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Smoking is one of the biggest avoidable causes of health inequalities, disease and premature death in the United Kingdom (Allender, 2009). It increases the risk of developing more than 50 serious health conditions including cancer, heart disease, heart attacks and stroke and on average, smokers live ten years less than non-smokers, having huge implications for health inequalities.
Smokers see their GP over a third more often than non-smokers and smoking is linked to nearly half a million hospital admissions each year. The NHS Long Term Plan has committed to prevent smoking related disease by systematically screening and treating people with tobacco dependence across NHS inpatient, maternity and mental health services, with all people admitted to hospital who smoke offered NHS funded tobacco treatment services by 2024.
This NHS investment is in addition to services provided by local government stop smoking services. Despite more people attempting to give up smoking there has been a rise in smoking rates in some groups during the pandemic. Some people who want to quit may not be able to take up support if the service being offered to them isn’t convenient, which perpetuates ill-health and widens health inequalities.
Yesterday was No Smoking Day and I’m delighted that from today (10 March 2022), a new service is being introduced across England to enable people leaving hospital to access support for their tobacco dependence through a local community pharmacy at a time convenient to them.
Pharmacy teams based within the heart of local communities have always had a key role as one of the first ports of call for people wanting advice or practical support with their health.
Over the past 18 months, the Royal Oldham Hospital working together with 12 community pharmacies and the NHS England Pharmacy Integration programme has been testing this approach. The hospital refers patients who have started to receive support to quit smoking whilst in hospital to a community pharmacy so they can continue their treatment easily and conveniently when they return home. The pharmacies used a 12-week evidence-based treatment pathway which was found to be effective and welcomed by people who smoke.
Following successful evaluation of this pilot and after consulting stakeholders, we are now making this referral pathway available across England.
Hospitals and community pharmacies will agree how they will make and receive the referrals, with the hospital referring the patient when they are discharged to their nearest chosen community pharmacy offering the service. Treatment options include behavioural support via private consultation and nicotine replacement therapy over a 12-week programme.
This new referral route from hospital to community pharmacy increases choice and access to support for people who want to stop smoking, whilst better integrating community pharmacy with other health care services to improve the long-term health of local people and reducing health inequalities.
The service will be in addition to smoking cessation services provided by local authorities, which can be accessed through self-referral, local pharmacies or GPs.
From March 2022 a new pilot is also being introduced to expand the scope of this community pharmacy tobacco dependence treatment service by taking referrals of pregnant women from maternity services in Nottingham who want support to stop smoking.
We hope that this closer integration between services will trigger quit attempts in hundreds of thousands of people who smoke across England. NHS and local government stop smoking services will play an important role in providing high quality, effective and accessible treatment that will reduce smoking related ill-health and health inequalities, contributing to England’s smoke free 2030 ambition.
Background and context:
In recent years community pharmacists have been testing and delivering additional clinical services, including taking referrals from GPs and NHS 111 as appropriate, and offering a hypertension case finding service to the over 40s.
Every pharmacy in England is now a ‘Health Living Pharmacy’ and responsible for promoting healthy lifestyles, either through individual conversations and ongoing consultation or by sharing information and signposting to other services. This could include advice on healthy eating, exercise or stopping smoking, to help people make healthier choices.