Achieving best value: Helping smokers quit

Healthcare professionals are uniquely placed to help smokers quit.

As part of the London Clinical Senate’s Helping Smokers Quit programme we invite you to join us on Thursday, 17 March, for an event which will inspire, challenge and give practical support to enable clinicians to add value to every clinical contact by treating tobacco dependence, improving the health of Londoners at an individual and population level. Further information about the programme and its CO4 initiative is available on our website.

Who should attend?

This event is aimed at clinical leaders, decision makers in provider and commissioning organisations, stop smoking specialists, service improvement and trasnformation programme leads and change agents..

Why attend?

• Celebrate success in London and showcase best practice in key areas: leadership, general surgery, respiratory, urology, maternity and mental health services.
• Consider the challenges of delivering change at scale and the benefits if we overcome them
• Share data and discuss ways to address unwarranted variation and embed feedback to clinicians so they know they are making a difference.
• Produce collaboratively the Right Care Pathway for Dependent Smokers: setting out key elements of an effective pathway for tobacco dependent patients and how to incentivise implementation.
• Help to tackle the greatest single cause of avoidable death and health inequalities which costs London’s NHS £416M a year.

Share examples of good practice – win a CO4 Award

A key part of this event is to celebrate and share the excellent work that is taking place across London to support patients attending or admitted to hospital to quit smoking. We have already identified some great examples but we know a lot more is out there.

Please share examples of good practice and innovation in your trust by completing the AWARD FORM (available on our website) and sending it to England.londonclinicalsenate@nhs.net by Friday 26 February 2016.

We will showcase as many examples as we can on the day and make sure that all are acknowledged and available via our website. We will recognise good practice that best demonstrates impact in each of the CO4 areas with an award. Please complete the form and share what you are doing!

Background

• Every year 8,000 people in London die from tobacco dependence – a preventable and treatable condition.
• The 2014 National review into asthma deaths reported that 46% could have been prevented. 1/3 of cases had regular exposure to tobacco smoke and shockingly, deaths where smoking was a factor included child smokers with one as young as ten.
• Improved outcomes are associated with smoking cessation before orthopaedic, cardiovascular, cancer, gastrointestinal, hernia, plastic and day surgery. Non-smoking patients need lower anaesthetic dosages and have fewer experiences of postoperative pain.
• The impact of alcohol misuse on health services, and in particular the ambulance service, is well documented but tobacco smoking has its impact too. A 2013 cross-sectional study demonstrated a higher odds ratio for ambulance call out in male current smokers - than regular strong alcohol drinkers
• Smoking cessation before the initiation of radiation therapy in lung cancer is associated with an increased rate of complete response to treatment compared to those who continue to smoke through treatment.
• Tobacco consumption is the modifiable risk factor contributing most to the development of non-AIDS-defining events among persons living with HIV/AIDS.
• On average 6% of pregnant Londoners smoke but 36% of pregnant teenagers smoke. Significant risks include reduced birth weight, infection and sudden infant death.
• Patients with schizophrenia will die on average 14.6 years earlier, with bipolar disorder will die on average 10.1 years, and with schizoaffective disorder will die on average 8 years earlier than the general population. This is equivalent to expected mortality in the 1950s.Smoking is the most significant contributory factor.
• Estimated deaths of Londoners attributable to smoking were 276 per 100,000 population aged 35+ with a range of 187 to 384 (2011/13 data)
• Nationally, 28% of adult admissions are attributable to smoking. In London 1,606 directly standardised admissions per 100,000 population aged 35 and over are attributable to smoking with a range from 2,534 to 1,223 per 100,000 (2013/14 data)
• There is at least a 10-fold variation by CCG in prescriptions for varenicline, which is a metric for right care for dependent smokers
• There is a variation of annual spend from zero to £4,674 in hospital trust expenditure on varenicline, which is a metric for right care for dependent smokers

These are stark statistics. Yet there are cost-effective interventions available, approved by NICE, which if routinely offered to patients would have a significant impact by supporting and motivating sick smokers to quit. This requires trained staff, medicines on formulary and leadership.

In September 2014 the London Clinical Senate set up its Helping Smokers Quit programme to facilitate this. It aims to ensure every London clinician adds value to every clinical contact by knowing the smoking status of each patient they care for and providing evidence-based interventions to those who are tobacco dependent. The Clinical Senate is asking all health professionals and organisations in London, providers and commissioners, to support its CO4 initiative and has developed a range of materials to assist.