1. Spend on health now to save on health costs later by
Trevor Shaw K0953840
Aims and objectives
An ever increasing number of patients each year attend sleep apnoea clinics within this
Trust; sleep apnoea is defined as a temporary cessation of breathing during periods of
sleep, in obstructive sleep apnoea syndrome the frequent pauses in breathing sleep due to
the closure of the air passage in the pharynx.
The signs and symptoms of obstructive sleep apnoea are many and may include some of
the following at night; heavy snoring, apnoea, restless sleep, insomnia, nocturnal choking,
sweating and reduced libido.
This range of symptoms then leads on to the day time symptoms of excess sleepiness,
impaired performance, morning headaches, intellectual deterioration, impaired memory,
impaired concentration, depressive symptoms and even heart burn.
These symptoms can be distressing and debilitating to the patient having a direct impact on
both their social as well as their working lives, leading to a reduced quality of life and in
some cases depression.
Patients who are identified by their own general practitioner as having the condition and
associated symptoms, would at first be referred to an apnoea specialist for confirmation and
then be referred on from there to a CPAP clinic for treatment.
The purpose of the clinic is to assess the patient for this condition, and then to prescribe a
continuous positive air pressure (CPAP) device to be used by the patient at night, the CPAP
device supplies positive air pressure to the patient via a face mask to keep the airways open
and so help to aid restful sleep and elevate some if not most of the day and night
symptoms..
It is suspected that worldwide 2% of women and 4% of men have sleep apnoea that causes
problems. Certain groups, however, have a much higher chance. So if we surmise that just
6% of the population could be potentially suffering from this debilitating condition that is 6%
of the 62,435,709 population of the United Kingdom, giving a total of 3,746,142 people each
needing the resources of the NHS.

2. This staggering figure is only the tip of the ice berg it would be hard to assess the potential
cost implications this condition may be exerting on industry through lost production due to
sickness or to the economy as a whole, not to mention the impact on the sufferer of such a
debilitating condition.
The cause of sleep apnoea are many and may include such things as Obesity, the natural
shape and size of the pharynx, nasal obstruction, alcohol and hypnotic drugs, this list is not
exhaustive but it gives an indication of the probable causes of sleep apnoea.
As the main cause of obstructive sleep apnoea seems to be related to obesity, any
measures aimed at reducing excess weight and improving fitness may help to prevent it or
alleviate some of the symptoms.
In addition to sleep apnoea, obese patients may also suffer from a whole host of other
debilitating conditions associated with obesity, this could potentially include:-
Type one or two diabetes.
High blood pressure.
Coronary heart conditions.
Poor blood circulation.
Increased risk of some cancers.
Bone joint damage.
So potentially an obese patient could represent a massive financial drain for the NHS over a
life span.
This project will become the basis of a community based partnership in which the patient will
be paid for losing weight over a specified period of time, this could be a nominal figure of
£100 per stone of weight loss, but the patient is also given a specific time frame which the
weight loss must occur, say for the figures, number of stones in weight loss in one year X
£100 would be the patients goal, the money would be paid to the patient on completion of
participation in the project for 2 full years.
To further help and encourage the patient on their road to recovery, the hospital Trust would
be required with the help of existing hospital staff, to provide specialist help and advice for
the patient on diet, nutrition and fitness and as part of the recovery plan the patient would
also be given some form of exercise plan tailored to their requirements.

3. If for the sake of figures each patient lost an average of approximately 10 stone this would
give the patient the sum of £1000, on these figures for the Trust’s initial outlay of £50,000 it
could make an immense difference to the lives of 50 people, over the 2 year that the project
would run. This would bring about immeasurable changes to the lives health and wellbeing
of the participants in this project.
The remaining £50,000 investment could then be used to set up the infrastructure needed to
run this project and provide any additional equipment and manpower needed for the project.
Aims
The aim of this project is to:-
Reduce the number of people requiring CPAP devices by 1% per year, by
introducing a program of monitory bonuses for weight loss and food awareness
classes.
Raise the Trust’s profile as progressive forward thinking Trust that treats not just the
patient’s symptoms but also the causes of the symptoms.
Reduce obesity in the target population.
Help 50 patients per year increase their quality of life and give them an improvement
in the quality of their health.
Objectives
The objective of this project would be to
Reduce the financial burden on the NHS, by reducing obesity in the target group.
Promote the fitness and wellbeing for the patients.
Promote the general health for the participating patients and hope this has some
effect on their families and friends health.
Reduce the burden on industry due to absence from work through sickness.