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07.12.16

All STPs urged to help patients quit smoking

The heads of all NHS trusts have been urged to use their sustainability and transformation plans (STPs) to help patients quit smoking.

Duncan Selbie, chief executive of Public Health England (PHE), wrote to the trust chief executives asking for a “personal commitment” to “a tobacco-free NHS”.

PHE has published a Menu of Preventative Interventions for STPs, which asks them to make a number of commitments to reduce smoking in order to protect the health of their populations and reduce the cost to health services.

Smoking led to 475,000 hospital admissions in 2014-15, a 5% increase over a decade. It also costs the NHS £2bn and social care £1.1bn.

STPs are recommended to ensure that the care plan of all patients who smoke addresses their tobacco dependence, and to screen pregnant women for smoking via carbon monoxide monitoring and refer them to services to help them stop.

Where patients are unwilling to stop smoking at once, the guidance recommends ways of reducing the harm from smoking, including temporary abstinence, cutting down to quit and long-term nicotine use to prevent relapse.

The letter also called for all acute, mental health and maternity trusts to make their estates completely smoke-free.

NICE has already published guidance on introducing smoke-free NHS buildings and grounds and helping patients stop smoking, but Selbie said that progress in implementing these has been “very variable”.

The British Thoracic Society (BTS) will soon publish the first-ever comprehensive audit of smoking cessation activity. In addition, from 2017-18 community and mental health trusts will be required to publish information on the smoking status of all their patients, followed by acute trusts in 2018-19.

The recommendation comes at a difficult time for STPs. Jim Mackey, the chief executive of NHS Improvement, said yesterday that the plans are failing to make a business case for short-term investment, and Chris Hopkins, chief executive of NHS Providers, has said they risk “blowing up” because of unachievable goals.

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