Reducing smoking in pregnancy in the West Midlands

Transcription

1 Reducing smoking in pregnancy in the West Midlands Nigel Smith, Health Improvement Manager Public Health England West Midlands

2 Public Health England Mission To protect and improve the nation s health and to address inequalities, working with national and local government, the NHS, industry, academia, the public and the voluntary and community sector. Objectives (2 of 8) Helping people to live longer and more healthy lives by reducing preventable deaths and the burden of ill health associated with smoking, high blood pressure, obesity, poor diet, poor mental health, insufficient exercise, and alcohol Supporting families to give children and young people the best start in life.

3 Smoking in Pregnancy: Risks and Impacts Smoking is the main modifiable risk factor in pregnancy and associated with a range of serious problem, including: Complications during labour; increased risk of miscarriage; premature birth; still birth; low birth-weight; sudden unexpected death in infancy It also increases the risk of: respiratory conditions attention and hyperactivity difficulties learning difficulties problems of the ear, nose and throat obesity and diabetes Each year it causes up to: 5,000 miscarriages 2,200 premature births 300 perinatal deaths (in the UK) Royal College of Physicians, 2010

4 Smoking in Pregnancy: England Smoking at time of delivery (SATOD) England 10.6% 70,000 babies born to mothers who smoke Geographical variation: 1.8% NHS West London to 31% in NHS Blackpool Data quality remains a concern e.g. methods of collection Disparities between SATOD data and related outcomes e.g. infant mortality Change in definition: removing those with unknown status from the baseline Royal College of Physicians, 2010

5 Smoking in Pregnancy: West Midlands Smoking at time of delivery rates (SATOD) 25.00% 20.00% 15.00% 10.00% 5.00% 0.00% Public Health Outcomes Framework Birmingham, Herefordshire, Solihull, Staffordshire, Walsall, Warwickshire not included due to data quality

6 NICE Guidance PH 26 8 Recommendations requiring action across the healthcare system. Identifying pregnant women who smoke (CO screening) and referring them to NHS Stop Smoking Services Contacting referrals and delivering support Use of NRT and other pharmacological support Meeting the needs of disadvantaged pregnant women who smoke Partners and others in the household who smoke Training to deliver interventions Strong national commitment & collaborative action across PHE, DH & NHS England Smokefree Pregnancy Champions Professor Viv Bennet (Chief Nurse, PHE); Professor Jacqueline Dunkley-Bent (Head of Maternity, NHS England)

7 Drivers Sustainability and transformation plans (STPs) A new tobacco control strategy for England Saving babies lives: a care bundle for reducing stillbirth Maternity transformation programme Smokefree hospitals Smokefree prisons European Tobacco Products Directive (TPD) Standardised plain packaging Minimum of 20 cigarettes per pack Ban on flavoured tobacco / menthol New rules on e-cigarettes

8 Self Assessment Toolkit Developed by PHE West Midlands, East Midlands and East of England Objective: To assess the collective actions of X local authority(s), CCG(s), NHS trusts and stop smoking service providers in respect of reducing smoking in pregnancy rates. Questions about networks, strategy and leadership; communications; Planning and commissioning; Training, referral pathways and service provision. Best undertaken at the same table at the same time with the NHS trust, CCG and local authority present. Has been undertaken in the last year across 50% of our local authority areas in the west midlands To work there has to be open and honest communication about how services, systems and processes are performing and a commitment to improve together.

9 On-line training resources NCSCT (open access) RCM (members only)

10 Communications Health Matters: Giving every child the best start in life Blogs: Viv Bennett, Chief Nurse Advice on e- cigarettes & vaping Start4Life & Smokefree

11 Challenge Group Resources The Smoking in Pregnancy Challenge Group continues to provide evidence based materials and resources to support local areas to implement NICE Guidance - Reports & recommendations Electronic cigarette: Q&A for HCP s & info for women Mapping report Shared Key Messages CO briefing & leaflets

12 Smokefree hospitals plea December 2016 and March 2017 PHE CEO Duncan Selbie wrote to all NHS Trusts encouraging them to go smokefree / stay smokefree. We re asking all strategic clinical networks and other clinical forums in the West Midlands to support their NHS Trust(s) to go or stay smokefree (buildings and grounds). 25% of hospital patients are smokers Tobacco is the single biggest cause of premature death in England It costs the NHS an estimated 2 billion every year and another 1.1 billion in social care

13 Summary Smoking in pregnancy remains the main modifiable risk factor for a range of poor pregnancy outcomes. Action to support all women to have a smokefree pregnancy is vital to achieving national and local ambitions. There is evidence and guidance to assist the challenge is now to ensure this is systematically and sustainably implemented across the WHOLE system. Further research is needed to identify new ways of engaging women (and their families), supporting them to stop and stay smokefree, use of medications, the role of e-cigarettes and the delivery of interventions. The new Tobacco Control Plan for England, NHS Five Year Forward View and Sustainability and Transformation Plans provide opportunities to further develop policy and embed a systematic approach into routine practice. Stop smoking interventions saves lives (and money) in the short, medium and longer term. Partnership is key to effective and sustainable action, including; clinical, commissioning, safety, finance and performance teams.

14 Thanks to Jo locker, PHE Tammy Coles (PHEEM) and Neil Wood (PHEEE) References ASH NICE, PH 26 Public Health Outcomes Framework Royal College of Physicians