Smoke Free 10.05 SECTION: 10 - HUMAN RESOURCES POLICY AND PROCEDURE: 10.05 NATURE AND SCOPE: SUBJECT: POLICY AND PROCEDURE TRUST WIDE SMOKE-FREE This policy sets out the Trust s commitment and framework for creating and maintaining a completely Smoke-Free environment (buildings and grounds), for the health benefits of all workers, patients and visitors. DATE OF LATEST RATIFICATION: 14 JUNE 2016 RATIFIED BY: HR CORE GROUP IMPLEMENTATION DATE: JUNE 2016 REVIEW DATE: MAY 2017 ASSOCIATED TRUST POLICIES & PROCEDURES: Conduct Policy 10.10 Health, Safety and Welfare Policy 16.01 ISSUE 10 JUNE 2016
UNOTTINGHAMSHIRE HEALTHCARE NHS FOUNDATION TRUST USMOKE FREE POLICY UCONTENTS 1.0 Introduction 2.0 Smoke free: Supporting Evidence 3.0 Policy Scope & Principles 4.0 Implementing a Smoke-Free Environment across the Trust 5.0 E-Cigarettes 6.0 Provisions for Implementing this Policy for Patients 6.4 Inpatient Smokers (see also Appendix 2) 6.5 Community Service Users (see also Appendix 1) 7.0 Staff Responsibilities 8.0 Managers Responsibilities 9.0 Smoking Cessation Support 10.0 Facilitating a Smoke-Free Environment - Visitors & Contractors 11.0 Care Provided by the Trust in Private Homes & Nursing/Residential Homes 12.0 Recruitment, Induction & Fire Training 13.0 Further Information & Support Available For Stopping Smoking 14.0 Target Audience 15.0 Equality Impact Assessment 16.0 Review Date 17.0 Consultation 18.0 Legislation Compliance 19.0 Champion and Expert Writer Appendix 1 Smoke-free Care Pathway for Community Service Users Appendix 2 Smoke-free Care Pathway for In-patients Appendix 3 Employee Record of Having Read the Policy ISSUE 10 JUNE 2016 1
UNOTTINGHAMSHIRE HEALTHCARE NHS FOUNDATION TRUST 1.0 UINTRODUCTION USMOKE-FREE POLICY Smoke-Free 10.05 1.1 The purpose of this policy is to create a completely smoke-free environment within all of the buildings and grounds owned or utilised by the Trust as of 3 October 2016. This policy applies to all staff, patients, service users, visitors, volunteers, carers, contractors and other persons who enter Nottinghamshire Healthcare NHS Foundation Trust owned or rented premises for any purpose. 1.2 This means that smoking tobacco products or using e-cigarettes/vaporisers on our wards and premises, including grounds, will no longer be allowed. This initiative is part of a wider public health strategy which the Trust is working to implement, linked to the health and wellbeing of our workforce, patients, service users, carers and the wider community. Consequently this is a Trust Board priority supported by National Guidance that advises that mental health trusts must become smoke free as soon as possible. 1.3 The aims of this smoke-free policy are to: protect and improve the physical and mental health and wellbeing of staff, patients, visitors and contractors; protect both smokers and non-smokers from the dangers to their health of exposure to second-hand smoke; promote a culture that promotes non-smoking at the norm, where all staff, service users etc. who wish to stop smoking have access to the best support possible to do so; comply with the NICE Public Health Guidance PH48 Smoking cessation in secondary care: acute, maternity and mental health services ; comply with the Public Health Responsibility deal pledge H5 Smoking Cessation/Respiratory Health. 2.0 USMOKE-FREE: SUPPORTING EVIDENCE 2.1 Smoking rates in the UK have dropped to an all-time low of just under 20% in 2015. This said, smoking remains the single largest cause of ill-health and premature death. Smoking rates are much higher amongst people with mental health problems than in the general population. Additionally, smokers with mental health problems tend to smoke more and be more dependent smokers than those in the general population. 2.2 The financial costs of smoking create an estimated economic burden of 2.7 billion per annum for the NHS. The local annual economic burden to NHS Trusts across the East Midlands, directly resulting from smoking related ill-health is approximately 151 million. The local annual economic burden to NHS Trusts across the East Midlands, from the impacts of passive smoking on the health of non-smokers, is approximately 21 million and an economic burden to the Trust of 13,500 hours of our staff time spent each year escorting patients for smoking breaks. ISSUE 10 JUNE 2016 2
1 2.3 The human costs of smokingp0f P includes the premature death of about a half of all life-long smokers, annually around 100,000 deaths in the UK; a reduction in life expectancy of an average of 10 years, compared to non-smokers; a reduction in life expectancy of an average 20 years for smokers who have a serious mental health condition; the cause of around 80% of all deaths from lung cancer; the cause of 80% all deaths from bronchitis and emphysema and 14% of all deaths from heart disease. 2.4 The benefits of promoting smoke-free as the norm in all healthcare premises cannot be underestimated. The primary Human Right is a Right to Life and therefore other choices that limit this are overridden by the right to life. Evidence demonstrates that there is no safe level of exposure to smoking so smoking always limits that right to life. 2.5 Smoking has been prohibited by law in virtually all enclosed, and substantially enclosed, work and public places throughout the United Kingdom since July 2007. Smoke-free legislation in England forms part of the Health Act 2006. From 1 October 2015, private vehicles have been smokefree if they are enclosed, there is more than one person present and one of them is under 18. From this date it has been an offence: for a person of any age to smoke in a private vehicle that is carrying someone who is under 18; for a driver (including a provisional driver) not to stop someone smoking in these circumstances. 2.6 Conclusive evidence identifies that exposure to second-hand smoke (breathing other people s tobacco smoke) causes fatal illnesses including lung cancer and heart disease. Major reviews of the evidence by bodies including the International Agency for Research on Cancer, the UK Scientific Committee on Tobacco and Health, the US Surgeon General and the US Environmental Protection Agency have concluded that second-hand smoke is a major health hazard. Nottinghamshire Healthcare acknowledges that breathing other people s smoke is both a public health hazard and a welfare issue. 2.7 When smoking is allowed anywhere on the premises an additional risk of fire breaking out remains. This has proved particularly problematic for some inpatient services in Local Services and in the Community Forensic Service. The implementation of this policy is therefore also expected to ensure greater fire safety for workers, patients, family and carers. 3.0 UPOLICY SCOPE & PRINCIPLES 3.1 The Trust acknowledges the challenges posed by implementing this Smoke-free Policy and will aim to support those that it affects. 3.2 Once fully implemented, from 3 October 2016, smoking will not be allowed for patients, workers, contractors or visitors within the buildings or grounds. 1 http://www.ash.org.uk/files/documents/ash_94.pdf ISSUE 10 JUNE 2016 3
3.3 Where the policy relates to staff or workers this includes locum, bank, agency, honorary contracts, volunteers, staff in training and seconded staff on either temporary or permanent contracts. 3.4 The policy applies throughout all buildings and grounds owned or utilised by the Trust, whether used by patients or not. Premises include buildings, their entrances and exits. As part of the Trustwide implementation programme for this policy, local determination of site/ground perimeters will be confirmed for staff and patients by the Directorate/Service Management Team. 3.5 The policy applies to all Trust owned or leased vehicles. 3.6 Staff are not allowed to smoke at any time and in any location whilst on duty or whilst overtly identifiable as Trust staff through wearing Uniform/ID badges, etc. 3.7 All staff have a duty to present a professional image, and uphold the public s confidence in the NHS and the Trust. 3.8 Staff should not smoke whilst on duty on any third party sites, e.g. whilst at other NHS premises, prisons or Social Services site. 3.9 All service areas/settings will be smoke-free. 3.10 Staff have the right to ask patients not to smoke whilst they are on home visits to minimise the effects of passive smoking. When care is offered to patients in their own home, there is an expectation that the environment will be smoke free for at least one hour prior to the visit taking place. If the act of smoking is instigated during the visit then the visit will be terminated. In the exceptional circumstance of emergency/urgent care being required, the staff will assess the risks and document their rationale for providing the care. Alternatives for provision of a suitable Smokefree environment for subsequent care will need to be identified.where it is known that there is smoking on the premises, this should be documented in patient notes. See Section 10. 3.11 By following the recommendations of the NICE Public Health Guidance 48, Nottinghamshire Healthcare will ensure: strong leadership and management to ensure secondary care premises (including grounds, vehicles and other settings involved in delivery of secondary care services) remain smoke-free to help to promote nonsmoking as the norm for people using these services; all our hospitals have access to an on-site stop smoking service; we identify people who smoke at the first opportunity, advising them to stop, providing pharmacotherapy to support abstinence, offering and arranging intensive behavioural support, and following up with them at the next opportunity; ISSUE 10 JUNE 2016 4
we provide intensive behavioural support and pharmacotherapy as an integral component of secondary care, to help people abstain from smoking, at least while using secondary care services; continuity of care by integrating stop smoking support in secondary care with support provided by community-based and primary care services; staff are trained to support people to stop smoking while using secondary care services; we support all staff to stop smoking or to abstain while at work; there are no designated smoking areas, no exceptions for particular groups, and no staff-supervised or staff-facilitated smoking breaks for people using secondary care services. 4.0 UIMPLEMENTING A SMOKE-FREE ENVIRONMENT ACROSS THE TRUST 4.1 Nottinghamshire Healthcare is committed to promoting health and reducing 'risk' across all of its services. This policy has been developed to promote health and protect non-smokers. 4.2 For clarity, E-cigarettes/vaporisers are also not to be used on Trust premises. 4.3 Whilst the Trust emphasises that individuals need to take responsibility for promoting their own general health and well-being, support will be provided for staff and patients who wish to give up smoking, providing smoking cessation advice and support to those who request it. 4.4 The Trust recognises the challenges posed by introducing this Smoke-free Policy and acknowledges the practical arrangements required to ensure its full and effective implementation, such as: the provision of awareness/training for clinical staff in assessing and supporting patients to stop smoking, as well as providing smoking cessation as part of the care pathway (see the protocol set out in Section 6 of this policy); the removal of the smoking pods located at Trust sites. 4.5 The specific implementation arrangements for patients, staff, visitors and contractors are detailed separately within this policy, as follows: Provisions for implementing this policy for patients SECTION 6 STAFF/MANAGERS Responsibilities under this policy SECTIONS 7/8 Provisions for implementing this policy for VISITORS AND CONTRACTORS SECTION 10 4.6 This policy has been developed with due consideration to the principles ISSUE 10 JUNE 2016 5
established by the Human Rights Act 1999. 5.0 UE-CIGARETTES 5.1 The Trust currently considers electronic cigarettes in the same way as tobacco cigarettes and does not permit their use on its premises. 5.2 We acknowledge that e-cigarettes are far less harmful than tobacco cigarettes. Although they are arguably a rational choice for patients trying to stop smoking or reduce harm from nicotine addiction, there are complex issues associated with e- cigarette use on inpatient wards that precludes their use in and on Trust premises. 5.3 The Trust will review the policy on a regular basis to ensure that its position is in line with the most up to date recommendations. As and when any licensed e- cigarettes become available, they will be considered for inclusion alongside the more traditional Nicotine Replacement Therapies, for cessation and temporary abstinence. 6.0 UPROVISIONS FOR IMPLEMENTING THIS POLICY FOR PATIENTS 6.1 The Smoke-Free Policy will be implemented for patients in all buildings and grounds with effect from 3October 2016. 6.2 All service users/patients will be informed that the Trust operates a Smoke free Policy at the earliest opportunity, and that they will not be allowed to smoke or use e-cigarettes or vaporisers within any of the buildings and grounds owned or utilised by the Trust when attending for out-patient appointments, if admitted to hospital and whilst a staff member is on a home visit. 6.3 On admission or first contact with Community Service Users, all patients will have smoking status assessed and recorded as either a smoker, recent ex-smoker or non-smoker. Those who are smokers should receive the following Very Brief Advice: Ask - smoker, recent ex-smoker, non-smoker or e-cigarette user Advise current, or recent ex-smokers, should be advised of the benefits of quitting and offered referral to the local stop smoking service; ex-smokers should be advised of the availability of Nicotine Replacement Therapy (NRT) to avoid relapse Act Arrange a referral to a stop smoking service for patients who wish to make a quit attempt (i.e. to stop smoking) 6.4 UIn-patient Smokers See Appendix 2 In-patient smokers who wish to make a quit attempt should be seen by a suitably trained member of staff who can provide access to Nicotine Replacement Therapy (NRT) within 20 minutes of arrival in the clinical area, and arrange ongoing, intensive behavioural support throughout their quit attempt. ISSUE 10 JUNE 2016 6
Inpatient recent ex-smokers or e-cigarette/vaporiser users should be made aware that NRT is available to support temporary abstinence throughout their admission, and offered behavioural support to remain smoke-free. Inpatientsmokers who do not wish to make a quit attempt, should be made aware that NRT is available to support temporary abstinence throughout their admission and offered behavioural support to remain smoke-free. Their readiness to make a quit attempt should be reassessed weekly whilst remaining an in-patient and if they subsequently feel ready to make a quit attempt, on-going intensive behavioural support throughout their quit attempt should be arranged. 6.5 UCommunity Service Users - See APPENDIX 1 Community Service Users who smoke, and wish to make a quit attempt, should be offered a referral to the local Stop Smoking Service and this should be made or arranged for them. Community Service Users who are recent ex-smokers should have the benefits of remaining smoke-free re-enforced, and should be asked if they feel additional support to avoid relapse is needed. Community Service Users who smoke and are not ready to make a quit attempt should be: advised of what help is available to them should they change their mind, and how to access this; Advised that when care is offered to patients in their own home, there is an expectation that the environment will be smoke free for at least one hour prior to the visit taking place. If the act of smoking is instigated during the visit then the visit will be terminated. In the exceptional circumstance of emergency/urgent care being required, the staff will assess the risks and document their rationale for providing the care. Alternatives for provision of a suitable Smokefree environment for subsequent care will need to be identified. Where possible, this advice should be provided as a printed resource that patients/service users receive before a visit or as an addition to appointment letters for home visits and appointments. Reassessed at each contact in relation to their readiness to quit and this recorded. 7.0 USTAFF RESPONSIBILITIES 7.1 Healthcare Professionals are important role models in promoting healthy lifestyles and behaviours to patients, their families and carers: especially children. It is not acceptable, therefore, for staff to be seen smoking whilst on duty or overtly recognisable as a member of staff (for example, when in uniform, or wearing identification, or handling Trust business). 7.2 Furthermore, workers who chose to smoke also expose colleagues, patients and others to the health risks and unpleasant smells associated with smoking. Staff seen/smelt to be smokers, makes it difficult to enforce a Smoke-free Policy for patients/carers. ISSUE 10 JUNE 2016 7
7.3 According to McCullagh (2012); staff who smoke, on average, take six 10-minute smoke breaks each day, which equates to an hour of lost productivity per smoker per day or five hours per week. The additional smoking breaks are often resented by non-smoking colleagues, which can cause tension between staff and lower morale. 7.4 It is recognised that the Trust cannot force staff members to stop smoking altogether. However, it is a requirement that staff refrain from smoking whilst on duty and/or whilst overtly recognisable as working for the Trust. 7.5 Staff are not permitted to smoke within any of the buildings and grounds owned or utilised by the Trust. If staff wish to smoke this is only permitted during official break times; provided entitlement is not exceeded. Therefore the following applies; European Working Time Directive allows, where staff work for longer than six hours, a break of a minimum of 20 minutes in total. All staff are encouraged to take a break, accordingly; staff are not entitled to any additional smoking breaks over and above their entitlement under the European Working Time Directive/rostered break time ; in health and social care workplaces, breaks are taken in a manner consistent with maintaining safe staff levels and managing risk. 7.6 From 3 October 2016, where staff smoke on Trust utilised grounds, or when recognisable as a member of staff, this may constitute a breach of the Smokefree Policy and will be addressed through recourse to the Conduct Policy or Procedure for Maintaining High Professional Standards Policy. 7.6.1 For clarity; for non-medical staff, a first breach of the policy may involve an informal discussion in accordance with the Conduct Policy and a discussion regarding whether support is required to stop smoking. Any further breaches will involve formal action in line with the Conduct policy. 7.6.2 For Medical staff, breaches of the policy may be addressed informally in the first instance with support being offered to quit and then in line with the Maintaining High Professional Standards Policy. 7.7 Staff are expected to report any incidences of breaches of this policy. If safe to do so by initially advising the smokers of the policy and their obligations not to smoke. If they do not feel confident to do so they should report the breach to their line manager or alternative appropriate Senior Manager. 7.8 If staff wish to try to stop smoking, the Trust will offer support to help them achieve this which includes allowing staff to attend stop smoking services for a maximum total of 3 working hours without loss of pay, e.g. an initial 30 minute assessment with weekly 15 minute follow up appointments. Any further interventions required within their employment may be taken as TOIL or annual leave at a time that meets the needs of the service. 8.0 UMANAGERS RESPONSIBILITIES ISSUE 10 JUNE 2016 8
8.1 All Managers are required to support the implementation of the Trust s Smokefree Policy. It is the Manager s responsibility to: ensure that all staff in their area of responsibility are made aware of the Trust s policy; make reference to the Trust s policy in all job descriptions and advertisements. References to the policy will be made in the Trust s employee handbook; ensure that all patients, visitors, contractors, etc. that enter their area of responsibility are aware of the Trust s Smoke-Free Policy and comply with it; ensure that any member of staff or patient within their area who smoke and wish to stop, receive appropriate advice and support on smoking cessation including referral to the New Leaf NHS Stop Smoking Service. deal with any conduct issues related to this policy 8.2 It is recognised that there will be occasions when staff may find it difficult not to smoke during working hours. Managers must ensure that staff experiencing problems are offered the appropriate level of encouragement, support and/or professional assistance including referral to their local Stop Smoking Service. 8.3 Where counselling and support fail and staff breach the policy, managers should refer to the Trust s Conduct policy & procedure, and for Medical Staff, the Maintaining High Professional Standards policy and procedure. 8.4 The Trust has a duty to take steps which are reasonably practicable to protect Workers from the risks they may encounter in the course of their employment. Staff need to be made aware of this policy and in particular section 6.5 when undertaking home visits. Where an individual feels they have been put at risk by entering smoking premises, they should notify their manager and complete an incident form to that effect, which should be followed up as appropriate by the Management team. 9.0 USMOKING CESSATION SUPPORT 9.1 Any worker of the Trust or patient attending a Trust establishment/service who wishes to stop smoking permanently or is experiencing difficulties in abstaining from smoking whilst at work or during their stay is encouraged to contact their local Stop Smoking Service for support/assistance. 9.2 This service is free and provides information, advice and offers a full support program to anyone that would like to quit smoking. This service is provided through regular one to one sessions, groups, or through telephone support for both staff and patients. 9.3 The contact details for local Stop Smoking Services provided across all of the Trust s areas are available on the Intranet. ISSUE 10 JUNE 2016 9
10.0 UFACILITATING A SMOKE-FREE ENVIRONMENT - VISITORS & CONTRACTORS Smoke-Free 10.05 10.1 The Smoke-free Policy will be implemented for visitors and contactors in all Trust buildings and grounds with effect from 3 October 2016. 10.2 The staff member inviting visitors and contractors onto Trust premises should make them aware of the Trust s Smoke-free Policy and ensure compliance. 10.3 Where staff observe a visitor smoking on Trust premises, if they feel safe to do so, they should make the visitor aware of the Trust s Smoke-free Policy and ask them to stop smoking. If the visitor does not comply with the policy they should be asked to leave the premises. If the staff member does not feel safe to speak directly to a visitor the staff member should refer to an appropriate senior manager or where applicable the security team. 10.4 Where a contractor has a specific closed compound, the Trust s contractual requirement will be that the contractor has in operation a comparable Smoke Free Policy. 10.5 Where staff observe a contractor smoking on Trust premises, they should make the contractor aware of the Trust s Smoke-Free policy and ask them to stop smoking. If the contractor does not comply they should report the contractor to the relevant department. 11.0 UCARE PROVIDED BY THE TRUST IN PRIVATE HOMES AND NURSING/RESIDENTIAL HOMES 11.1 When care is offered to patients in their own home, there is an expectation that the environment will be smoke free for at least one hour prior to the visit taking place. If the act of smoking is instigated during the visit then the visit will be terminated. In the exceptional circumstance of emergency/urgent care being required, the staff will assess the risks and document their rationale for providing the care. 11.2 Alternatives for provision of a suitable Smokefree environment for subsequent care will need to be identified. 12.0 URECRUITMENT, INDUCTION & FIRE TRAINING 12.1 Reference will be made to the Trust s Smoke-Free Policy in all job descriptions, person specifications, advertisements, interviews and in the contract of employment. 12.2 All tenders and contracts will also stipulate adherence to this policy as a contractual condition as a smoke-free Trust. 12.3 All staff induction sessions will include information and reference to the Smokefree Policy. ISSUE 10 JUNE 2016 10
12.4 All fire lectures will refer to the Smoke-free Policy and the reasons for its implementation. 13.0 UFURTHER INFORMATION & SUPPORT AVAILABLE FOR STOPPING SMOKING Smoke-Free 10.05 13.1 Information on stop smoking support from local stop smoking services will be provided for smokers (patients/service users, workers, carers and visitors) in the Trust. For information on local stop smoking services go to 33TUwww.nottinghamshirehealthcare.nhs.uk The NHS Smoking Helpline number is also available, 0300 1231044. The helpline can offer advice and support on stopping smoking along with a website at Uwww.nhs.uk/smokefree 14.0 UTARGET AUDIENCE 14.1 All Trust employees, workers, patients/service users, visitors, private contractors or any other persons entering Trust facilities. 15.0 UEQUALITY IMPACT ASSESSMENT 15.1 This policy has been screened to identify its relevance to equality and diversity. 16.0 UREVIEW DATE 16.1 The policy will be reviewed as a minimum 1 year following implementation or in light of organisational, clinical or legislative changes. 17.0 UCONSULTATION 17.1 Internal: Smoking Cessation Group, ELC, Executive Team and Core Group. 18.0 ULEGISLATIVE COMPLIANCE 18.1 PH48, NICE Guidance. Health Act 2006, Choosing Health: Making Healthy Choices Easier. The Case for a Completely Smoke-Free NHS in England, Guidance for Smoke-Free Hospital Trusts. 19.0 UCHAMPION AND EXPERT WRITER 19.1 The Champion of this policy is: Chris Packham, Associate Medical Director and Clare Teeney, HR Director. The Expert Writer is Alexandra Lyon, Corporate HR Advisor. ISSUE 10 JUNE 2016 11
APPENDIX 1 USmoke-free Care Pathway for Community Service Users Action 1 At first contact provide all patients with written & verbal information of the Trust s Smokefree policy Action 2 Implement 3A s ASK ADVISE ACT Action 3 YES ASK & record Do you smoke or are you a recent ex-smoker? Check ex-smokers are confident with maintaining their quit at present Action 4 NO ADVISE Ex-smokers that support is available if needed to help remain smoke free The best thing you can do is stop for good and we can arrange help for you to try Reinforce the benefits of being Smokefree and ensure patient is not exposed to second hand smoke Explain the effect on some medications and stress levels I can arrange help for you to try and stop. Would you like me to do that? Offer of support declined Offer of support accepted Action 5 ACT Refer to the stop smoking service for provision of pharmacotherapy and intensive behavioural support. Document Reassure that they are not under pressure to stop but reiterate they will not be able to smoke while in hospital,and that Nicotine Replacement Therapy (NRT) can be provided to help manage their nicotine dependence whilst they are an in-patient. Document If patient relapses re-enter pathway at Action 4 Action 6 ISSUE 10 JUNE 2016 12 Complete Fagerstrom test for nicotine dependence if possible, ensuring result accompanies patient on admission (possible Rio development). For planned admission arrange supply of NRT obtained through GP prescription where possible
USmoke-free Care Pathway for In-patients APPENDIX 2 Action 1 At first contact provide all patients with written & verbal information of the Trust s Smokefree policy Action 2 Implement 3A s ASK ACT ADVISE Action 3 YES ASK & record Do you smoke or are you a recent ex-smoker? Check ex-smokers are confident with maintaining their quit at present NO Commence Nicotine Management plan with short term supply of Nicotine Replacement Therapy (NRT) following the protocol Once NRT given to good effect, and patient is more settled continue with 3 A s Action 4 Reinforce the benefits of being Smokefree and ensure patient is not exposed to second hand smoke Offer of support accepted ADVISE Ex-smokers that support is available if needed to help remain smoke free The best thing you can do is stop for good and we can arrange to help you try while you re here. Explain the effect on some medications and stress levels I can arrange help for you to try and stop. Would you like me to do that? Offer of support declined ACT Refer to the appropriately trained member of staff who can assist Medics with recommendations for on-going pharmacotherapy and intensive behavioural support for the length of the in-patient stay On discharge, ensure on-going support is arranged through referral to Stop Smoking Service and that one week s supply of NRT is given as TTO. Document referral See ISSUE reverse 10 information JUNE 2016 sheet for Stop Smoking 13 Service contact details Action 5 Action 6 Reassure that they are not under pressure to stop but reiterate they will not be able to smoke while in hospital, and that Nicotine Replacement Therapy (NRT) can be provided to help manage their nicotine dependence whilst they are an in-patient. Review and reassess NRT effectivity and motivation to quit recording weekly. Refer to the appropriately trained member of staff who can provide on-going pharmacotherapy and intensive behavioural support for the length of the in-patient stay
P March P 2007 Smoke-Free 10.05 APPENDIX 2 The Policy/Procedure for: SMOKE-FREE Issue: 10 Status: Author Name and Title: APPROVED Alexandra Lyon, Corporate HR Advisor Issue Date: 22 JUNE 2016 Review Date: MAY 2017 Approved by: HR CORE GROUP URECORD OF CHANGES DATE AUTHOR POLICY DETAILS OF CHANGE 11/06 J Fleet/ I Cormac PE/14 Replaces the No Smoking Policy References to April 1P replaced to 01/07 J Fleet/ I Cormac PE/14 st read 31P 2007 (section 4.4, 5.1,6.2 and 6.8) References to Occupational Health/GP 02/07 J Fleet /I Cormac PE/14 replaced with New Leaf /Stop Smoking Services 03/07 J Fleet/I Cormac PE/14 Amendment to paragraph 5.4 04/07 J Fleet/I Cormac PE/14 Amendment to paragraph 5.5 & para 7.4 01/09 M Harris PE/14 Amendments to introduction, paras 1.1; 2.0; 2.2.1; 2.3.1; 2.4.1; 3.2; 3.6; 3.7;4.3; 5.2; 6.7; 18.1; 18.2;Appendix2 05/09 M Harris PE/14 Amendment at para 1.1 (addition of last sentence) 25/1/10 M Harris Amendment to 18.1 (new Exec Director of 14.21 Nursing and AHPs) and change to policy (Issue 7) number. 12/12/12 M Harris 14.21 (Issue 8 ) Update to Appendix 1 only 18/02/13 M Harris 14.21 (Issue 9) Deletion of timescale at 6.5 st May 14 M Harris 10.05 Nov 15 A Lyon 10.05 Changes to policy number and other Trust relevant policy numbers to reflect changes Changes throughout to reflect PH48 Guidance, including strengthening of guidance for staff, managers and carers. Change of Author and Champion. ISSUE 10 JUNE 2016 14
EMPLOYEE RECORD OF HAVING READ THE POLICY APPENDIX 3 UTitle of Policy/Procedure:U SMOKE-FREE I have read and understand the principles contained in the named policy. PRINT FULL NAME SIGNATURE DATE ISSUE 10 JUNE 2016 15