Leicestershire Partnership NHS Trust provides high quality integrated mental health, learning disability and community health services mainly for people living in the city of Leicester and the neighbouring counties of Leicestershire and Rutland.
As part of their commitment to the health and wellbeing of their patients and staff, the Trust started working towards going smokefree in April 2015. A core part of their service is caring for people with mental health problems, a group who are much more likely to smoke, and to smoke more heavily, than the general population, leading to poorer physical health and lower life expectancy.
The Trust set up a smokefree action team comprising of relevant representatives across the organisation including health and safety, premises communications, pharmacy, clinical areas, stop smoking services and organisational development.
Getting everyone on board
A key factor in driving the team forward and ensuring everyone was on board was the exceptional support and buy in from the Trust’s executive team. The smokefree action team met every six weeks to drive the smokefree policy forward, deliver on actions and looked to other smokefree Trusts for support and guidance, particularly South London and Maudsley and Nottingham Community Health Trust.
Dr Peter Miller, Chief Executive of Leicestershire Partnership Trust, said:
As a health and wellbeing Trust, we know that everyone who stops smoking extends their disease-free years. I am proud that our hospital will be helping everyone from staff and patients to contractors and visitors to quit.
“We understand that stopping smoking can cause discomfort, and have put in place a number of initiatives to support people to not smoke while on our premises, or ideally give up for good. This includes the provision of nicotine replacement therapy and, if required, products for vaping. Whilst we are not there yet, we are committed to continuing on this journey to be smokefree
It was decided early on in the implementation process that mental health wards would be looked at first as these had the most potential obstacles to overcome. With many mental health patients having prolonged stays in hospital, the needs of these patients are paramount and addressing these can assist in their recovery.
It was essential therefore that the approach to becoming smokefree was not to force people into stopping smoking but to provide and offer other options.
Communicating with patients
Through talking to patients and understanding what could be put in place as a supportive tool to enable them to potentially stop smoking, the Trust decided to run a trial use of e-cigarettes that were freely provided to patients and which could be used in certain designated areas on site and in some cases on wards.
Louise Ross, Stop Smoking Service Manager, said:
The patients understood why the wards would become smokefree, but they wanted to use e-cigarettes as a way to manage their nicotine needs. Our policy was written to reflect their views, and every effort has been made to help patients, staff and visitors see this as a positive step forward.
“Vaping is allowed in the grounds, and smoking is not. This helps to manage nicotine needs while at the same time giving people a chance to try a far less harmful way of using nicotine than by smoking. Nicotine replacement products are also available through the pharmacy on site.
Training staff
In support of providing stop smoking advice to patients both nursing staff and pharmacists within the Trust were trained in stop smoking approaches. This enabled them to confidently talk to patients on a one to one basis and offer access to services that patients would not necessarily have engaged with if they were allowed to smoke on site.
With the trial a success, the Trust planned a soft launch for going smokefree on the 1st October 2016. Signage was put in place across the site and staff were prepared for any behavioural issues that could arise from policing and enforcement of the policy.
Nine months on, the implementation of the smokefree policy is building success with patients, staff and visitors.
However it has not been without its pitfalls and still has ongoing live issues, largely around policing and enforcement. Tobacco management is in the hands of the staff, which can be difficult in an already over stretched resource and with the added complexity of behavioural issues of patients.
Ongoing work
The Trust is now looking at ways in which they can ease patients’ anxiety and manage expectations even before they come into hospital. The problem solving phase of the policy is looking at encouraging community staff to talk to outpatients on the smokefree policy and offering referrals to stop smoking services.
This will be hugely beneficial to patients as they will feel equipped and prepared for any stays in hospital and have advanced knowledge of the smokefree policy, easing anxiety and decreasing any behavioural issues on site.
While challenging for all involved, it is clearly being recognised as the right thing to do and the Trust is committed to continuing its efforts to go fully smokefree, with the ultimate outcome of improving the health and lives of the community as a whole.
Read our blog on tips to help Trusts go smokefree.