Four Week Wait campaign success in Newcastle clinical trial

The results of an NHS trial to fast track commercial drivers who display the symptoms of a sleeping disorder to ensure they are provided with treatment within four weeks of diagnosis, has been welcomed by RAC Business and campaign groups.

Obstructive Sleep Apnoea Syndrome (OSAS) is more common among those who drive for a living than the general driving population, and RAC Business is backing a campaign to identify and treat the condition within a maximum of four weeks.

The condition and the symptoms of daytime drowsiness can impair driving which may have a significant impact on the ability of commercial drivers to earn a living. Fear of lengthy investigations and licence regulations may deter these patients from seeking treatment. DVLA guidelines state that those with sleepiness “sufficient to impair safe driving” should cease driving until they have been investigated and treated.

Now, a trial by Newcastle Sleep Service at the Freeman Hospital in the city has established that it is possible to implement a four week wait maximum for commercial drivers. The Four Week Wait campaign, led by the Obstructive Sleep Apnoea Partnership Group, issued its campaign paper to Dr Sophie West in Newcastle, who instigated the trial.

Between September 2014 and July 2015, 29 commercial drivers were referred and 22 were given access to treatment within four weeks.

Dr West said: “After being made aware of the aims of the Four Week Wait campaign, we developed a dedicated service for vocational drivers that aimed to diagnose OSA and successfully establish and review CPAP treatment within four weeks of GP referral.

“The data demonstrates that a fast track service is deliverable. It can diagnose OSA in vocational drivers and successfully provide treatment within a short time scale, many within four weeks of referral.

“It is vital that GPs are aware of the service and identify patients as vocational drivers at point of referral. We hope that this service will encourage vocational drivers with suspected OSA to present for investigation and treatment, and potentially lead to safer roads.”

Professor John Stradling, one of the UK’s leading authorities on the condition of obstructive sleep apnoea, said the success of the trial supports the feasibility of the 4WW campaign on the basis that if it can work in Newcastle, it can work in sleep centres across the country.

The National Institute for Health and Care Excellence (NICE) has now updated its Clinical Knowledge Summaries (CKS) to suggest that general practitioners communicate with the local sleep centre to request diagnosis and treatment within four weeks, where there is concern about job security. Referring to this important decision Professor Stradling added: “It is also good to see that NICE has endorsed the view that commercial drivers need to have access to rapid diagnosis and treatment.”

Jenny Powley, sales director for corporate business at RAC Business, said: “The clinical trial at Newcastle is a crucial milestone in this campaign as it confirms that it is possible for drivers with symptoms of OSA to be seen by their GPs and provided with the right treatment within four weeks.

“The UK’s commercial drivers literally keep the economy moving every day and night, and we know that they are highly professional and skilled in their profession. But unfortunately this is a condition that can affect a significant number of drivers, often without them realising they are becoming steadily more ill.

“Commercial drivers often feel they cannot report their symptoms because they fear losing their licence and therefore their living because they have to wait many weeks or months for treatment once the initial diagnosis is made.

“Clearly that is a difficult position so ensuring there is a four week maximum wait for treatment means they could use that time doing other duties if possible, or perhaps take it as annual leave. The disruption to their lives will be significantly less than the worst case scenario which is to fall asleep at the wheel and be involved in an accident as a result.

“We feel it is imperative that fleet operators and the commercial transport sector more widely takes note of this trial and supports the call for a maximum four week wait for treatment of drivers suffering obstructive sleep apnoea. And more importantly, drivers themselves need the support of their employers so they have the confidence of knowing their job will be safe if they are diagnosed with the condition.”

ENDS