No Smoking Policy. 5.0 Final. Deterring Smoking by Staff, Patients and Visitors

No Smoking Policy 5.0 Final Deterring Smoking by Staff, Patients and Visitors EQUALITY IMPACT The Trust strives to ensure equality of opportunity for all both as a major employer and as a provider of health care. This policy has therefore been equality impact assessed by the No Smoking Group to ensure fairness and consistency for all those covered by it regardless of their individual differences, and the results are shown in Appendix 4. Version: 5.0 Final Authorised by: Director of Estate & Facilities Date authorised: 15 th April 2016 Next review date: July 2018 Document author: Head of Facilities

VERSION CONTROL SCHEDULE Deterring Smoking by Staff, Patients and Vistors Version : 5.0 Final Version Number Issue Date Revisions from previous issue 2.0 draft 03/02/2009 The policy was developed by the security manager and fire safety adviser and director of nursing for consultation with the risk management committee for comment 2.0 draft 02/04/2009 Comments were received and where considered relevant & important inserted into the policy 3.0 Final 01/08/2011 Comments received from Human Resources and policy amended accordingly. Repetitive sections omitted 3.1 Final 19/08/2011 Smoking Cessation 3 A s Brief Intervention Pathway information considered relevant & important inserted into the policy. 4.0 24/03/2014 Added a section under the introduction and under section 7 of the policy that states: E-cigarettes are unregulated nicotine products for which there is insufficient evidence of safety. In view of this the use of e-cigarettes are not permitted at Tameside Hospital. 5.0 final 05/07/2016 7.11 E-cigarettes, added evidence of known fire risk due to explosion of products. Included Analysis of Effects VERSION 5.0 July 2016 Page 2 of 19

Contents EQUALITY IMPACT... 1 1. INTRODUCTION... 4 2. AIM... 4 3. SCOPE... 5 4. DEFINITIONS... 5 5. DUTIES... 5 6. POLICY STATEMENT... 6 7. ELIMINATING SMOKING AT TAMESIDE HOSPITAL... 6 8. SMOKING CESSATION... 7 9. STAFF... 8 10. PATIENTS... 8 11. VISITORS... 9 12. POLICY DEVELOPMENT & CONSULTATION... 9 13. IMPLEMENTATION... 9 14 MONITORING... 10 15. REFERENCES... 10 16. APPENDICES... 10 17. REVIEW... 10 Appendix 1 - PROCEDURE FOR DEALING WITH PATIENTS WHO SMOKE... 12 Appendix 2 - Smoking Cessation Guidance for Staff using the 3 A s approach... 13 Appendix 3 - Smoking Cessation Smoking Status & Referral Form... 14 Appendix 4 Analysis of Effects... 15 VERSION 5.0 July 2016 Page 3 of 19

1. INTRODUCTION 1.1 Smoking is a major cause of illness and early death and the government is taking active measures to decrease smoking behaviour by reducing the number of public areas in which smoking is permitted. 1.2 As one of the main providers of health services in Tameside and Glossop, the Trust is committed to eliminating smoking on Trust premises, and to assisting staff, patients and visitors to achieve greater health through smoking cessation. 1.3 On July 1st 2007, the Government introduced a new law to make virtually all enclosed public places and workplaces in England smoke free. A smokefree country ensures a healthier environment, so everyone can socialise and work free from passive smoke inhalation. 1.4 E-cigarettes are unregulated nicotine products for which there is insufficient evidence of safety. In view of this the use of e-cigarettes are not permitted at Tameside Hospital 2. AIM 2.1 The aim of this policy is to: Ensure that non smokers can work in or visit the Trust in a smoke free environment. Support patients and employees who wish to stop smoking Encourage employees to become involved in health promotion initiatives Set a good example to the public and enhance the image of the Trust through the positive action Demonstrate adherence to the national NHS No Smoking Statement. Adhere to National no smoking in line with Smoke Free Regulations 2007 Reduce the risks associated with passive smoking which government research has shown to be dangerous to health. Reduce the negative effects of littering on the environment caused by discarded cigarette ends, which account for 50% of all litter worldwide. Reduce the effects on the environment from discarded cigarette ends. A cigarette butt contains up to 4,000 chemicals including hydrogen, cyanide and arsenic. Strive to become a good neighbour and reduce the effects of littering on local residents. VERSION 5.0 July 2016 Page 4 of 19

3. SCOPE 3.1 This policy applies to all persons on the Tameside Hospital site, including staff, volunteers, contractors, patients and visitors. The policy is applicable to all Trust property and premises, including inside and outside of Trust buildings and the Hospital grounds and car parking areas, plus associated sites and Trust vehicles. 4. DEFINITIONS 4.1 Smoking is the inhalation of the smoke of burning tobacco or any other substance encased in cigarettes, pipes, e-cigarettes and cigars. 5. DUTIES 5.1 The Trust The Trust has a responsibility to ensure that staff are not exposed to health risks from passive smoking at work. The Chief Executive of the Trust has overall responsibility for all aspects of this policy, and delegates this responsibility to senior managers of the Trust as detailed below. 5.2 Managerial Responsibility Managers will take reasonable steps to ensure that adequate arrangements are in place to enable the policy to be fully implemented at ward, department and clinic level. This will include ensuring that all staff, patients and visitors comply with the policy. Managers have a duty to ensure this policy is enforced within their area of management responsibility. This includes making employees aware of this policy and appropriately dealing with employees who are in breach of this policy. Managers have a responsibility to provide their employees with appropriate support (ie: counselling or advice on smoking cessation groups) Managers have a responsibility to ensure breaches of this policy are dealt with appropriately in accordance with the Trusts Conduct and Disciplinary policy. 5.3 Occupational Health Department Occupational Health Department will provide advice and support for staff wishing to stop smoking. Regular smoking cessation sessions are undertaken for staff which can be on a one to one or group basis. This will include help and guidance regarding available therapies. Educational literature and information will be provided at any available opportunity e.g. health days, national no smoking days. VERSION 5.0 July 2016 Page 5 of 19

5.4 All Employees Have a duty to comply with the requirements of this policy by not smoking on Trust premises, including the grounds of Trust premises. All employees will, in addition to adherence to this policy, be expected to adhere to the no smoking policies of any external premises at which they are working, based or visiting. Smoking is not allowed in any vehicle owned, leased or rented by the Trust. In addition, vehicle owners who utilise their private vehicles for work, transportation of patients or transportation of equipment will not be permitted to smoke or allow passengers to smoke whilst on Trust business. Employees will not be permitted to smoke whilst in their own vehicle on Trust premises. Smoke breaks are not permitted whilst on duty. Employees are expected to have consideration for local neighbours. This includes avoiding smoking directly outside a neighbouring house, discarding cigarettes in neighbouring gardens and littering the neighbouring community. 6. POLICY STATEMENT 6.1 The Trust as a healthcare provider must set an example to other organisations, promote public health and create an environment that minimises the health risks to members of the public who access the service. 6.2 The Trust recognises that it has a legal obligation under the Health and Safety at Work Act 1974 S2 to provide and maintain a working environment for all employees that is, so far as is reasonably practicable, safe and without risks to health. 6.3 A failure to comply with this policy will be treated as misconduct and as such may lead to formal action in accordance with the Trusts Conduct and Disciplinary Policy. 7. ELIMINATING SMOKING AT TAMESIDE HOSPITAL 7.1 All staff (whether uniformed or not and including contracted, agency and other external staff), patients and visitors are not permitted to smoke on any part of the Trust site, including buildings, entrances/exits, cars, car parks, pavements and walkways, and residences. Smoking by any member of staff whilst on the Trust site, and/or during working hours (e.g. whilst on escort duty off site, working in a community setting, whilst in a vehicle) will be treated as misconduct and may lead to formal action in accordance with the Trusts Conduct & Disciplinary Policy. VERSION 5.0 July 2016 Page 6 of 19

7.2 Any member of staff who smokes should ensure that they do not smell of smoke whilst on duty. Staff smelling off smoke whilst on duty will be treated as a failure to comply with this policy. 7.3 A statement regarding the Trusts No Smoking Policy will be included in all job adverts and job descriptions. New starters will also be made aware of the policy via the Trust s Induction Programme. 7.4 The Trust will erect and maintain signs clearly indicating the Trust s No Smoking policy, stating This is a no smoking site. Signs will be arranged to cover all areas of the site, particularly entry points. 7.5 All members of staff will be expected to reinforce the Trust s No Smoking Policy in circumstances which they are comfortable to do so. This will include asking patients and visitors to cease smoking on Trust premises. Senior staff should support junior staff in enforcing the policy. 7.6 No facilities will be provided on site for smoking. 7.7 Staff will not be permitted to take smoking breaks. 7.8 Staff will not be permitted to assist patients who wish to smoke. Staff must not accompany patients who wish to smoke, and any member of staff who does so will be subject to disciplinary action in line with Trust policy. All staff should receive the support of senior colleagues and Security Officers if patients or visitors place staff under pressure to violate the Trust s No Smoking status. 7.9 If a patient leaves a Ward without permission from Ward staff, the patient will be wholly responsible for anything that may occur as a result of their action. Patients should be notified of this in line with the Trust s guidance to clinical areas. (The Trust s duty to provide reasonable care to the patient will not be affected). 7.10 Cigarettes and other smoking materials will not be sold on Trust premises. 7.11 E-cigarettes are unregulated nicotine products for which there is insufficient evidence of safety. In view of this the use of e-cigarettes are not permitted at Tameside Hospital. There has been numerous cases reported in the media of E-cigarettes causing fires due to an explosion and subsequent harm to people. 8. SMOKING CESSATION 8.1 The Trust is obliged under current regulations to provide a smoke free environment. VERSION 5.0 July 2016 Page 7 of 19

8.2 The Trust has additional responsibilities in relation to staff, patients and visitors and as a matter of principle provides support to staff, patients and visitors who wish to stop smoking. 8.3 All patients to be assessed utilising 3 A s Stop Smoking Brief Intervention, and offered referral to the Stop Smoking Team a record of assessment to be filed in the patient medical records. (see appendix 2 and 3). The smoking status of the patient to be recorded in the nursing admission documentation. 8.4 Members of staff who wish to attend smoking cessation support groups must negotiate their release with their Line Manager and it is recognised that such release will not necessarily be possible. 9. STAFF 9.1 A statement regarding the Trusts No Smoking Policy will be included in all job adverts and job descriptions. 9.2 The Trust internet and intranet websites will contain links to sources of help and information regarding smoking cessation (i.e. Smoking Cessation 3 A s Pathway & NHS Smoking Helpline). 10. PATIENTS 10.1 Prior to arrival at the Trust elective patients will be informed on the booking letters, of the Trusts No Smoking Policy and provided with details of the NHS Tameside and Glossop smoking cessation team for patients wishing to stop smoking prior to admission. 10.2 On arrival patients must be made aware of the Trust s no smoking policy. 10.3 All patient s are to be assessed for smoking status by Wards/Departments/Clinic areas, by use of the 3 A s Smoking Status & Referral Form (see appendix 3) available in the Ward Stop Smoking File, the form is to be filed in the patients medical records. Encouragement and support to cease smoking should form part of the clinical management plan for all smokers. Nicotine replacement patches are available on Wards, but must be prescribed by a doctor. 10.4 If patients are known to be smoking on the Ward, they should be made aware of the Trust s no smoking policy, the fire risk and informed that it is illegal to smoke on Trust premises. 10.5 Patients should be discouraged from leaving Wards/Departments to smoke outside. If they choose to leave the Ward/Department they do so at their own risk. VERSION 5.0 July 2016 Page 8 of 19

10.6 If no smoking legislation is breached by a patient, the Divisional Nurse Manager or Matron must be informed plus either the Security Manager or the Fire Safety & EPRR Manager. 10.7 Patients will be made aware of legal situation with regard to smoking in buildings. Tameside Metropolitan Borough Council Environmental Health Department will enforce the smoking ban with a 30 fine. Enforcement will be dependent on two members of staff corroberating the breach in writing. Note: the fine will be increased to 50 if not paid within 15 days. 10.8 If a patient persists in smoking, their Consultant or a Senior Nurse Manager should consider discharging the patient. 10.9 All clinical areas should provide posters, leaflets, and other forms of information, advising on the dangers of smoking, and include signage directing smokers to sources of help, Hospital based. 10.10 Pregnant smokers should be given specific information relating to the risks associated with the unborn child. 10.11 Support to cease smoking should form part of the clinical management plan for all pregnant smokers, providing specific support where appropriate; 11. VISITORS 11.1 The hospital will provide posters, leaflets, and other forms of information, advising on the dangers of smoking, and include signage directing smokers to sources of help. 11.2 The Trust will take appropriate professional advice to maximise the appropriateness and effectiveness of these media. 11.3 All hospital staff will endeavour to assist any visitor who asks for help in smoking cessation either by providing information and advice directly, or directing the patient to an appropriate source of information or assistance. 12. POLICY DEVELOPMENT & CONSULTATION 12.1 This policy has been developed in conjunction with the Director of Nursing, Occupational Health, Fire Safety & EPRR Manager, AQ Project Team and the Security Manager. 12.2 The policy was circulated to the Risk Management Committee. Their comments are incorporated into this policy 13. IMPLEMENTATION VERSION 5.0 July 2016 Page 9 of 19

13.1 All members of staff have a role to play in implementing and complying with this policy and are expected to be familiar with its content. 13.2 The Medical and Nursing Directors, and Director of Human Resources will lead on the implementation of this policy, supported by the Executive Team. 13.3 Other managers within the Trust have a crucial role to play in the operational implementation of the policy. 13.4 Staff representatives have been fully consulted on the content of this policy and will co-operate with management in its implementation, development and review. 13.5 For contracted services, the contract or service agreement between the Trust and the service provider will specifically require that contracted staff adhere to the Trust s No Smoking policy in every respect. 13.6 The implementation of this Policy will be monitored by the Risk Management Committee. The Committee will provide regular reports to the Trust Executive Group on compliance with this policy. 14 MONITORING 14.1 The Risk Management Committee will monitor the implementation of this policy. 14.2 Where monitoring has identified deficiencies, recommendations and action plans will be developed and changes implemented accordingly. Progress on these will be reported to the Trust Executive Group. 14.3 Compliance will be monitored by the Risk Management Committee, Advancing Quality and CQUIN target Monthly results. 14.4 Any subsequent actions required following implementation will be developed by the Risk Management Committee. 15. REFERENCES 15.1 Guidance for Smoke Free Hospital Trusts, Health Development Agency, 2005 15.2 Smoking Cessation 3 A s Pathway V2, 2014 15.3 NHS Stop Smoking Service It only takes 30 Seconds to change a smokers life 16. APPENDICES 16.1 Appendix 1 Procedure for dealing with Patients Who Smoke Appendix 2 - Smoking Cessation Guidance for Staff using the 3 A s Approach Appendix 3 Smoking Cessation Smoking Status & Referal Form Appendix 4 Analysis of Effects 17. REVIEW VERSION 5.0 July 2016 Page 10 of 19

17.1 This policy will be formally reviewed 2 years after first approval), or earlier depending on the results of monitoring. VERSION 5.0 July 2016 Page 11 of 19

Appendix 1 - PROCEDURE FOR DEALING WITH PATIENTS WHO SMOKE Procedure for Dealing with Patients Who Smoke SMOKING OUTSIDE OF BUILDING PATIENTS SHOULD BE DISCOURAGED FROM LEAVING WARDS/DEPARTMENTS TO SMOKE OUTSIDE. IF THEY CHOOSE TO LEAVE THE WARD, PATIENTS DO SO AT THEIR OWN RISK! KEY CONTACTS VERSION 5.0 July 2016 Page 12 of 19 Fire Safety & EPRR Advisor 0161 922 6022/07778 217 872 Head of Facilities 0161 922 6156 Asst Chief Nurse (Medicine & Clinical Support) 0161 922 4091 Asst Chief Nurse (Surgery, Women s & Children s) 0161 922 6179 Director of Nursing 0161 922 6006 TMBC Environmental Health 0161 342 8355

Appendix 2 - Smoking Cessation Guidance for Staff using the 3 A s approach VERSION 5.0 July 2016 Page 13 of 19

Appendix 3 - Smoking Cessation Smoking Status & Referral Form VERSION 5.0 July 2016 Page 14 of 19

Appendix 4 Analysis of Effects Title of Policy: No Smoking Policy Short description of Policy The aims of this policy is to ensure that non smokers can work in or visit the Trust in a smoke free environment and to support patients and employees who wish to stop smoking Date of assessment: 15/04/16 Person responsible for assessment: Steve Peet, Head of Facilities Is this a proposed new policy/proposal? No Is this a review of an existing policy/proposal? Yes 1. Who is responsible for the policy/proposal? Estates & Facilities (Consider the following; i. Who is accountable? ii. Who implements it? iii. Who is responsible for policing/monitoring? iv. Who enforces the policy?) VERSION 5.0 July 2016 Page 15 of 19

2. Who are the main stakeholders in relation to the policy/proposal? This policy was approved by the Smoking group, formed to review existing policy. Representatives include Director of Estate and Facilities, Chief Nurse, staff side (Consider the following; i. Who needs to be consulted / informed about the policy/proposal? ii. Who is the policy/proposal intended to involve in the wider sense? For example; Staff/professionals, the public/community 3. What outcomes are expected / desired from this policy/proposal? (Consider the following; i. Who will benefit from this policy/proposal and in what way will they benefit? This policy has been developed by knowledge gained through deterring smoking and national guidance This policy has been developed to ensure the best possible service for our patients ii. Does the policy/proposal explicitly involve the elimination of inequality, or the promotion of equality?) VERSION 5.0 July 2016 Page 16 of 19

4. The following section requires you to assess the likely negative impact and positive impact of your policy/proposal on the nine Protected Characteristics as defined by the Equality Act as follows. Please support any answers with evidence. Protected Characteristics Answers to: What likely adverse impact will this Policy / Service have on the public or staff, giving particular regard to potential impacts negative and positive in relation to: Evidence: (What is your evidence for this answer? Consider; both quantitative and qualitative existing data.) a. Race The promotion of this policy will raise awareness to staff of their responsibilities to deter smoking and signposts staff so that they can assist patients who ask for help in smoking cessation b. Disability c. Sex d. Religion and belief VERSION 5.0 July 2016 Page 17 of 19

e. Sexual orientation f. Age g. Carers h. Gender Reassignment i. Marriage & Civil Partnership j. Pregnancy & Maternity K. Human Rights 5. Is there any further evidence / data that you would consider relevant or necessary in order to answer the above question? If so, please detail. * 6. Are any of the above impacts (detailed in 4a K) justifiable, valid or legal? Not applicable None VERSION 5.0 July 2016 Page 18 of 19

Please explain? 7. Is this policy/proposal missing a valid opportunity to promote equality of opportunity for one or more of the groups (see 4a) concerned? Please expand. Not applicable 8. Based on the above, do you consider that this policy/proposal now requires a full impact assessment? Yes outlines employee/management responsibilities in the policy. Signed (Responsible Manager for Policy/proposal) Steven Peet Date 5 th July 2016. VERSION 5.0 July 2016 Page 19 of 19