Stop Smoking Wales Quarterly Report

Transcription

1 Stop Smoking Wales Quarterly Report Author: Emma Rogerson, Dr Emma Lydall Date: 27 February 2013 Publication/ Distribution: Public (Internet) NHS Wales (Intranet) Public Health Wales (Intranet) Review Date: N/A Purpose and Summary of Document: Version: 1a To provide an update on activity and outcomes between 1 October to 31 December 2012 Work Plan reference: Stop Smoking Wales work plan 2012/13 Date: 22/03/2013 Version:1 Page: 1 of 24

2 Contents Page 1.0 Introduction Data Analysis Findings Wales Abertawe Bro Morgannwg Summary Aneurin Bevan Summary Betsi Cadwaladr Summary Cardiff and Vale Summary Cwm Taf Summary Hywel Dda Summary Powys Summary 14 Appendices 15 References 23 Date: 22/03/2013 Version:1 Page: 2 of 24

3 1.0 Introduction Stop Smoking Wales is now well established as the National Health Service (NHS) specialist smoking cessation service covering the whole of Wales. The service provides high quality smoking cessation to local populations across Wales. During the period from, 2544 clients were scheduled an appointment to attend the local behavioural support programme. Smoking Cessation services sit within a wider context of tobacco control and Stop Smoking Wales has made a valuable contribution to developing tobacco control plans at a national and local level. Stop Smoking Wales is a two tier service and advocating brief intervention followed by behavioural support. We therefore deliver fully accredited brief intervention courses in all local authority areas across Wales. During the period, 23 accredited Brief Intervention courses were scheduled across Wales with 257 participants attending in total. 2.0 Data Analysis Stop Smoking Wales data collection methodology has changed and therefore caution must be used when comparing information in this quarterly report to any previous reports. The previous method extracted the data-set by initial contact date for the reporting period to provide a principal data-set. This data-set would then be analysed to provide the outcome and activity information for the reporting period. As the length of the client pathway through the service can be variable from the date of contact, clients may still be attending sessions when data is extracted, and consequently the data-set analysed can either be incomplete or the report deadline is delayed to produce the reports. As Stop Smoking Wales is committed to ensuring reports are produce timely and accurately, data will now be extracted by the assessment session date for the reporting time period to provide the principal data-set for analysis. This data- Date: 22/03/2013 Version:1 Page: 3 of 24

4 set will be complete and reports can be produced within a shorter time frame as all these clients pathways will have concluded at the time of report writing. The report will contain information on contacts received by health board and local authority area for the report period, however, no further analysis will be taken. Improving the quality and consistency of outcomes recording and reporting has been one of Stop Smoking Wales key priority areas in recent years. The service adopts nationally agreed standards in recording and reporting its outcomes, in line with other services across the UK. The Russell Standard (West, 2005) is widely accepted as the leading standard for calculating outcomes in smoking cessation services. The standard is composed of set criteria and these are used to define Stop Smoking Wales services outcomes for 2012/13. Further detail on the Russell standard is contained in Appendix Findings 3.1 Wales A full and detailed analysis of the activity and outcomes of Stop Smoking Wales between 1 October and 31 December 2012 is provided in Appendix 2. Across Wales between the : 2544 clients scheduled to attend an assessment session to begin a treatment programme 1520 clients attended an assessment session, (59.7 per cent of all those scheduled to attend) 1174 clients attended at least one treatment session, therefore becoming treated smokers (46.1 per cent of those scheduled to attend an assessment session). 946 were successfully followed-up 4 weeks after their quit date (80.6 per cent of treated smokers) 56.3 per cent of treated smokers were self-reported quit at 4-weeks post quit date 40.6 per cent of treated smokers were CO verified as quit at 4-week post quit date by attending the last treatment session Date: 22/03/2013 Version:1 Page: 4 of 24

5 In December 2012 there was an expected inherent decline in the number of clients scheduled an appointment compared to October and November (see figure 1). Figure 1: Activity and outcome graph Call operators received 3258 calls on the Stop Smoking Wales freephone number between 1 October and 31 December A total of 2347 clients were recorded as contacts who scheduled to attend an appointment (via phone calls, referrals and s) on the Stop Smoking Wales database between 1 October and 31 December Although this was an overall 21.9 per cent decline for the same period in 2011, these figures demonstrate that at least 65.5% of contacts to our service result in appointments being scheduled. This rate would be higher if it was calculated only upon all potential clients who contact the service, as the phone line also receives many calls from health professionals and service staff, and we do not currently record the nature of calls received. (Please note this contact information is independent of the data on assessment session attendance within this report as clients that attended assessment session during this reporting period may have made contact with the service prior to this time). Date: 22/03/2013 Version:1 Page: 5 of 24

6 All Wales comparison of contacts 1 October to 31 December 2011, 2012 Betsi Abertawe Bro Cadwaladr Morgannwg University LHBUniversity LHB Hywel Dda LHB Powys LHB Aneurin Bevan LHB Cardiff and Vale Cwm Taf LHB University LHB Figure 2: Graph showing the number of contacts in each health board 1 October to 31 December during 2011 and Activity and outcomes at 4 weeks by age, gender and ethnicity Of those scheduled appointments, 57.6 per cent were female and 42.4 per cent were male Of those who became treated smokers, 56.6 per cent were female and 43.4 per cent were male Of those who self-reported abstinence at 4-weeks post quit date, 57.4 per cent were female and 42.6 per cent were male per cent of clients were in the 35 to 59 year age group 98.2 per cent of client described themselves as White British. Of all contacts 60.4 per cent heard about the service from GP or practice nurse. This was the most common means by which clients heard about Stop Smoking Wales in each health board area Twelve month follow up Clients who successfully quit smoking at 4-weeks post quit date between 1 October and 31 December 2011 were contacted for 52 week follow-up during this reporting period. Date: 22/03/2013 Version:1 Page: 6 of 24

7 756 clients self-reported not smoking at 4-weeks post quit date and were therefore due to be followed up at 52 weeks. Out of the 756 clients only 696 were eligible to be contacted due follow-up consent. 439 (63.1 per cent) of clients eligible for follow-up were successfully contacted at 52 weeks 218 (31.3 per cent) of clients eligible for follow-up self-reported that they were abstinent at 52-weeks (49.7 per cent of clients successfully contacted). We request consent from clients who quit at 4 weeks in order to contact them for follow-up at 52 weeks post quit. However, if a client does not want to be contacted then they will be recorded as lost to follow-up at 52 weeks. Stop Smoking Wales is currently exploring ways of ensuring a more accurate 52 week quit figure can be obtained. This will involve redesigning our client consent forms to ensure that they are more user-friendly and explain more clearly the reasons why we follow up our clients Pre-operative contacts and appointments From 2544 clients scheduled to attend an appointment 160 (6.3 per cent) were preoperative clients Maternity contacts and appointments From 2544 clients scheduled to attend an appointment 212 (8.3 per cent) were maternity clients Waiting times The average number of days a client waited for an appointment during 1 October to 31 December 2012 was 15 days. Date: 22/03/2013 Version:1 Page: 7 of 24

8 3.2 Abertawe Bro Morgannwg Summary During in Abertawe Bro Morgannwg: 652 clients were scheduled to attend an appointment 15 days was the average wait for an appointment 424 clients (65 per cent) attended at least one session 122 clients (28.8 per cent) did not attend after the assessment session 302 clients became treated smokers (71.2 per cent of all clients that attended a session) 170 clients (40.1 per cent of all clients that attended a session) quit at 4 weeks self reported, of which 132 clients (31.1 per cent) were CO validated as quit During the equivalent period in 2011, 206 clients quit smoking at 4 weeks and were therefore due for follow-up at 52 weeks during this reporting period, which 198 (96.1 per cent) were eligible to be contacted. 130 clients (65.7 per cent of those eligible for follow up) were successfully contacted, and 64 clients self reported they had quit at 52 weeks, a quit rate of 31.1% (based on all clients who quit at 4 weeks, regardless of whether they consented to follow up and were successfully contacted). Out of the 652 clients scheduled an appointment, 26 (4.0 per cent) were preoperative clients and 34 (5.2 per cent) were maternity clients. Table 1: ABMU Health Board How clients heard about Stop Smoking Wales Friend/rela tive/word of mouth GP / Practice Nurse Hospital internet Leaflet / Flyer Heard of service (%) Media Advert NHS Direct other Pharmacist referral Used Before work place Date: 22/03/2013 Version:1 Page: 8 of 24

9 3.3 Aneurin Bevan Summary During in Aneurin Bevan: 397 clients were scheduled to attend an appointment 15 days was the average wait for an appointment 235 clients (59.2 per cent) attended at least one session 56 clients (23.8 per cent) did not attend after the assessment session 179 clients became treated smokers (76.2 per cent of all clients that attended a session) 77 clients (43.0 per cent of all clients that attended a session) quit at 4 weeks self reported, of which 51 clients (28.5 per cent) were CO validated as quit During the equivalent period in 2011, 140 clients quit smoking at 4 weeks and were therefore due for follow-up at 52 weeks during this reporting period, which 134 (95.7 per cent) were eligible to be contacted. 93 clients (69.4 per cent of those eligible for follow up) were successfully contacted and 43 clients self reported they had quit at 52 weeks, a quit rate of 30.7 per cent (based on all clients who quit at 4 weeks, regardless of whether they consented to follow up and were successfully contacted). Out of the 397 clients scheduled an appointment, 33 (8.3 per cent) were preoperative clients and 21 (5.3 per cent) were maternity clients. Table 2: Aneurin Bevan Health Board How clients heard about Stop Smoking Wales Friend/rela tive/word of mouth GP / Practice Nurse Hospital internet Leaflet / Flyer Heard of service (%) Media Advert NHS Direct other Pharmacist referral Used Before work place Date: 22/03/2013 Version:1 Page: 9 of 24

10 3.4 Betsi Cadwaladr Summary During in Betsi Cadwaladr: 573 clients were scheduled to attend an appointment 16 days was the average wait for an appointment 266 clients (46.4 per cent) attended at least one session 42 clients (15.8 per cent) did not attend after the assessment session 224 clients became treated smokers, (84.2 per cent of all clients that attended a session) 131 clients (58.5 per cent of all clients that attended a session) quit at 4 weeks self reported, of which 110 clients (49.1 per cent) were CO validated as quit During the equivalent period in 2011, 146 clients quit smoking at 4 weeks and were therefore due for follow-up at 52 weeks during this reporting period, which 102 (69.7 per cent) were eligible to be contacted. 69 clients (67.6 per cent of those eligible for follow up) were successfully contacted and 35 clients self reported they had quit at 52 weeks, a quit rate of 24.0 per cent (based on all clients who quit at 4 weeks, regardless of whether they consented to follow up and were successfully contacted). Out of the 573 clients scheduled an appointment, 60 (10.5 per cent) were preoperative clients and 73 (12.7 per cent) were maternity clients. Table 3: Betsi Cadwaladr Health Board How clients heard about Stop Smoking Wales Friend/rela tive/word of mouth GP / Practice Nurse Hospital internet Leaflet / Flyer Heard of service (%) Media Advert NHS Direct other Pharmacist referral Used Before work place Date: 22/03/2013 Version:1 Page: 10 of 24

11 3.5 Cardiff and Vale Summary During in Cardiff and the Vale: 181 clients were scheduled to attend an appointment 14 days was the average wait for an appointment 120 clients (66.3 per cent) attended at least one session 22 clients (18.3 per cent) did not attend after the assessment session 98 clients became a treated smoker(81.7 per cent of all clients that attended a session) 51 clients (52.0 per cent of all clients that attended a session) quit at 4 weeks self reported, of which 44 clients (44.9 per cent) were CO validated as quit During the equivalent period in 2011, 69 clients quit smoking at 4 weeks and were therefore due for follow-up at 52 weeks during this reporting period, which 67 (97.1 per cent) were eligible to be contacted. 54 clients (78.3 per cent of those eligible for follow up) were successfully contacted and 28 clients self reported they had quit at 52 weeks, a quit rate of 40.6 per cent (based on all clients who quit at 4 weeks, regardless of whether they consented to follow up and were successfully contacted). Out of the 181 clients scheduled an appointment, 7 (3.9 percent) were preoperative clients and 11 (6.1 per cent) were maternity clients. Table 4: Cardiff and the Vale Health Board How clients heard about Stop Smoking Wales Friend/rela tive/word of mouth GP / Practice Nurse Hospital internet Leaflet / Flyer Heard of service (%) Media Advert NHS Direct other Pharmacist referral Used Before work place Date: 22/03/2013 Version:1 Page: 11 of 24

12 3.6 Cwm Taf Summary During in Cwm Taf: 254 clients were scheduled to attend an appointment 13 days was the average days for an appointment 154 clients (60.6 per cent) attended at least one or more sessions 32 clients (20.8 per cent) did not attend after the assessment session 122 clients became treated smokers (79.2 per cent of all clients that attended a session) 46 clients (37.7 per cent of all clients that attended a session) quit at 4 weeks self reported, of which 37 clients (30.3 per cent) were CO validated as quit During the equivalent period in 2011, 70 clients quit smoking at 4 weeks and were therefore due for follow-up at 52 weeks during this reporting period, which 69 (98.6 per cent) were eligible to be contacted. 45 clients (64.3 per cent of those eligible for follow up) were successfully contacted and 23 clients self reported they had quit at 52 weeks, a quit rate of 32.9 per cent quit (based on all clients who quit at 4 weeks, regardless of whether they consented to follow up and were successfully contacted). Out of the 254 clients scheduled an appointment, 14 (5.5 per cent) were preoperative clients and 17 (6.7 per cent) were maternity clients. Table 5: Cwm Taff Health Board How clients heard about Stop Smoking Wales Friend/rela tive/word of mouth GP / Practice Nurse Hospital internet Leaflet / Flyer Heard of service (%) Media Advert NHS Direct other Pharmacist referral Used Before work place Date: 22/03/2013 Version:1 Page: 12 of 24

13 3.7 Hywel Dda Summary During in Hywel Dda: 400 clients were scheduled to attend an appointment 15 days was the average wait for an appointment. 260 clients (65.0 per cent) attended at least one or more sessions 64 clients (24.6 per cent) did not attend after the assessment session 196 clients became treated smokers (75.4 per cent of all clients that attended a session) 119 clients (60.7 per cent of all clients that attended a session) quit at 4 weeks self reported, of which 74 clients (37.8 per cent) were CO validated as quit. During the equivalent period in 2011, 102 clients quit smoking at 4 weeks and were due for follow-up at 52 weeks during this reporting period, which 95 (93.1 per cent) were eligible to be contacted. 44 clients (43.1 per cent of those eligible for follow up) were successfully contacted and 22 clients self reported they had quit at 52 weeks, a quit rate of 21.6 per cent (based on all clients who quit at 4 weeks, regardless of whether they consented to follow up and were successfully contacted). Out of the 400 clients scheduled an appointment, 19 (4.75 per cent) were preoperative clients and 48 (12.0 per cent) were maternity clients. Table 6: Hywel Dda How clients heard about Stop Smoking Wales Friend/rela tive/word of mouth GP / Practice Nurse Hospital internet Leaflet / Flyer Heard of service (%) Media Advert NHS Direct other Pharmacist referral Used Before work place Date: 22/03/2013 Version:1 Page: 13 of 24

14 3.8 Powys Summary During in Powys: 87 clients were scheduled to attend an appointment 14 days was the average wait for an appointment. 61 clients (70.1 per cent) attended at least one or more sessions 8 clients (13.1 per cent) did not attend after the assessment session 53 clients became treated smokers (86.9 per cent of all clients that attended a session). 18 clients (34.0 per cent of all clients that attended a session) quit at 4 weeks self reported, of which 13 clients (24.5 per cent) were CO validated as quit During the equivalent period in clients quit smoking at 4 weeks and were therefore due for follow-up at 52 weeks during this reporting period, which 22 (95.7 per cent) were eligible to be contacted. 4 clients (17.4 per cent of those eligible for follow up) were successfully contacted and 3 clients self reported they had quit at 52 weeks, a 13.0 per cent quit rate (based on all clients who quit at 4 weeks, regardless of whether they consented to follow up and were successfully contacted). Out of the 87 clients scheduled an appointment, 1 (1.1 per cent) were preoperative clients and 8 (9.2 per cent) were maternity clients. Table 7: Powys How clients heard about Stop Smoking Wales Friend/rela tive/word of mouth GP / Practice Nurse Hospital internet Leaflet / Flyer Heard of service (%) Media Advert NHS Direct other Pharmacist referral Used Before work place Date: 22/03/2013 Version:1 Page: 14 of 24

15 Appendix one: Calculations of Service Outcome 1. The Russell Standard (Clinical) is widely accepted as the leading standard for calculating outcomes in smoking cessation services. 2. The following definitions from the Russell Standard have been used to produce the service outcomes for 2011/12: i. Contact A contact is a person who has contacted the service and has been provided with an appointment to attend an assessment session. ii. Treated Smoker A treated smoker is a client who undergoes at least one treatment session. Smokers who attend the initial assessment session but fail to attend a treatment session are not counted. iii. 4-Week Quitter (self-reported) A smoker is counted as a 4-week quitter (self- report) if s/he is a treated smoker, who is assessed (face-to-face, by postal questionnaire or by telephone), 4-weeks after the designated quit date and declares that he/she has not smoked even a single puff of a cigarette in the past 2 weeks. iv. 4-Week Quitter (Carbon Monoxide (CO)-verified) A smoker is counted as a 4-week quitter (CO-verified) if s/he is a self-reported 4- week quitter and his/her expired air CO is assessed 4-weeks after the designated quit date and found to be less than 10ppm. v. Lost to Follow Up A treated smoker is counted as lost to follow-up if, on attempting to determine the 4-week quit status, s/he cannot be contacted. vi. 52-Week Quitters A smoker is counted as a 52-week quitter if they are a 4-week quitter (selfreport) and if when contacted at 52-weeks (face-to face, by postal questionnaire or by telephone) report that they have smoked no more than 5 cigarettes over the past 50 weeks. Date: 22/03/2013 Version:1 Page: 15 of 24

16 Appendix two. Table 1: Activity and outcomes at 4 weeks by Local Authority area, based on clients addresses, between 1 October and 31 December 2012 Health Board Area Local Authority area Clients scheduled to attend an appointment No. attending assessment session only No. of treated smokers No. followed up at 4-weeks post quit date No. quit at 4- weeks (self report) % quit at 4- weeks (self report) No. quit at 4-weeks (COvalidated) % quit at 4-weeks (COvalidated) Abertawe Bro Morgannwg University Health Board Aneurin Bevan Health Board Betsi Cadwaladr University Health Board Bridgend Neath Port Talbot Swansea Blaenau Gwent Caerphilly Monmouthshire Newport Torfaen Anglesey Conwy Denbighshire Flintshire Gwynedd Wrexham Cardiff and Vale Cardiff University Health Board Vale of Glamorgan Cwm Taf Health Merthyr Tydfil Board Rhondda Cynon Taff Carmarthenshire Hywel Dda Health Ceredigion Board Pembrokeshire Powys Teaching Health Board Powys Total Wales Date: 22/03/2013 Version:1 Page: 16 of 24

17 Appendix two. Table 2: Activity and outcomes at 4 weeks by Health Board based on clients addresses, between 1 October and 31 December 2012 Health Board Area Clients scheduled to attend an appointment No. attending assessment session only No. of treated smokers No. followed up at 4-weeks post quit date No. quit at 4- weeks (self report) % quit at 4- weeks (self report) No. quit at 4-weeks (COvalidated) % quit at 4-weeks (COvalidated) Abertawe Bro Morgannwg University Health Board Aneurin Bevan Health Board Betsi Cadwaladr University Health Board Cardiff and Vale University Health Board Cwm Taf Health Board Hywel Dda Health Board Powys Teaching Health Board Wales Date: 22/03/2013 Version:1 Page: 17 of 24

18 Table 3: Activity and outcomes at 4 weeks by age, gender and ethnicity, between 1 October and 31 December 2012 No. No. %. quit Clients Attended quit quit No. at 4 scheduled to info Treated at 4 at 4 Gender Age band followed weeks attend an session smokers weeks weeks up self appointment only self COreport report validated Persons Female Male Persons % quit at 4 weeks COvalidated All ages under All ages under All ages under All persons White Mixed Asian Black Other includes age not given 2 includes ethnic group not given Date: 22/03/2013 Version:1 Page: 18 of 24

19 Table 4: How clients heard about Stop Smoking Wales between 1 October and 31 December 2012 No. of contacts % of contacts Source Family / friend GP / practice nurse Hospital Internet Leaflet / flyer NHS Direct helpline Other Pharmacist Referral TV or radio advert Used service before Workplace Total Date: 22/03/2013 Version:1 Page: 19 of 24

20 Table 5: Outcomes at 52-weeks post quit date by Health Board and Local Authority area, between 1 October and 31 December 2011 No. No. No. Due to eligible to followed No. quit be followed be followed up at 52- at 52- Health Board Area Local Authority area up 52-weeks up at 52- weeks weeks post quit date weeks post quit date post quit date (self report) Abertawe Bro Morgannwg University Health Board Aneurin Bevan Health Board Betsi Cadwaladr University Health Board Cardiff and Vale University Health Board Cwm Taf Health Board Hywel Dda Health Board % quit at 52-weeks self report Bridgend Neath Port Talbot Swansea Blaenau Gwent Caerphilly Monmouthshire Newport Torfaen Anglesey Conwy Denbighshire Flintshire Gwynedd Wrexham Cardiff Vale of Glamorgan Merthyr Tydfil Rhondda Cynon Taff Carmarthenshire Ceredigion Pembrokeshire Powys Teaching Health Board Powys Total Wales Date: 22/03/2013 Version:1 Page: 20 of 24

21 Table 6: Number of maternity and pre-operative clients scheduled to attend an appointment between 1 October and 31 December 2012 Health board Number of Maternity clients Number of preoperative clients Abertawe Bro Morgannwg University LHB Aneurin Bevan LHB Betsi Cadwaladr University LHB Cardiff and Vale University LHB 11 7 Cwm Taf LHB Hywel Dda LHB Powys All Wales Date: 22/03/2013 Version:1 Page: 21 of 24

22 Table 7: Average waiting time by Health Board and Local Authority area between 1 October and 31 December 2012 Health Board Area Abertawe Bro Morgannwg University Health Board Aneurin Bevan Health Board Betsi Cadwaladr University Health Board Cardiff and Vale University Health Board Cwm Taf Health Board Hywel Dda Health Board Powys Teaching Health Board Local Authority area Average number of days waiting Total 15 Bridgend 16 Neath Port Talbot 15 Swansea 15 Total 15 Blaenau Gwent 13 Caerphilly 15 Monmouthshire 18 Newport 14 Torfaen 17 Total 16 Anglesey 15 Conwy 17 Denbighshire 16 Flintshire 16 Gwynedd 14 Wrexham 14 Total 14 Cardiff 13 Vale of Glamorgan 18 Total 13 Merthyr Tydfil 11 Rhondda Cynon Taff 14 Total 15 Carmarthenshire 14 Ceredigion 17 Pembrokeshire 16 Total 14 Powys 14 Total Wales 15 Date: 22/03/2013 Version:1 Page: 22 of 24

23 Table 8: Number of brief intervention courses delivered across Wales between 1 October and 31 December Health Board Number of courses Number of Participants attended Abertawe Bro Morgannwg University Health Board 2 27 Aneurin Bevan Health Board 2 36 Betsi Cadwaladr University Health Board Cardiff and Vale University Health Board 2 18 Cwm Taf Health Board 1 11 Hywel Dda Health Board 2 7 Powys Teaching Health Board 1 10 Total Date: 22/03/2013 Version:1 Page: 23 of 24

24 References: West, R., Hajek, P., Stead, L. and Stapleton, J. (2005) Outcome criteria in smoking cessation trials: the need for a common standard. Addiction 100, pp Date: 22/03/2013 Version:1 Page: 24 of 24