Background

It is known that patients with serious coronavirus symptoms often do not go to hospital early enough, and this can have a negative impact on outcomes.
Promoting general public knowledge of monitoring with pulse oximeters can mean people whose health is deteriorating rapidly but without visible signs are more likely to be identified and can get the help they need as quickly as possible.

Some populations are at much higher risk of developing COVID-19 and its complications. These include:

  • people aged over 65
  • those with co-morbidities (e.g. diabetes, lung disease, heart disease)
  • people from minority ethnic groups
  • poorer people.
  • Individuals falling into more than one of these groups are at even greater risk.

Early oxygen therapy improves outcomes in acute Covid-19, but many people who need it have ‘silent hypoxia’ (i.e. no symptoms). Pulse oximeters help to detect this. These simple devices measure oxygen levels and heart rate. They can give early warning that someone is unwell with Covid-19 or another health condition.

Distribution of pulse oximeters and other medical devices requires individuals to have a fixed address; individuals with homelessness therefore do not get access. This study gave them access to the technology and was supported by the local GP practice who could not initially provide the technology due to the fixed address requirement.

This inequity should be flagged when other initiatives are rolled out.

Close up of oximeter on black girl hand

What we did

A collaboration between community leaders, GPs, NHS commissioners, researchers and the Oxford AHSN supported groups at greater risk from Covid-19.


Between January 2021 and September 2021 pulse oximeters were made freely available at a local food bank, mosque and a homeless shelter linked to a GP practice.

They were given to 15 people at each venue along with supporting information. These people were subsequently contacted as part of a research study.

Key themes that emerged included:

  • initial lack of knowledge around what an oximeter is and what it can be used for,
  • willingness to learn how to use a pulse oximeter and take regular readings at home,
  • enthusiasm and positivity around the device’s ease of use,
  • lack of preventive education around Covid-19 and viruses in general in vulnerable communities, and
  • community platforms as potential route to raise awareness on the benefits of pulse oximetry.

Real-world impact

Equity of access to pulse oximetry was improved. Community leaders, trusted and well-respected figures in minority groups, have the capacity to influence healthcare promotion and engagement on a communal scale.

Engaging with trusted figures, tapping into existing community support systems and utilising word-of-mouth spread could all help to enfranchise vulnerable communities.

The lessons learned from this initiative are being applied to disseminating health education through other community networks.

Recommendations were provided to Oxfordshire CCG on how to improve the uptake of pulse oximeters in deprived groups. The Oxford AHSN shared learning from this initiative regionally and nationally through AHSN and NHS networks.