BTS has published an updated Position Statement: Driving and Obstructive Sleep Apnoea (OSA) 2018, in response to recent legislative changes in this area.

In January 2016, a European Commission Directive on Driving led to extensive changes to the “Excessive Sleepiness including OSA” section of the DVLA “Assessing Fitness to Drive – a guide for medical professionals” document of March 2016. Following consultations with professional and patient bodies, the DVLA guidance was subsequently updated in October 2017. See Related Links for the full current guidance. To keep up to date with any changes to the DVLA guidance, readers can sign up for email alerts.

The BTS Position Statement contains information on the roles and responsibilities of medical professionals, along with a series of real life scenarios and advice on how these should be approached.

The Registration Council for Clinical Physiologists (RCCP) and the Academy for Healthcare Science (AHCS) have been discussing joint working for the last 2 years.

A number of options have been discussed and at the RCCP Council meeting on 19/6/17 it was agreed by a majority to continue discussions with the AHCS and to pursue an RCCP application to the Professional Standards Authority (PSA) to accredit its register.

For more information, please contact RCCP Chief Executive Paul Sharpe or RCCP Chair Trefor Watts

Current Position – BSS (proposed)

The impact of the proposed changes to the current registration procedures for Clinical Physiologists / Clinical Physiology in the UK is currently unclear and in dire need of clarification by the principal stakeholders in this process.

Given the changing political environment and moves towards statutory regulation of clinical physiology in the UK, makes the current impasse perplexing.  This helps no one and should not be used for any political gain.  This is further diluted when a primary objective of all governing bodies must be the effective validation of the skills of practicing physiologists together with patient safety.

To that end, the BSS is not beholden to any specific option and is prepared to support the majority opinion. However, we (The BSS) feel that the perceived agenda does not support the ongoing needs of current and future registrants.  Therefore, the BSS is in agreement with position of our colleagues in the ARTP, to assume a “watching brief”, in regard of any alternative proposals generated.

As many of you who manage narcolepsy patients will know, there have been increasing difficulties in persuading commissioning groups that the controversial drug sodium oxybate is a worthwhile and effective treatment for severe narcolepsy. The vast majority of requests are turned down, predominantly due to a perceived lack of cost effectiveness. A recent court ruling and an editorial letter in the British Medical Journal may be of interest. The former relates to an adolescent being refused the drug despite persuasive arguments from her paediatric neurologist, provoking an appeal in which the high court judge overturned the negative decision and ruled against NHS England. The link to the wording of the judge’s ruling can be found here.

The BMJ editorial outlines the inequities and confusion over the current processes for sanctioning prescribing of sodium oxybate. In particular, how “exceptionality” can or cannot be defined is addressed. A link to the article is www.bmj.com/content/353/bmj.i2367

Paul Reading

Non-respiratory sleep disturbance among children with neurodisabilities is common and a range of interventions, both pharmacological and non-pharmacological, have been developed to address these. Previous systematic reviews on the effectiveness of these interventions have typically focused either on particular interventions (e.g. melatonin) and/or specific sub-groups (e.g. autism).   NIHR’s HTA programme has recently commissioned a holistic systematic review to identify and evaluate evidence on the effectiveness of pharmacological and non-pharmacological interventions in the management of sleep disturbance across all children with neurodisabilities. Additional objectives are to synthesise evidence regarding the acceptability and feasibility of interventions, and to identify ‘promising interventions’. The review is being carried out by a team at the University of York with input from senior sleep practitioners based in paediatrics, CAMHS and the third sector.  It commenced in February 2015 will take 12 months to complete. For further information, see http://www.nets.nihr.ac.uk/projects/hta/1421202  or contact Gemma Spiers (gemma.spiers@york.ac.uk).