A breath of fresh air Our vision for smoke-free hospital sites

Transcription

1 A breath of fresh air Our vision for smoke-free hospital sites Have your say on our smoke-free vision 1

2 Our responsibility We are a large acute trust serving a population of 700,000 people, with over 6,000 staff and volunteers. We know that the overwhelming majority of patients would like to see our hospitals become smoke-free. As a health service dedicated to fighting illness, we cannot condone an activity which is known to cause disease and early death. Allowing smoking on-site would send out the wrong message. Our vision is to create an environment where smokers feel supported and encouraged to stop smoking. As an NHS Trust, we have a duty to promote measures that improve health. Patients, staff, visitors and others working on our sites will be encouraged to remain smoke-free while on our premises, and to make plans to quit in the long term. What we pledge to do Following the amendments to the Health Act 2006, many hospitals across the country became smoke-free. We therefore want to provide a smoke-free environment across all our hospital sites, reducing the potential for harmful second hand smoke, and encouraging people who want to stop smoking. Everyone has a part to play in helping us to achieve our vision to become smoke free and move a step closer to reducing health inequalities. Dr Rob Fowler Lead Consultant for Smoking Cessation 2

3 Our Approach We will lead by example, providing a smoke free environment, which will protect those we serve and those we work with from second hand smoke. Once we have received feedback from our staff, patients and stakeholders we will use this to update existing policies and to enforce a smoke-free policy that will apply to all staff, patients, visitors, volunteers, and contractors working on our sites. We hope that our stakeholders will support a zero tolerance approach to smoking throughout our hospitals, including in and around our buildings, entrances and exits, car parks, pavements, walkways and gardens. With our smoke-free policy we will: 1. Communicate and explain our smoke-free approach to all staff, patients and visitors, volunteers, and to contractors working on our sites. 2. Encourage and support smokers to stop smoking through their free local stop smoking service. The stop smoking service offers advice and counselling, as well as nicotine replacement therapy (NRT) and other smoking cessation medications. 3. Train and educate our staff. We will encourage clinical and support staff to complete online training for the smoking referral pathway. This training is called Very Brief Advice (Ask, Advise and Act). The training will ensure all patients who are smokers are routinely recorded and offered a referral to their local stop smoking service and inpatients are offered nicotine replacement therapy to help reduce nicotine withdrawal pains or cravings; whether or not they accept a referral to their free local stop smoking service. 4. Build confidence through staff training so staff feel confident to challenge smokers on our premises. 5. Stop staff smoking while wearing our uniforms or wearing our identity badges and when in any vehicle owned, leased or rented by our Trust. 6. Improve our environment by ensuring it is clean and tidy. We will prevent our hospital entrances, pavements, walkways, car parks, flowerbeds, and open spaces from being littered with discarded cigarette ends. 3

4 What will the policy mean? Our smoke-free policy will set out a zero tolerance approach to smoking on our premises, which we believe will have a positive impact on patients, staff, volunteers, contractors and visitors. We will work with all groups to provide support and guidance to help them follow and understand the policy. For our patients We will support our patients to improve their health and wellbeing, and to play their part in respecting our smoke-free environment. We will support our patients by: Encouraging smokers to accept a referral to their free NHS local stop smoking service. Routinely offering nicotine replacement therapy (NRT) to patients who suffer nicotine withdrawal throughout their admission, whether or not they accept referral to their free local stop smoking service (similar to the care of those withdrawing from drugs or alcohol addiction). We will encourage self-referral by providing information. Providing and promoting local stop smoking services, commissioned by the local authorities, and available through GP practices, pharmacies and specialist clinics. We will include information onsite, in leaflets, patient letters and online. Offering additional local stop smoking services to meet the needs of specific community groups. Including the referral to local stop smoking services in patient discharge letters, where appropriate. Challenging those who do not respect the smoke-free environment. This means security giving a verbal warning and if that is ignored the smoker will be asked to leave our grounds. For our staff, volunteers and contractors We will support everyone who works with us, including staff, volunteers and contractors, to improve their health. Our staff will be offered education, encouragement and the tools necessary to succeed in making a difference. We will support those working with us by: Encouraging smokers to refer themselves to their local stop smoking service, either directly or through our Occupational Health service. They will be able to attend in their own time, or may request their line manager to release them for a course of sessions, where possible. Providing for our staff nicotine replacement therapy once they have agreed to a referral to the local stop smoking service for the duration of their course. Providing training for staff and volunteers within our learning and development framework and individual training and competency status will be recorded on the electronic staff record (ESR), which will signal the need for refresher training. We will enforce a zero tolerance culture. This will include: no smoking on any of our premises, including entrances and exits no smoking in any of our vehicles or private vehicles being used on Trust business staff should not smoke while they are on duty, whether or not in uniform we will ask staff to challenge those who do not follow our policy and provide them with the support to do so. All staff, volunteers and contractors are expected to respect our smoke-free environment and actively support a zero tolerance culture. 4

5 For our visitors We will provide our visitors with a smoke-free environment, access to smoking cessation services and information about our smoke-free policy. We will actively encourage visitors to improve their health and wellbeing. We will offer visitors who have to spend long periods of time in hospital and suffer nicotine withdrawal a referral to their free local stop smoking service and access to nicotine replacement therapy. We will expect our visitors to respect our smoke-free environment. And there will be zero tolerance of visitors smoking on our sites. We will challenge those who do not respect the smoke free environment. We will have regular security patrols in known smoking areas across our sites and will work with our local authorities and Transport for London to deter littering, which is a criminal offence under the law and carries a fixed penalty notice. For our communities We are determined to provide a smoke-free environment to promote the safety of those we care for and we ask those who work with us and our local communities to respect this. We believe that we can have a positive impact on health in our local boroughs, reducing health inequalities and improving life expectancy by taking positive action and going smoke-free. We will support our local communities by encouraging self-referral and will actively promote local stop smoking service contact information through a wide range of communication channels and signage across our estate. Local Stop Smoking Services London Borough of Barking and Dagenham Telephone: or Freephone stopsmoking@lbbd.gov.uk North East London NHS Foundation Trust (NELFT) Havering, Redbridge and Waltham Forest Telephone: , Quitline: , Fax: stopsmokingservice.bdchs@nhs.net For staff please contact our Occupational Health team 5

6 Our zero tolerance approach to smoking To create a smoke-free environment we will take every opportunity to help and support smokers who wish to stop smoking, We will support our staff through training, helping them feel more confident when challenging a smoker (whether staff, patient, or a member of the public) who is breaking our smoke-free policy. All frontline clinical and support staff will be expected to complete online training called Very Brief Advice (Ask, Advise and Act) for the smoking referral pathway. The training will ensure all patients who smoke are identified and offered a referral to their local stop smoking service. This will also help to ensure that inpatients who smoke are offered nicotine replacement therapy; whether or not they accept a referral to their free local stop smoking service. Once the policy has been developed we will take action where there is non-compliance. If a patient breaches the smoke -free policy a senior member of the clinical team would be informed. If non-compliance continues, the consultant or a senior nurse may consider discharging the patient. If a member of staff breaches the policy this will be regarded as misconduct and should lead to formal action within our Disciplinary Policy. If a volunteer breaches the policy they will be counselled by the voluntary services management. If the breach persists, they will be asked to leave our Trust. If a contractor breaches the policy their employer will be asked to address this. If a visitor breaches the policy they will be reminded about our policy. If non -compliance continues, they will be asked to leave our premises. Information and communication We will make the implications of the smoke -free policy clear: on our internet and intranet websites (which will include contact details to the local stop smoking service) in our job adverts and descriptions at every induction programme for new staff in every clinic and admission booking letter, including the offer of help to stop smoking. Admitted patients will be informed that it is against our policy to smoke anywhere on our premises. They will also be discouraged from leaving the ward, and made aware that if they do it is at their own risk. Next steps The questionnaire on the last two pages of this vision document will be open until 26 October We would like to hear your views. We will use your input to shape and finalise our smoke-free policy by the end of the year. Throughout October, with our local partners, we will be promoting the benefits of a smoke-free life and the support that is available, at both the King George and Queen s site. From the 8 October we will remove the smoking shelter at the entrance of Queen s and we will be encouraging visitors at the Queen s site to smoke off site and away from the main entrance or in the smoking shelter closer to our Emergency Department to offer visitors the courtesy of a smoke-free entrance to the hospital. We will count down to be a smoke-free Trust by 15 March 2015, (national nosmoking day), from which date our full policy will be in place. From now and beyond that date we will be encouraging our staff and visitors to live smoke-free lives. 6

7 Have your say about smoking on our sites Our vision is to create an environment where smokers feel supported and encouraged to stop smoking. Patients, staff, visitors and others working on our hospital sites will be encouraged to remain smoke-free while on our premises, and to make plans to quit in the long term. To ensure we do this effectively we want to ask you some simple questions to help inform our action planning and to inform our smoke-free policy. Please take a couple of minutes to complete the quick survey below or please complete it online at For further background you can read about and comment on our smoke free vision A breath of fresh air at You can further comments and suggestions to communications@bhrhospitals.nhs.uk. Please tick as appropriate 1. Are you a patient staff member visitor 2. I mainly visit King George Queen s 3. Do you smoke? please go to question 9 Questions for smokers only 4. Have you ever smoked in or around the hospital entrance? 5. Have you smoked anywhere in the hospital grounds? 6. Are you aware of the help and advice that is available to help you stop smoking if you wanted to give up? 7. What is your main reason for not giving up? 8. What would encourage you to give up? 7

8 Questions for everyone 9. Do you believe it is reasonable for us to allow people to use the hospital entrance or grounds for smoking? 10. Is it your impression that smokers do use the hospital entrance for a cigarette before entering the hospital? 11. Is it your impression that smokers use the hospital grounds for a cigarette before entering the hospital? 12. What impression does smoking at the hospital entrance give you of our hospitals? 13. Would you support a complete ban on smoking in our hospital entrances and grounds, including e-cigarettes? 14. Why? please give your reasons to the answer above 15. Is there anything else you would like to add? 16. Would you be happy to be kept updated on any progress on this issue and other Trust news? If so, please write your contact address below: Thank you for your time 8