Stop smoking service leads and commissioners need to ensure that SLAs or Local Enhanced Service contracts with service providers include clear criteria for delivery and reporting requirements. All staff involved in this work should be trained, either by the service or in-house,18 to provide stop smoking interventions. Service delivery in all settings will need to be spot-checked at regular intervals to ensure that the intervention being provided is of acceptable quality and duration. Providers who fail to return data within the prearranged deadlines should be made aware that payments will not be made for late data.
Primary care is a key setting for stop smoking interventions and an important source of referrals toStop Smoking Services. Service leads will need to ensure that all local GPs and other healthcare professionalsare aware of the AAA model for the provision of brief advice and referral of smokers to local Stop Smoking Services. GPs should be made aware of all local service and referral options. It is not recommended that GP teams be paid for stop smoking activities or for the return of data monitoring forms to the stop smoking service, unless the work is being conducted outside normal working hours or by bank staff. Helping smokers to quit is a key part of the remit of all primary care staff, and payments are already made to practices for this activity under the Quality and Outcomes Framework.
While smoking cessation interventions in GP practices and pharmacies are in general less effective than interventions delivered by specialist staff, they remain a valuable resource and should continue to form part of the overall support offered. They provide clients with greater choice and flexibility, since they are often available in places and at times when specialist provision may be unavailable. Service users should be given a menu of options along with their typical efficacy rates, enabling them to make informed choices.
Pharmacies have a good track record of providing stop smoking services to the general public. Ideally placed to provide this service, they are based in the heart of communities and are accessible to people who may not access GPs. Hospital-based pharmacies can also play an important role in developing and delivering stop smoking services in acute settings.
Commissioners and service leads should be encouraged to commission services from pharmacies and should continue to work in partnership with them to develop high-quality stop smoking services that the general public can access easily. Pharmacy staff may need to be remunerated for providing such services, with commissioners determining the level of payment according to the time and duration of interventions given, as well as team inputs for data handling.
Almost 60% of the adult UK population visit a dentist for regular check-ups, including a high proportion of people aged 25–35. Dentists also have regular contact with pregnant women and teenagers, who are important groups for referral. Dental teams are therefore well placed to offer brief advice and refer smokers to their local Stop Smoking Service. Where appropriate they can provide in-house intensive stop smoking support.19 Hospital-based dental teams can also help to develop stop smoking services in acute settings.
It is not recommended that dental teams be financially rewarded for referring smokers to local NHS Stop Smoking Services. Where they deliver in-house stop smoking support, however, dental teams should be paid fairly and appropriately for this.
meNtal HealtH ServiceS aNd priSoNS
Given that up to 70% of people in mental health units smoke,20 mental health services are an important source of referrals to stop smoking services. So too are prisons, where 80% of the population smoke.21 Further support for stop smoking interventions in prisons, as well as in children’s centres and workplaces, is currently being scoped.