For healthcare professionals
Clinical indications
Hyperbaric oxygen therapy has thirteen approved indications in the manufacturer's Instructions For Use for the chamber Heal & Go₂ uses, closely matching the lists published by the Undersea and Hyperbaric Medical Society and the European Committee for Hyperbaric Medicine. In England, NHS England commissions the treatment for decompression illness and gas embolism only, and NICE recommends against or restricts it in three specific settings. Which of these indications Heal & Go₂ assesses and treats is set by the Medical Director, and treatment is always adjunctive to standard care in selected patients.
Referral criteria
The thirteen indications in the manufacturer's Instructions For Use are:
- Air or gas embolism
- Carbon monoxide poisoning
- Crush injuries and other acute traumatic ischaemias
- Decompression sickness
- Delayed radiation injury
- Selected problem wounds, including some diabetic foot ulcers
- Gas gangrene (clostridial myonecrosis)
- Intracranial brain abscess
- Necrotising soft tissue infections
- Refractory osteomyelitis
- Severe anaemia
- Compromised skin grafts and flaps
- Thermal burns
The Undersea and Hyperbaric Medical Society's approved list covers the same ground and adds central retinal artery occlusion, sudden sensorineural hearing loss and avascular necrosis.
European consensus grades each indication by the strength of its recommendation and the level of evidence, and in every elective indication it lists, hyperbaric oxygen is an adjunct to conventional medical or surgical treatment in selected patients, never a stand-alone therapy.
Decompression illness and gas embolism are emergencies, treated at NHS commissioned hyperbaric centres via the emergency services, with acceptance agreed by a hyperbaric physician at the receiving centre. They are outside the referral pathway described on this site.
Which of these indications Heal & Go₂ assesses and treats is set by the Medical Director. The elective conditions with a published page on this site each state their selection criteria and the UK guidance position, and are listed on the conditions index. A referral for any indication is a request for individual assessment, not a commitment to treat.
Contraindications and exclusions
Absolute
The screening list is on our safety page and is not restated here. It is the Medical Director's determination for this clinic and supersedes the manufacturer and society lists.
Relative
See the safety page. Relative contraindications will be assessed individually by the Medical Director at referral.
Evidence and guidelines
UK commissioning and NICE recommendations are distinguished from international professional guidance and from the chamber manufacturer's permitted use.
NHS England's January 2025 national HBOT service specification, implemented from October 2025, covers decompression illness and gas embolism. It says HBOT is not routinely commissioned for other indications, including carbon monoxide poisoning, necrotising soft tissue infections, pelvic soft tissue radiation damage and diabetic lower limb ulceration.
This is a commissioning position, not a universal finding that HBOT can never help any patient with another condition.
NICE NG19 says not to offer HBOT for diabetic foot ulcers except as part of a clinical trial. NICE NG36 says to consider HBOT or medical management for osteoradionecrosis only as part of a clinical trial. NICE CG179 says not to offer HBOT for pressure ulcers in adults or children. The 2025 NICE surveillance decision on topical oxygen for diabetic foot ulcers concerns a different intervention and does not change the current HBOT recommendation.
International professional guidance takes a different approach from UK commissioning. The European Committee for Hyperbaric Medicine's 2016 consensus assigns different recommendation and evidence grades to radiation injury, selected diabetic foot lesions, compromised grafts and flaps, and refractory osteomyelitis, among other conditions. These recommendations must not be presented as NICE endorsement or proof of benefit in every case. The 2023 IWGDF/IDSA diabetic foot infection guideline suggests against HBOT solely to treat diabetic foot infection.
Systematic reviews report different results by condition, outcome and follow-up. Cochrane's 2023 late-radiation review found possible benefit for some head, neck, bladder and rectal outcomes, with uncertainty and a greater risk of reduced visual acuity. Reviews of chronic wounds suggest a short-term healing benefit in some diabetic foot ulcers, but long-term benefit remains uncertain. The acute surgical and traumatic wounds Cochrane review, updated in 2013, found insufficient high-quality evidence to establish benefit for grafts or flaps. These findings do not override NICE recommendations.
How to refer
Referrals are not open yet. They will open when our first hospital-based Centre of Excellence opens, and will follow the steps on our referral pathway page. Until then, register your interest through the enquiry form on this site, choosing Healthcare Professional, and we will tell you when referrals open. Every referral will be reviewed individually by the Medical Director, and we will contact you or the treating team where needed before deciding.
Governance
Every clinical page on this site is approved by the Medical Director before publication, and the approval is shown on the page. Our clinical governance framework, including how to raise a concern, is set out on the clinical governance page.
- Clinical and advertising approval
- Approved 1 October 2026 · Dr Anil Dasineni (own revision)
- Reviewed by
- Dr Anil Dasineni, MBBS, DNB (Emergency Medicine), MRCEM. Registered with the General Medical Council with a licence to practise.
- Last reviewed
- 1 October 2026
- Next review due
- 1 October 2027
Sources (12)
www.england.nhs.uk/wp-content/uploads/2018/11/Hyperbaric-oxygen-therapy-services-all-ages-Service-specification-January-2025.pdf, www.england.nhs.uk/commissioning/spec-services/npc-crg/group-d/hyperbaric-oxygen-therapy/, www.nice.org.uk/guidance/ng19, www.nice.org.uk/guidance/ng36, www.nice.org.uk/guidance/cg179, www.england.nhs.uk/wp-content/uploads/2018/07/hbot-for-soft-tissue-radiation-damage-v2.pdf, www.echm.org/documents/DHM%202017-Mathieu%20D-Tenth%20European%20Consensus%20Conference%20on%20Hyperbaric%20Medicine.pdf, uhms.org/resources/featured-resources/hbo-indications.html, onlinelibrary.wiley.com/doi/full/10.1002/dmrr.3687, www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD005005.pub5/full, www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD004123.pub4/full, www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD008059.pub2/full
Clinically governed and CQC-aligned. Heal & Go₂ Medical is working towards CQC registration and does not describe itself as CQC registered.