DERBY HOSPITALS NHS FOUNDATION TRUST

Agenda Item:

Title: Smoke Free Hospital

Presented by: Tony Riley

Director of Human Resources

Summary of Report:

The purpose of this report is to bring forward to the Trust Board recommendations for implementing smoke free hospital status.

Action required by the Trust Board:

The Trust Board is asked to support and approve the recommendations contained in this paper and the introduction of policy in the manner described in order for this Trust to achieve “gold standard” smoke free status by the 1^st September 2006.

DERBY HOSPITALS NHS FOUNDATION TRUST

TRUST BOARD MEETING MAY 2006

SMOKE FREE HOSPITAL

INTRODUCTION

The recent white paper, Choosing Health, announced that NHS hospitals must be smoke free by the end of 2006. The two key drivers for this requirement are :-

Public health, in so far as smoking remains the largest single cause of death and disease in England.

Health and safety for hospital workers, with the report accepting the well established risks caused by second hand smoke.

The government sees the NHS as the foremost health promoting and treatment organisation in the UK and the largest employer in Europe as a key exemplar and leader for its overall national approach to smoking in public places.

As a minimum the white paper requires NHS buildings to go smoke free, however there was a very strong recommendation in the white paper that hospitals should aspire to what is described as the “gold standard” of smoke free building, grounds and vehicles.

DERBY HOSPITALS PROJECT

The Trust's HR Director was appointed as executive lead for implementing the recommendations of the white paper at Derby Hospitals NHS Foundation Trust.

A steering group was formed with wide ranging membership including :-

Patients
Member
Members Council Member
Senior medical staff
Senior nursing staff
Senior management
Pharmacy
Facilities Management
Communications
Staff Side Trade Unions
Health Promotion
PCT
Occupational Health
Fresh Start (smoking cessation support)

Care was taken to ensure that a number of members were smokers and / or ex-smokers.

The group met several times and conducted a number of virtual debates on draft documentation in between meetings. During this process the group considered the white paper and the Department of Health “Guidance for Smoke Free Hospital Trusts”, and contacted a number of best practice and reference sites.

POLICY AND GUIDANCE

The group has now produced a Policy and associated guidance document to support Derby Hospitals NHS Foundation Trust achieving “gold standard” smoke free status (attached as appendix 1 and 2).

SUPPLEMENTARY POINTS FOR THE ATTENTION OF THE BOARD

During the development and consultation phase of the documents referred to above, the group became aware of and sought to address a wide range of issues and the Board is asked to note that the group suggest the following measures to achieve timely and well managed implementation :-

That the policy be adopted as drafted with effect from 1^st September 2006.
That the Trust begins a phased removal of the existing staff smoking rooms. At the DCGH site the smoking room is due for demolition in June and it is proposed not to replace this. At the DRI site it is planned to convert the smoking room into a smoking cessation centre later this summer.
That the guidance be issued as drafted to support the introduction of the policy.
That the period between Board decision and policy launch be used to enable the Nightingale Macmillan Unit and Mental Health wards to develop patient protocols based on the national good practice guidance for such areas.
That the Trust's Pharmacy Department and the health community Fresh Start team develop and introduce smoking cessation support arrangements based on the following model :-

Option 2 of the Fresh Start proposal for implementation of support for staff. The Trust will provide a 2 week free supply of NRT at a cost of approximately £2,000. Subsequent NRT would be issued through the Fresh Start Voucher Scheme at no cost to Derby Hospitals. Patients requiring further treatment will meet the cost unless they receive free prescriptions.

That post Board agreement a sophisticated and wide ranging communication plan be put in place. Specific external communications should include :-

Medirest, Nottingham University, School of Nursing, School of Radiography, Social Services and other site occupants who should be written to and required to implement the Trust policy.

That GPs be contacted asking them to raise awareness of our policy with their patients / referrals.

That where Trust employees are required to visit patients in the home, the Trust asks those patients in writing to respect our policy for the duration of the visit.

That staff renting Trust accommodation be allowed to continue to smoke within their rooms for the time being, but that this be reviewed in line with any reviews of accommodation leasing arrangements.
That additional trained security staff be engaged on the lines of the Chesterfield Foundation Trust model.

(CFT arranged for their security company to provide a small team of more highly trained staff with sophisticated customer relations skills to act as smoking wardens for the first three months after implementation of the policy. Chesterfield's feedback has been extremely positive and the first two months post implementation have been entirely problem free).

COST IMPLICATIONS

The Board is asked to note that Chesterfield and Coventry Hospital Trusts both spent in the region of £30-35K in support of their introduction of smoke free arrangements. At present the Trust plan is anticipated to require investment of at least £25K and it is anticipated that the Charitable Fund (General Fund) will resource this.

RECOMMENDATION

Tony Riley

Director of Human Resources

17^th May 2006

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