Smoking Cessation (Kirklees) Care Pathway

Review in progress

Disclaimer: The guidance contains helpful primary care information for management of referrals and up to date referral criteria. These guidelines are locality specific to best reflect local services. This guidance does not override or replace the individual responsibility of healthcare and social care professionals involved in the delivery of care to make informed professional judgements appropriate to the circumstances of the individual.

Scope

This guidance refers to:

  • People age 12+
  • Patients living in the Kirklees district (North Kirklees & Greater Huddersfield).
  • While all smokers can be provided with smoking cessation, there are specific population groups which Kirklees Public Health would like to target. These include:
    • smokers in areas or population groups of high smoking prevalence
    • women of childbearing age and pregnant women
    • smokers with long term conditions including mental ill health
    • smokers in secondary care and routine and manual workers.
  • Tobacco users motivated to quit.

This guidance does not cover:

  • Patients that do not reside in the Kirklees district
  • Patients under 12 years.
  • Tobacco users not motivated to quit

Management

Very brief advice for smoking cessation (less than 30 seconds)
  • An intervention designed for GP's, pharmacy staff and all other health care professionals to raise the issue of stopping smoking.
  • Very brief advice from a GP/health professional is one of the most important triggers for a quit attempt.

Ask

  • Are you a smoker?
  • Are you smoking at all these days? How do you feel about your smoking?
  • Establish and record smoking including use of electronic cigarettes.

Advise

  • Example Script: "Did you know the best way to stop is with a combination of support and medication which is available on the NHS? You are four times more likely to stop and stay stopped".

Act

  • Example Script: "We have a registered stop smoking advisor here at the practice/pharmacy. An appointment with them to discuss your treatment options can offer you your best chance of stopping. Are you happy for me to refer you now?'
Patients who decline
  • Record in patient notes that the offer of support has been offered and declined.
  • Reinforce the role of pharmacies in assisting patients with NRT and quit attempts and explain that a number of pharmacies in Kirklees have in house registered stop smoking advisors.
GP in-house registered community Intermediate Level 2 Stop Smoking Advisor
  • Refer the client to the person/s in your practice who is/are responsible for delivering stop smoking support.
  • If your GP practice does not offer stop smoking support please refer the client to their local pharmacy that offers the support. Please also see the Kirklees council website for stop smoking support and advice
  • A GP in-house intermediate level 2 advisor must be trained and registered with Kirklees Public Health. They will carry out stop smoking support for patients registered with a Kirklees practice according to the Community Smoking Cessation contract for Kirklees.
  • If your GP practice does not offer the stop smoking support to clients currently, but would like to offer it in the future, please contact Kirklees Public Health via email publichealthcommissioning@kirklees.gov.uk.
Pharmacy in-house registered community Intermediate Level 2 Stop Smoking Advisor
  • Refer the client to nearest pharmacy that delivers stop smoking support
  • Please also see the Kirklees council website for stop smoking support and advice
  • A pharmacy in-house intermediate level 2 advisor must be trained and registered with Kirklees Public Health. They will carry out stop smoking support for patients registered with a Kirklees GP practice according to the Community Smoking Cessation contract for Kirklees.
Specialist service
  • There is no specialist stop smoking service in Kirklees.
Training
  • Free online training modules developed by the National Centre for Smoking Cessation and Training ("NCSCT") are available on http://www.ncsct.co.uk/
  • The modules include:
    • Very brief advice on smoking (will take less than 30 minutes to complete)
    • Very brief advice on smoking for pregnant women (will take less than 30 minutes to complete)
    • Practitioner training: core competencies in helping people stop smoking. A more in depth training course covering a range of topics including; statistics on smoking, smoking and health, target population groups, importance of behavioural support and the range of nicotine replacement therapies on the market.

Kirklees Council provide the level 2 intermediate smoking cessation training for GPs, health care professionals and other front line staff.

Referral

Referral Instructions

  • The options available to clients to access advice and support:
    • In person: Patients can contact their GP or pharmacist for support to stop - Please also see the Kirklees council website for stop smoking support and advice
  • If your GP practice or pharmacy is interested in supporting patients to quit smoking but does not currently offer the support, please contact Kirklees Public Health publichealthcommissioning@kirklees.gov.uk to receive the free training and claim against the payment incentive scheme.

Supporting Information

Shared decision making

  • Patients have a right to make decisions about their care and should be fully informed about the options they face. They should be provided with reliable evidence-based information on the likely benefits and harms of interventions or actions, including any uncertainties and risks, eliciting their preferences and supporting implementation. If relevant patients should be signposted to Smoking Cessation decision aid which can be printed off for the patient if required

Patient Information/Public Health/Self-Care

Evidence/Additional Information

Assurance & Governance

  • This guidance was developed on: 05.2017
  • This guidance was ratified by: The OSCAR Assurance Group
  • Date ratified: 06.2017
  • Publication Date: 06.2017
  • Review Date: 05.2019
  • Ref No: RS5 - 05.2017
Any feedback or suggestions to improve this guidance should be sent to: oscaradmin@this.nhs.uk
Only the electronic version is maintained, once printed this is no longer a controlled document

 

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