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Corporate
Developing a smokefree
organisation
Jane Beenstock,
Public health
consultant
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Developing a smokefree organisation
Why? How? The challenges
Corporate
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Lancashire Care NHS Foundation Trust (LCFT)LCFT provides health and wellbeing services for a population of around 1.5 million people within the Lancashire and South Cumbria footprint, including specialist commissioned services for the wider population of the North West region.
Our range of services includes a portfolio of integrated physical and mental health services, with both inpatient and community provision, across children and adults.
We currently employ around 7,000 staff across more than 400 sites.
The map shows the footprint of LCFT and the CCG boundaries along with the local authority boundaries.
CCG Key Lancashire North
East Lancashire
Greater Preston
Fylde & Wyre
Blackpool
Chorley & South Ribble
West Lancashire
Blackburn with Darwen
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Corporate
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Major causes of death in England
Corporate
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Corporate
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Why?
CorporateSource: Public Health England
44,000 fewer deaths would
occur if people with SMIs had the
same mortality rate as the
general population
(1) Chang C-K, Hayes RD, Perera G, Broadbent MTM, Fernandes AC, et al. (2011) Life Expectancy at Birth for People with Serious Mental Illness and Other Major Disorders from a Secondary Mental Health Care Case Register in London. PLoS ONE 6(5): e19590. doi:10.1371/journal.pone.0019590(2) Brown S, Kim M, Mitchell C et al (2010) Twenty-five year mortality of a community cohort with schizophrenia. British Journal of Psychiatry 196:116-21.
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The untold storyThis corresponds to LE in
1950s in general population!
Chin-Kuo Chang et al May 2011
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Corporate
Source: Public Health England
Smoking prevalence
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20
Mins
Your blood pressure and pulse rate return to normal
8
Hours
Nicotine and carbon monoxide levels in your blood half, oxygen levels return to normal
24
Hours
Your lungs start to clear out mucus and carbon monoxide is eliminated.
48
Hours
There is no nicotine in the body. Ability to taste and smell is greatly improved
72
Hours
Your breathing becomes easier and energy levels increase
3-9
Months
Improvement with coughing, wheezing and breathing, lung function is increased by up to 10%
5
Years
Risk of stroke falls to about the same as a non-smoker
10
Years
Risk of lung cancer falls to half that of a smoker and risk of heart attack falls to the same as a non-smoker
Corporate
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Corporate
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How? The components of implementation
Corporate
EvaluationAgreement Communication & engagement
Training & support
EstatesPolicy & procedures
Agreement from executive team to implement NICE
guidance and become completely smokefree,
establish budget and project lead. Establish implementation
team and plan
Establish detailedcommunication plan
(internal and external stakeholders). Gather
baseline views of staff to help with developing
briefings
Monitor the impact of implementation and refresh as and
when required
Develop policies and procedures, seeking
legal advice if required
Develop smokefree champion training
and support, deliver training to staff across the trust
Remove all smoking shelters and bins. Erect signs across
trust buildings and sites
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Timeline - based on the Scottish plan*
14*Nicholson, N. 2011. Smoke-free mental health services in Scotland Implementation guidance. NHS Scotland. Accessed 20.6.14. http://www.healthscotland.com/documents/5041.aspx
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Challenges
Training and NRT Culture - mixed views among staff
and service users The media Relations with neighbours Reframe smoking e-cigarettes
Corporate
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Challenges: training and NRT
Time to release staff Knowledge and skills to use NRT
Corporate
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Challenges: culture
• animation
Corporate
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Corporate
http://www.youtube.com/embed/-5yYbVDw_dw
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Challenges: the media
Corporate
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Challenges: reframing
Corporate
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Corporate
An addiction is not a choice
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Corporate
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Corporate
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Challenges: e-cigarettes
Corporate
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Successes
Service user engagement New ways to communicate
Corporate
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Service user involvement
• Focus groups held to discuss the policy
• Animation designed by service users for service users
• Posters designed by service users
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Image designed by a service user and used on posters to promote the trust going smokefree
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5th January 2015 Nicotine Management Policy introduced
“Staff and other service users supported and helped me first give up cigarettes and then reduce my addiction to nicotine. They believed in me
and eventually so did I. I say “I can beat cigarettes they no longer own me!” (Guild service user)
Feedback from service users has resulted in policy updates
Quit rate = 26% of (95) service users at Guild Lodge who were seen in clinic as attempting to quit
Service users who had quit smoking were presented with a certificate and vouchers
by the Trust’s Chief Executive Heather Tierney-Moore, who said:
“It was a delight to be able to present the service users with their awards and mark such a fantastic achievement. To be able
to stop smoking is a great achievement. It was good to hear about their stop
smoking journeys and the reasons behind wanting to quit, which included both
health and financial benefits.”
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Acknowledgments Andy Hesketh, Human Resources Advisor Barbara Hummer, Brian Lawson, Staff Side Lead Rep, Staff Governor Caroline Waterworth, Deputy Clinical Director, Children and Families Dawn Kenyon, Quality Improvement and Experience Senior Officer Gareth Lewis, Clinical Specialist Nurse Gillian Penson, Psychologist Heather Harrison, Stop Smoking Service Lead Jacquetta Hardacre, now Tania Derbyshire, Project Manager for Medical Directorate John Pascoe, Programme manager for fire, H&S, estates and facilities Tracy Topham, Stop Smoking Service Lead Julie Trezise, Stop Smoking Service Manager Lorna McGlynn, Physical Health Care Lead Nafisa Motora, Administration Support to Consultants in Public Health Pam Tester, NICE Implementation Lead Paul Morris, Risk Manager and Staff Governor Sarah Regan, Communications Officer Catherine Harding, Lead Pharmacist Yvonne Guilfoyle, Practice & Quality Development Lead, Adult Mental Health Network
Corporate
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32
Service user animation
https://youtu.be/sPq6Z9yWP3Y
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How? The components of implementation
Corporate
EvaluationAgreement Communication & engagement
Training & support
EstatesPolicy & procedures
Agreement from executive team to implement NICE
guidance and become completely smokefree,
establish budget and project lead. Establish implementation
team and plan
Establish detailedcommunication plan
(internal and external stakeholders). Gather
baseline views of staff to help with developing
briefings
Monitor the impact of implementation and refresh as and
when required
Develop policies and procedures, seeking
legal advice if required
Develop smokefree champion training
and support, deliver training to staff across the trust
Remove all smoking shelters and bins. Erect signs across
trust buildings and sites