SMOKE FREE WORKPLACE POLICY

SMOKE FREE WORKPLACE POLICY First Issued BKW PCT Npv 2005 Issue Purpose of Issue/Description of Change Version 3 Revised update to unify policy systems across new organisation/change to responsible officer KPIs added Planned Review Date 2009 Named Responsible Officer:- Approved by Date Health & Safety Advisor Health Safety & Welfare July 2007 Committee Policy File:- Health & Safety Policy Impact Assessment Screening Complete- Date: January 2007 Full Impact Assessment Required No No HS23 KPIs i) NHS Wirral premises and owned / leased vehicles are signed to indicate smokefree workplace ii) The smoke-free workplace policy is included in local induction arrangements for employees and contractors iii) Written communication with service users reinforces NHS Wirral s smoke-free policy

Section 1.00 Introduction NHS Wirral Smoke-Free Workplace Policy Table of Contents 2.00 General Principles and Scope 3.00 Definitions 4.00 Employer Responsibility 5.00 Managers Responsibility 6.00 Employee Responsibilities 7.00 Responsibilities of Patients, Contractors and Visitors 8.00 Signage and Communication 9.0 Community Visits 10.0 Exceptions to the Policy 11.0 Monitoring, Evaluation and Review 12.0 Stop Smoking Advice and Support 13.0 Smoke-Free Policy Guidance to Staff 14.0 Incident Reporting and Management 15.0 Other Related Documentation Appendix 1 Process Map: Breach of Smoke-Free Policy Appendix 2 Communicating the Smoke-Free Message Appendix 3 Penalties 2/13

1.0 Introduction The Health Act 2006 has resulted in the introduction of legislation to prevent smoking in enclosed or substantially enclosed public places by summer 2007. Effective dates for implementation are as follows: Scotland 26 March 2007 Wales 2 April 2007 Northern Ireland 30 April 2007 England 1 July 2007 It will be against the law to smoke in virtually all enclosed public places, workplaces and in public and work vehicles. Failure to comply with the new law will be a criminal offence enforceable by the local council and subject to fines and penalties. The aim of the new smoke-free law is to protect employees and the general public from the harmful effects of second hand smoke. To achieve this, premises which are enclosed or substantially enclosed must be smoke-free at all times. Second-hand smoke breathing other people s tobacco smoke has now been shown to cause lung cancer and heart disease in non-smokers, as well as many other illnesses and minor conditions. As employers we acknowledge that tobacco smoke is a public health hazard and a workplace health, safety and welfare issue. NHS Wirral has been smokefree since 8 th March 2006. This Policy recognises that second-hand smoke adversely affects the health of all employees and is not concerned with whether anyone smokes but with where they smoke and the effect this has on smoking and non-smoking colleagues, patients, visitors and all members of the wider community. It is also concerned with the presence of preventable carcinogenic substances in the locality of health sites. 2.0 General Principles and Scope The aim of this policy is to promote a non-smoking environment throughout NHS Wirral, including buildings, grounds, car parks, vehicles and entrances and exits. This policy applies to all premises owned or rented by NHS Wirral and refers to buildings, offices, common areas, grounds, vehicles and car parks. Smoking at entrances and exits by staff, patients, visitors or contractors will not be tolerated. The policy applies to all staff, patients, visitors, contractors and other persons who enter NHS Wirral premises for any purpose whatsoever. The Policy applies to all staff without exception and is concerned with where someone smokes not whether they smoke. It has been drawn up by a multidisciplinary working group, which has sought the opinions of staff and patients and has been endorsed by the Trust Board. The policy also extends to: All vehicles owned by NHS Wirral Leased and private cars during business usage when transporting passengers All vehicles when on NHS Wirral premises 3/13

At all other times staff are reminded to cover their uniform and / or badge if they smoke in their own car. The aim of this Policy is to: Protect and improve the health of staff Protect and improve the health of patients, visitors and contractors Protect both smokers and non-smokers from the danger to their health from exposure to secondhand smoke Act in a manner consistent with public health and health promotion activity undertaken by NHS Wirral Support those who wish to stop smoking Set an example to other employers and workforces, particularly in health-related locations 3.0 Definitions Smoking: Smoking tobacco, anything which contains tobacco or smoking any other substance. Being in possession of lit tobacco or any other lit substance in a form in which it could be smoked. Enclosed premises: are those premises which have a ceiling or roof and, except for doors, windows or passageways, are wholly enclosed either on a permanent or temporary basis Substantially enclosed premises: are those premises with a ceiling or roof but which have an opening in the walls which is less than half of the total area of the walls. Note: the area of the opening should not include doors, windows or any other fittings that can be opened or shut. 4.0 Employer s responsibility This policy was determined by a multidisciplinary working group and ratified by NHS Wirral s Heath Safety & Welfare Committee. Responsibility for implementing this Policy rests with the Chief Executive. 5.0 Managers responsibility Day-to-day responsibility for ensuring compliance with the policy lies with the departmental managers and with those to whom they delegate specific responsibility. This includes dealing with staff breaches of the policy and also ensuring that all contractors, visitors and patients are made aware of the policy and asked to comply (See Appendix 1- Process Map: Breach of NHS Wirral Smoke-Free Policy). Managers of smoke-free premises and vehicles have a duty to prevent smoking within workplaces and vehicles. Managers also have a duty to monitor the smoke-free arrangements within those premises and vehicles. Failure to prevent smoking in smokefree premises or vehicles can result in a fine of 2,500 for the person who manages or controls the premises or vehicle. See appendix 3 Penalties. 4/13

NHS Wirral encourages managers to assist their staff to access the confidential, free, professional, NHS stop smoking service available to all staff and has agreed to allow staff, who wish to stop smoking, time, during working hours, to attend this service. Any member of staff who continues to be in breach of the policy should be dealt with through disciplinary procedures. If individual staff members challenge their manager on their right to smoke the manager should refer to these points: This an NHS Wirral Policy relating to Health and Safety and is based on the same principles as policies relating to toxic substances and dangerous machinery NHS Wirral has a duty to its patients and staff to protect them from the health hazard that smoking represents An employee cannot challenge the employer s right to introduce healthier working practices If staff need to go off-site to smoke during their break, the following applies: Under the Working Time Directive, where staff work longer than six-hours they are entitled to a break of a minimum of 20-minutes. In most health and social care workplaces, breaks are taken in a manner consistent with maintaining minimum staffing levels, managers need to plan effectively for staff who leave the premises for a break for any reason. Under no circumstances should a confrontational attitude be adopted or allowed to develop. All managers should seek to support staff to enable them to comply with the policy. 6.0 Employees Responsibilities Staff cannot smoke in buildings, grounds, car parks or at entrances and exits of premises operated by NHS Wirral or when working as representatives of NHS Wirral Staff may not smoke at any time whilst wearing a visible uniform or badge, which identifies them as an NHS Wirral employee. They may not smoke in vehicles owned by NHS Wirral at any time or in leased or private cars during business usage when transporting passengers, whilst on NHS Wirral premises or whilst wearing a visible uniform or badge, which identifies them as an employee. Where employee owned vehicles are used on NHS Wirral business (i.e where business mileage is being claimed), and others are being transported within that vehicle, the driver and occupant(s) must refrain from smoking and must not request permission to smoke each from the other. A fixed penalty notice of 50 (reduced to 30 if paid in 15 days) can be imposed by the local authority on the person smoking, or a maximum fine of 200 if prosecuted and convicted by a court. see Appendix 3 Penalties and fines 5/13

All staff who experience difficulties in complying with or implementing the policy should seek support from their line manager in the first instance. All staff are contractually obligated to comply with the policy For those who wish to stop smoking free, confidential NHS Stop Smoking advice is provided by Wirral SUPPORT specifically for staff, for details telephone: 0151 630 8383 Staff are expected to remind patients about the Policy. They are not expected to enter into any confrontation which may put their personal safety or patient / professional relationship at risk. 7.0 Responsibilities of patients, contractors and visitors The Policy applies to all contractors, visitors and members of the public irrespective of their circumstances. Contractors who contravene the Policy should be reported to the person responsible for managing the contract on site. Staff should report to their line manager in the first instance. Visitors who are distressed for any reason should be supported, but the policy still stands. Visitors and Contractors who may wish to give up smoking can obtain free, confidential, NHS Stop Smoking advice from Wirral SUPPORT, for further details telephone 0151 630 8383. 8.0 Signage and Communication To ensure that everyone entering NHS Wirral sites understands that smoking is not allowed in the buildings, grounds and car parks, clear signs will be prominently displayed on or immediately within entrances to site, bearing internationally recognised prohibition no smoking sign of a slashed red circle over a black cigarette. Signage provided at entrances to individual buildings must meet the minimum requirement in England for an A5 size sign showing the international no smoking symbol at least 70mm in diameter and the wording: No smoking. It is against the law to smoke in these premises. Leased and NHS Wirral owned vehicles must display a no smoking symbol with the international no smoking symbol at least 70mm in diameter (for England) and 75mm diameter (for Wales) in each compartment of the vehicle where people may be carried. Signs can be downloaded from www.smokefreeengland.co.uk or www.smokingbanwales.co.uk Adhesive signs can also be ordered from either of these websites or by phoning 0800 169 1697. Tenders and contracts with NHS Wirral will stipulate adherence with this Policy as a contractual condition. 6/13

Patients will be advised of the Smoke-Free Policy in all appropriate written communications disseminated by NHS Wirrral (see also section 6.0 Employees Responsibilities). The recruitment process will include reference to the Smoke-Free Policy and indicate that adherence is contractual. 9.0 Community Visits NHS Wirral s Board recognises that staff face special circumstances when visiting patients in the community: A programme of public education and awareness raising has been in place for sometime and will continue. Patients, their relatives or visitors are asked not to smoke when NHS Wirral staff visit All appropriate patient communications, including appointment letters disseminated will draw attention to the Smoke-Free Policy When an appointment to visit a patient in their own home is made by telephone, staff are required, to inform the patient of NHS Wirral s Smoke-Free Policy. For this purpose the statement suggested in Appendix 2 may be used. Staff with particular problems related to visiting patients who smoke should raise these with their line manager in the first instance and complete an incident report form Heart of Mersey has launched the Mersey Charter to assist organisations in the development of policies and practices to protect community staff from exposure to second hand smoke in the course of their work within clients own homes 10.0 Exceptions to the Policy The NHS Wirral Board recognises that some individual patients may have circumstances that will require staff to make an assessment as to whether specialist arrangements need to be made so that they are permitted to smoke on an NHS Wirral site or in the presence of NHS Wirral employees. In all cases where an exception is made, full consideration should be a part of the patients care plan or pathway in conjunction with the patient and/or their relatives. In such exceptions every effort must be made to minimise staff exposure to smoke, which may mean smoking only taking place outdoors where staff and others would not be in close proximity and ideally out of sight of other patients, visitors and staff.. 11.0 Monitoring, Evaluation and Review This policy will be reviewed and evaluated by the Health and Safety Advisor in conjunction with the multidisciplinary Smoke-Free Working Group. The first review will take place six months from implementation and thereafter, two yearly as per the policy review and 7/13

ratification procedures. The purpose of the review is to ensure that the policy is effectively implemented and meets its aims. Specific issues related to the management, application or implementation of the Policy should be addressed to your line manager in the first instance. 12.0 Stop Smoking Advice and Support NHS Wirral, sincerely encourages all smoking employees to consider giving up smoking to protect their future health and wellbeing and encourages managers to assist their staff to access the confidential, free, professional, NHS stop smoking advice available to all staff. The Trust has agreed to allow staff, who wish to stop smoking, time, during working hours, to attend this service. The service is provided at various venues across Wirral. To access the service telephone WIRRAL SUPPORT on 0151 630 8383 and ask for staff stop smoking advice. A course of treatment will normally consist of 2.5 hours over a 3-month period (please note the initial appointment is 30 minutes). In addition to the service for staff, the PCT offers stop smoking advice at all GP practices across Wirral and within a range of other settings and locations. This service is available to any smoker living or working in Wirral or registered with a Wirral General Practitioner. To access these services or for further information telephone: WIRRAL SUPPORT on 0151 630 8383. 13.0 Smoke-free Policy Guidance for Staff The Smoke-Free Policy applies to staff, patients, visitors and contractors. The following guidance points are intended to give all staff key phrases and references to enable them to implement the policy effectively. General Smoking is the biggest single, preventable cause of ill health and premature death in the country and the major contributing factor to inequalities in health. The Trust is doing everything it can to promote the no-smoking message. As an NHS employer, NHS Wirral has a duty to its staff and patients to protect them from all the health hazards that smoking represents. Vehicles The toxic and carcinogenic properties of tobacco smoke are intensified in small enclosed spaces and we would strongly recommend that smoking in cars be avoided at all times. For this reason, staff are not permitted to smoke in vehicles owned by NHS Wirral at any time or in leased or private cars during Trust business usage when transporting passengers. 8/13

Patients, contractors, visitors and members of the public This policy applies to all patients, contractors, visitors or members of the public. In the case of patients, there may be some exceptions (see 11.0 above). Polite signage and reminders are usually sufficient to deter smoking, but patients will be reminded of the policy within all communications and appointment letters.. For this purpose see statements suggested in Appendix 2. 14.0 Incident Reporting and Management Staff are reminded to report any incident which they believe may affect their health & safety in relation to this policy to their line manager using an incident report form. It is the service Head/Leads responsibility to ensure that all incidents are investigated and recommendations for reducing risk and improving health and safety are implemented 15.0 Other Related Documentation: The following NHS Wirral policies are also relevant: Health & Safety Policy General Statement of Intent Incident Reporting Policy Arrangements & Responsibilities Policy Risk Assessment Policy COSHH Policy Whistle Blowing Policy Violence and Aggression Policy Withholding Treatment from Violent or Abusive Patients 9/13

Process map following a breach of NHS Wirral s Smoke-free Workplace Policy Breach of Smoke-free Workplace Policy Other Trust Employee Member of Staff Contractor Patient Visitor Member of the Public Policy shared with other Trust Employee Informal Counselling Contact NHS Contractor manager informed Policy shared with Patient Policy shared with Visitor Policy shared with Member of the public Further breach. Disciplinary process may be invoked No Explain Policy applies Offer Stop Smoking Service referral Is there an exemption? Yes Refer to Policy Discuss with patient/relative incorporate within care plan or pathway

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Appendix 2 Communicating the Smoke-Free Message. Signage: The NHS is Smoke-Free. Thank you for not smoking on our sites. Written: The NHS is Smoke-Free, thank you for not smoking on our sites. and / or We request clients provide a room which has been smokefree for a minimum of 30 minutes as far as is practicable prior to a planned visit and that you, your relatives or visitors do not smoke whilst receiving a visit from a member of our community staff Verbal: When making a telephoned appointment: Can I remind you that the NHS is Smoke-Free, thank you for not smoking on our sites. Or Can I remind you that the NHS is Smoke-Free. We request clients provide a room which has been smokefree for a minimum of 30 minutes as far as is practicable prior to a planned visit and that you, your relatives or visitors do not smoke whilst receiving a visit from a member of our community staff When approaching someone breaching the policy, the following statement may be less confrontational: Did you know the NHS is smoke-free, will you please leave the site to finish your cigarette?

Appendix 3 What are the penalties and fines for breaking the smokefree law? If you don't comply with the smokefree law, you will be committing a criminal offence. The fixed penalty notices and maximum fine for each offence are: Smoking in smokefree premises or work vehicles: a fixed penalty notice of 50 (reduced to 30 if paid in 15 days) imposed on the person smoking. Or a maximum fine of 200 if prosecuted and convicted by a court. Failure to display no-smoking signs: a fixed penalty notice of 200 (reduced to 150 if paid in 15 days) imposed on whoever manages or occupies the smokefree premises or vehicle. Or a maximum fine of 1000 if prosecuted and convicted by a court. Failing to prevent smoking in a smokefree place: a maximum fine of 2500 imposed on whoever manages or controls the smokefree premises or vehicle if prosecuted and convicted by a court. There is no fixed penalty notice for this offence.