Effective Implementation of a Smokefree Policy at TEWV NHS Foundation Trust
Detailed review and implementation of a smokefree policy at TEWV NHS Foundation Trust, including key elements for preparation, time frames for implementation, development of relevant information and training provision. The Trustwide audit in January 2017 showed a significant reduction in smoking rates across all specialities.
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Effective Implementation of a Smokefree Policy Tees, Esk & Wear Valleys NHS Foundation Trust (TEWV) Lesley Colley - Project Lead Nicotine Management & Smoking Cessation
NICE Guidance PH48 Detailed review of the NICE PH48 guidance 16 clear recommendations to implement guidance Provision of Information & Training Leadership & Strategy Smokefree Policy and Communication of Policy Identification of smokers and support Commissioners Pharmacy
Key elements to support initial preparations Identify Senior Leads to support and sponsor the project Identify a dedicated Project Lead Set up an operational Steering Group Review all TEWV policies, guidance and literature Identify training packages and training providers Identify patients and carers to support implementation
Time Frames 2015: May - Sub groups established, work commences to develop identified information to support going smokefree Identify all staff, patients and carers required to support project Two conferences held to provide opportunity for discussion 2016: 9th March Target date identified to go fully smokefree (Jointly with NTW)
Develop or update relevant information Guidance Updated Nicotine Management Policy Pharmacy Guidance inclusive of Homely Remedies Information Detailed project plans Communications Information leaflets for staff, patients and carers Communications Plan Training Training materials and programme delivery
Training Provision Level 1: NCSCT - Very Brief Advice Brief Intervention Level 2: NCSCT - Practitioner Training NCSCT - Mental Health Module 3 hour Face to Face session for Level 2 staff 1500+ staff trained to Level 1 189 staff trained to Level 2 Ensure a systematic approach to training and delivery
Trustwide Audit - January 2017 Trustwide smoking rates reduced from 42.5% (2015/16) to 28% (2016/17) All specialities have seen a reduction in smoking rates 98% of patients were offered a brief intervention on admission Of those whoaccepted a referral 95% had a full assessment completed 95% were offered Homely Remedies (patches and Inhalator) on admission 80% were offered NRT/E-cigs within 30-60 minutes of admission 10% of identified smokers wish to remain smokefree on discharge
Evaluation An evaluation project is on-going which is currently conducted by FUSE, the North East Centre for Translational Research in Public Health along with the Public Health England Knowledge and Intelligence Team, supported by TEWV and NTW The final evaluation report should be available late 2017
Lessons Learnt - Areas for concern Staff resistance to change-biggest barrier Patient's continued to smoke in grounds Ensure removal of all smoking shelters to prohibit the facilitation of continued smoking Patients took to smoking in their bedrooms Initially pushed smokers from courtyards to front entrances Then smoked at entrance to hospitals Staff facilitated smoking especially after 7pm Human Rights raised
Areas for concern: Section 17 Leave being used to facilitate smoking Staff left or moved department so required additional provision to train more staff on a regular basis Staff smoking in cars Contractors caught using Tank e-cigarettes and setting off fire alarms in patient areas Ensure enough preparation time is available-Minimum12-18 months Ensure additional funding identified for NRT costings
