WOLVERHAMPTON CITY PRIMARY CARE TRUST Meeting: 5 th June 2007 Subject: Report of: Smoke-Free Public Places Director of Public Health 1. Purpose of Report 1.1 To inform the Board of the forthcoming ban on smoking in public places and the implications for the Primary Care Trust 1.2 To outline how the PCT is working to effectively implement the new legislative requirements. 1.3 To describe how the PCT and City Council are collaborating to implement the legislation cross the city. 2. Recommendations 2.1 That the Board notes: The scope of the new Smoke-free legislation The impact of the law on the PCT The work that the PCT and City Council have undertaken within the City to ensure smooth implementation of the law The risks identified in 9.1 9.3 2.2 That the Board agrees the proposals identified in 8.1 8.5 3. Detail 3.1 The Health Act 2006 received Royal Assent in July 2006. Section 2 of the Act provides for a comprehensive ban on smoking in workplaces and enclosed or substantially enclosed premises which are open to the public in England, now known as the Smoke-free law. This law will be introduced on 1 st July 2007. Smoking is recognised to be the greatest single cause of preventable illness and premature death in Wolverhampton, directly killing 450 people per year. The main aim of the legislation is to reduce exposure to secondhand tobacco smoke, especially by employees. Smoking in public places reduces the choice available to people using the public realm especially the many in Wolverhampton who have chronic lung disease, including children with asthma. This Smoke-free legislation is seen as one of the most significant developments in protecting public health for many decades. All employers have a duty to protect its staff and users of services from the effects of tobacco products and second hand smoke. This PCT and the City
Council is committed to providing a safe, healthy and smoke-free environment for staff, service users and the general public including visitors. There are compelling reasons for employers to actively support this law: Smokers take about twice as much sick leave as non smokers; nationally approximately 34 million working days are lost each year as a consequence of smoking. Insurance costs are greater where smoking is allowed. Fifteen per cent of all fires in industrial premises arise from smoking materials. Cleaning costs are higher in work places where smoking is allowed because of increased litter, dirtier walls and damage to furnishings. Reducing the risk of litigation by employees whose health has deteriorated due to exposure to tobacco smoke. Most employees want a smoke-free working environment 4. The Legislation 4.1 Key Aspects This law will introduce a smoking ban in buildings and vehicles for operators, staff, drivers, customers and visitors if: They are open to the public and/or They are used as a place of work and They are enclosed or substantially enclosed. The Government has now published five sets of Statutory Instruments relating to the Smoke-free regulations that are to be made under the Health Act 2006 (Full details can be accessed by visiting: www.opsi.gov.uk): 1. The Smoke-free (Premises and Enforcement) Regulations, 2. The Smoke-free (Signs) Regulations, 3. The Smoke-free (Exemptions and Vehicles) Regulations, 4. The Smoke-free (Penalties and Discounted Amounts) Regulations, and 5. The Smoke-free (Vehicle Operators and Penalty Notices) Regulations. 4.2 Exemptions to the Act Draft regulations propose that the following premises will not be required to be smoke-free: Private accommodation and vehicles Designated bedrooms in hotels, guest houses, inns, hostel, and member s clubs. Certain residential accommodation eg. Care homes, hospices. Performers, where artistic integrity of a performance makes it appropriate. Specialist tobacconists Prisons Offshore platforms Research and testing facilities
The regulations allow for a temporary exemption for residential mental health units which will cease on 1 st July 2008 (after this date, all residential mental health units will be required to be smoke-free in any enclosed parts). Wolverhampton PCT already has a Smoke-free policy covering the Penn site. This is compliant with the full legislation. 4.3 Compliance & Penalties The Act provides for the following offences:- Smoking in a smoke-free place (which includes premises, additional places and vehicles). Permitting others to smoke in non-smoking premises. Failing to display no-smoking signs Obstruction of officers, including failure without reasonable cause to give name and address. Enforcement of the smoke-free legislation will fall to Wolverhampton City Council Environmental Services department. Failure to comply with the Law will be a criminal offence. Individuals may be issued with a fixed penalty notice of 50 (reduced to 30 if paid within 15 days), for smoking in a smoke-free premise. The manager or person in control of any smoke-free premise could be prosecuted for allowing others to smoke with a fine of up to 2,500, unless it can be demonstrated that: They could not reasonably have known smoking was taking place, or All reasonable steps to prevent the smoking taking place had been taken. He/she may also be issued a fixed penalty of 200 (reduced to 150 if paid within 15 days) for failing to display warning notices in smoke-free premises. 5. Impact on the PCT as an employer legislative duties 5.1 Signage The legislation is prescriptive regarding signage and the PCT has a legal duty to display no-smoking signs that meet the requirements in buildings and vehicles that are subject to the law. The Department of Health and Smokefree England will make signs that meet the requirements of these regulations available free of charge (in reasonable quantities). The implications for buildings are reasonably clear but slightly less so for vehicles. The rules for the latter are based on the potential for some-one to be exposed to second-hand smoke. Thus a vehicle used for transporting the public must be smoke-free. Similarly a vehicle used for work purposes which is used by more than person (not necessarily at the same time, e.g. different shifts) must also be smoke free.
Vehicles used primarily for private purposes are excluded. There is a grey are for vehicles used for work and private measures (i.e. not primarily private use). Legal advice is being sought for vehicles which are subject to regular user status including vehicles which the PCT financially supports through the lease scheme as these by definition have a substantial work element. Any vehicle which carries a passenger for work business must be smoke-free. The PCT encourages the efficient use of transport and may need to consider the implications on its travel policy. 5.2 Compliance & Penalties It is recommended that each PCT site has a nominated officer accountable for ensuring compliance, although the PCT will need to consider potential implications related to whistle blowing. Accountability should be through the Health and Safety Committee. The Head of Estates should be responsible for signage. 6. Impact on PCT staff 6.1 Challenging smokers There will be occasions when staff will be required to challenge smokers. Staff should remind the patient and or visitor of the PCT s No Smoking Policy and the No Smoking notices displayed in the area. The individual should be asked firmly and politely to extinguish the cigarette or smoke away from PCT premises and grounds. 6.2 Smoking cessation support In order to assist employees to comply with the smoking policy, staff who smoke will be offered the opportunity to attend a smoking cessation programme including time off to attend once per week for the 6 week programme. The specialist Stop Smoking Service based at 10E West Park Hospital site can be contacted on 0800 073 4242 or 4246. 6.3 Community Staff The PCT maintains the right to protect the health of its community staff and not to submit them to smoky environments. Patients will be requested not to smoke in their homes whilst they are being treated by community staff. If patients refuse then staff will be encouraged to speak to their line manager and patients will be requested to attend for treatment at an alternative venue where reasonably practical. The PCT proposes to adopt the 2006 Royal College of Nursing (RCN) best practice guide Protecting Community Staff from Second Hand Smoke. 7. Actions with City Council Smoke-free Wolverhampton
7.1 Publicity During the countdown to July 1 st the PCT will continue to work with partners including the Royal Wolverhampton Hospitals NHS Trust. A var iety of communication channels, including Stop Press will be used to ensure that staff are made aware and reminded of the implications which include the following: Staff, visitors and patients are not allowed to smoke whilst on duty, in the buildings or the grounds within 15 metres of the premises. Staff are only entitled to their normal unpaid breaks i.e. lunchtime, additional smoking breaks are not allowed. That from the 1 st July, in law, there will be fixed penalty notices to individuals, and managers could be prosecuted for allowing others to smoke in smoke free areas. Further promotion of smoking cessation There will be a national campaign by the Department of Health. However, Wolverhampton City Council (Environmental Services) in partnership with the PCT has developed a Health Act action / campaign plan to educate and raise awareness of the implications of the Act across Wolverhampton. 7.2 Working with Employers The PCT and City Council received Neighbourhood Renewal Funding to target businesses in our priority neighbourhoods and this work has allowed us to make good preparations for the smoke-free law. All employers in the city have received both written and electronic information on the law, its implications for business as well as signs etc. Targeted work has occurred with taxi drivers and licensed premises. Localised visits and publicity has started with business parks and industrial units, especially in the Priority Neighbourhoods. This has been supported by focussed advertising using resources shared with our Black Country partners. A full action plan and communication strategy is available for review. 7.3 Supporting Cessation An analysis of the experience in Scotland has revealed that in the three months before the introduction of the ban on smoking in public places the number of people wanting to quit before the ban almost doubled in some parts of the country. We are already experiencing increased demand, especially from local businesses. In order to address the need to provide more capacity the PCT is establishing a smoking cessation intermediate advisor bank to provide for Saturday opening at the shop and the increase in demand currently being seen from workplaces. Utilising bank staff is seen as the most sensible option as Scottish services reported that the number of people accessing services dropped fairly quickly once the ban was in place.
8. Proposals 8.1 That each site has a nominated member of staff responsible for ensuring compliance with the legislation and reports through the Health and Safety Committee. 8.2 That the head of estates is responsible for signage within the PCT. 8.3 That the PCT maintains its current policy regarding its mental health unit 8.4 That the PCT adopts the RCN policy for community workers 8.5 That the PCT reviews its legal obligations for regular car and lease car users. 9 Risk Assessment 9.1 The key risks to the PCT are: complying with the legislation providing enough support to help people quit in the run-up to its introduction. 9.2 The risk regarding non-compliance is well controlled as we have had 18 month experience with our smoke-free policy and have sufficient health and safety controls in place. 9.3 Providing enough quit support is mainly reliant on adequate human resources. We believe we can provide an enhanced city centre service and also new services at key sites such as Supermarkets as well as maintaining services at Bilston. We continue to provide a bespoke service to employers across the city. This is reliant on recruiting trained staf to our bank. Experience to date suggests that this risk is moderately well controlled.