongoing clinician training to help tailor oxygen delivery to each patient’s condition, lifestyle and risk profile. “Everything we do is about making sure it’s safe for the patient and works for them in the real world,” she said.
