Leeds Teaching Hospitals NHS Trust Stop Smoking Service has celebrated its first birthday. Carl Hickman, project and service manager leading both acute inpatient and maternity pathways, tells us more about the challenges and successes, as well as what those using the service are saying and plans for the future.
“The first year has been challenging with so many changes and continual quality improvements to the service, pathways, recruitment and protocols,” he says. “But on reflection, the outcomes achieved by the whole team have been amazing.”
Highlights include:
- meeting a series of key performance indicators set by Yorkshire Cancer Research for the inpatient service
- supporting 340 inpatients to stop smoking – that’s more than one a day over the working week,
- working with local midwife teams with 71 smokers quitting during pregnancy - equating to more than one a week
- implementing the maternity pathway, with a focus on those living in areas of deprivation
- working together well as a team
“Those are fantastic achievements for a new service and new team,” says Carl. “It’s still early days and Leeds is a big trust and operates across different sites and specialities. That means it will take some time to embed the inpatient pathway 100% trust-wide. The maternity pathway is more targeted and is already fully implemented with midwife teams across Leeds now referring all pregnant smokers at their booking appointment.”
Teamwork and collaboration is key to success
Carl says: “The team has really gelled, risen to the constant changes and adopted new ways of working and ensuring patient care is at the centre. It’s not just the immediate team, we work really closely with many clinical teams too. The service couldn’t support people to quit without data reports, ward clinical teams, prescribers, even our post-room colleagues assisting with the postage of nicotine replacement therapy (NRT). It’s a real collaboration right across the trust.
“We also work together with Leeds Stop Smoking Service, community pharmacists, Leeds City Council and Leeds and York Partnership NHS Foundation Trust to reduce smoking rates across our local communities.”
Not all plain sailing
Carl says: “Since launch, we’ve been on a roller-coaster of continuous service and quality improvements. Gathering data on a daily basis helps us to identify areas that we can fine tune to boost effectiveness and efficiency.
“In the early days referring to community pharmacies was a challenge” he adds. “But we are now working closely with West Yorkshire Community Pharmacy to help improve how patients get the support they need when they need it. Recruitment, NRT provision and future funding are ongoing challenges too.”
Feedback
Feedback from patients has been very positive and has also helped improve services. Sometimes it’s the simple things that can make a big difference, such as the way we use language.
“Rather than saying we are from the ‘stop smoking service’, we say we are from the ‘specialist service’,” says Carl. “Many smokers do not identify as having either an addiction or dependency, so we tend to avoid those words too. We don’t mention smoking in our initial introduction with maternity patients either. Instead, we talk about raised carbon monoxide levels, and then discuss smoking later in the conversation.”
Stopping smoking helps the individual and their baby immediately. Harmful gases, such as carbon monoxide, and other damaging chemicals clear from the body and the developing baby. Our mums can website pages has lots of useful resources, insight and links to support services across West Yorkshire.
The bigger picture
The service is part of the Leeds Smoking Collaborative that contributes collectively to reducing the burden of tobacco in our local communities.
Carl says: “As we continue to embed the service and expand into all clinical specialties, we will be able to support more people to quit. We know smokers who quit have better treatment outcomes from cancer, cardiovascular disease, stroke and surgery, and non-smokers have lower risks of heart and lung complications, post-operative complications, improved wound healing, reduced admission to intensive care and re-admission to hospital. All of these contribute to our strategic and operational objectives as well as the wider system approach to tobacco control, whilst reducing health inequalities and improving population health.”
“To look back at our achievements in the first year of operation, given the challenges we have faced, the service and team have performed exceptionally well. Going forward, our ambition is to embed the service across the whole Trust and continually pursue those marginal gains to make our Stop Smoking Service one of the best in the country.”
A short film about the role of a Tobacco Dependency Advisor
In this short video, Carl's colleague, Oluwaseyifunmi Akinyele, a Tobacco Dependency Advisor describes the role of the inpatient department.