Quality statement 7	Short burst oxygen therapy (SBOT) should only be offered in the context of cluster headache. SBOT should not be ordered for patients with chronic cardiorespiratory disease.
Rationale	Oxygen therapy should be used to treat hypoxaemia, and not simply breathlessness. There is no evidence to support the use of SBOT in patients with chronic cardiorespiratory disease. SBOT does not improve exercise tolerance or reduce breathlessness in patients with chronic cardiorespiratory disease and should not be ordered for use prior to or following exercise. SBOT does not improve health-related quality of life or reduce healthcare utilisation when ordered for patients following an acute exacerbation of COPD (AECOPD) and should not be ordered on discharge from hospital. The only indication for SBOT is for use in cluster headaches where there is evidence to show delivering high flow oxygen therapy (>12 L/min via non-rebreather mask) significantly reduces pain from acute attacks of cluster headache.
Quality measure	Structure: Evidence that patients with chronic cardiorespiratory disease do not have SBOT ordered. Patients who are hypoxaemic should be assessed for LTOT if resting stable saturation meets the qualifying criteria. Evidence that patients discharged from hospital with AECOPD are not ordered SBOT. Evidence that patients with cluster headaches have appropriate access to SBOT. Process: The proportion of patients with chronic cardiorespiratory disease with SBOT. The proportion of patients with cluster headaches who have access to SBOT. Numerator 1: The number of patients with chronic cardiorespiratory disease with SBOT. Denominator 1: The number of patients with SBOT.
	Numerator 2: The number of patients with cluster headaches who have appropriate access to SBOT. Denominator 2: The number of patients with SBOT for cluster headache.
Description of what the quality statement means for each audience	Service providers: Ensure systems are in place to provide LTOT, NOT and AOT assessments with cardiorespiratory disease, but not SBOT. Ensure systems are in place to provide SBOT to patients with cluster headaches. Healthcare professionals: Ensure all patients with chronic cardiorespiratory disease are not offered SBOT. Instead, where indicated, patients should be assessed for LTOT, NOT or AOT. Ensure all patients with cluster headache have access to SBOT. Commissioners: Ensure patients with chronic cardiorespiratory disease do not have access to SBOT. Facilities should be available for assessment for LTOT, NOT or AOT where indicated. Ensure patients with cluster headaches have access to SBOT. People who require home oxygen: Should have appropriate assessments for LTOT, NOT and AOT, where indicated. SBOT should only be available to patients with cluster headaches.
Relevant existing indicators/data sources	For example, local data collection/audit.
Source references	BTS Guideline for Home Oxygen Use in Adults June 2015.3 BTS Guidelines for Oxygen Use in Adults in Healthcare and Emergency Settings 2017.8 NICE Guidelines on Management of Cluster Headache 2012.9