{
  "abstract": "Introduction Sleep services are experiencing rapid growth in demand for long term CPAP follow-up, creating financial and workforce pressures. Within our service, high utilisation of rental CPAP devices and routine follow-up for stable patients were identified as key contributors to inefficiency. This quality improvement project aimed to improve sustainability within 18 months by reducing rental device use, introducing patient initiated follow up (PIFU), and embedding digital solutions to support self-management.Methods A structed quality improvement approach was undertaken. A fishbone analysis identified root causes of inefficiency across processes, workforce, equipment, technology, demand and governance. Interventions included transitioning patients from rental to trust-owned CPAP device and implementing a stratified PIFU pathway for stable patients. Digital support was expanded through the development of a dedicated service webpage hosting patient resources, introduction of an online form enabling CPAP users to request consumables or clinical call-back, and standardisation of tele-monitoring-enabled CPAP devices incorporating manufacturer self-management apps. Outcome measures included monthly expenditure on rental devices and estimated clinical hours released through transitioning patients to PIFU.Results Transitioning patients from rental to trust owned CPAP devices generated savings of approximately £10,000 per month. Implementation of PIFU released an estimated 500 clinical hours annually, which can be directed to patients with complex needs, poor adherence, or persistent symptoms. The digital webpage, online request system, and manufacturer app enhanced patient autonomy, streamlined communication, and supported safe remote monitoring which maintaining clinical governance.Conclusion A multifaceted service redesign aligned with the Optimal Sleep Pathway 1 can sustainably manage increasing long term CPAP demand. Stratified follow-up, digital integration, and proactive financial oversight delivered measurable cost savings, improved workforce utilisation, and strengthened patient-centred self-management.Reference Read N, Anderson KN, Craig S, Kendrick A, Quinnell T, Steier J, Hare A. The Optimal Sleep Pathway: Towards better care for patients with sleep conditions. [online; accessed 21/01/2026], 2025. Available from: https://www.sleepsociety.org.uk/wp-content/uploads/2025/02/Optimal-Sleep-Pathway.pdf",
  "authors": [
    {
      "affiliations": [
        "Southern Health & Social Care Trust, Craigavon, United Kingdom"
      ],
      "name": "Micheala Lagan"
    },
    {
      "affiliations": [
        "Southern Health & Social Care Trust, Craigavon, United Kingdom"
      ],
      "name": "Emma Jane Simpson"
    },
    {
      "affiliations": [
        "Southern Health & Social Care Trust, Craigavon, United Kingdom"
      ],
      "name": "Kerrie Smyth"
    },
    {
      "affiliations": [
        "Southern Health & Social Care Trust, Craigavon, United Kingdom"
      ],
      "name": "Eimear Gillis"
    },
    {
      "affiliations": [
        "Southern Health & Social Care Trust, Craigavon, United Kingdom"
      ],
      "name": "Andrea McGuigan"
    },
    {
      "affiliations": [
        "Southern Health & Social Care Trust, Craigavon, United Kingdom"
      ],
      "name": "Gillian Hewitt"
    }
  ],
  "title": "P39 Improving sustainability and capacity in a growing sleep service: a quality improvement project",
  "uid": "37c40ca9-e3b7-57e9-8c49-3fe979eb9aab"
}