Patients admitted to hospital will be offered smoking cessation support during their admission and, upon discharge, will receive a referral to a community pharmacy of choice for continuing treatment, advice and support with their attempt to quit smoking.
This pilot service proposes that community pharmacies deliver a smoking cessation service for patients discharged from hospitals where their smoking cessation treatment was initiated. This pilot supports treatment of tobacco addiction and the commitments outlined in chapter 2 of the NHS Long Term Plan to make England a smoke-free society.
The pilot will connect hospitals with primary care by using the accessible network and skills available within community pharmacy. It will also improve follow-up after patient discharge, which is identified as a key stage in the Ottawa Model for Smoking Cessation (OMSC) (Reid, 2010).
Aim of the service
Current smoking cessation services exist in secondary care, primary care and community services. This pilot service aims to address the gap in the handover between secondary care and primary care, testing a model for transferring the care and creating capacity in primary care with a service commissioned through community pharmacy.
The OMSC, which 120 hospitals in Canada currently use and will be adopted by the NHS according to the NHS Long Term Plan, identifies the smoking status of all admitted patients.
Inpatient smokers are offered evidence-based cessation support for 12 weeks. The model has increased 1-year quit rates by 11% and is expected to save the NHS “£85 million in healthcare resource use within 1 year once rolled out” (Mullen, 2010; Royal College of Physicians, 2018).
What the service will provide
The agreement is for the pharmacy to provide smoking cessation advice and support to patients referred to them as part of their discharge from secondary care.
The ongoing consultation may include behavioural support as well as the supply of Nicotine Replacement Therapy (NRT).
There is a significant increase in successful quit attempts when behavioural support and treatment are combined. This could include:
- behavioural support and supply of Varenicline under Patient Group Direction (PGD)
- onward referral into another community pharmacy engaged in the pilot
- onward referral into a local specialist smoking cessation service (where one exists)
How patients access the service
Only patients who have been referred during their discharge from secondary care are eligible to receive advice and treatment under this service.
An electronic transfer of data to support the referral will be sent from secondary care to a participating local community pharmacy.
Patients who wish to consult another healthcare provider for smoking cessation support are still free to do so. Patients being referred through this pathway have already agreed to be referred to community pharmacy.
The NHS England Smoking Cessation Referral from Secondary Care into Community Pharmacy Pilot will run from 14 September 2020 to 31 March 2021.
If the pilot is extended, it will be assumed that pharmacy contractors will continue to provide this service unless they opt-out. An opt-out process will be detailed in the run-up to the extension.
This does not prevent pharmacists from opting out earlier, as set out in Section 5 of the SLA.
Guidance on consultations during the coronavirus (COVID-19) pandemic
Due to the coronavirus pandemic, contractors are requested not to offer face-to-face consultations until the guidance changes. Pharmacy teams providing this service will be expected to follow the guidance available from the NCSCT and CPPE on remote consultations.
Analysis published in July 2020 by Action on Smoking and Health found that over a million people in the UK have stopped smoking since the coronavirus (COVID-19) pandemic hit the country. While thousands have heeded advice to quit, there is significant variation by age, with younger smokers quitting at a much greater rate than older smokers. Around 400,000 people aged 16-29 have quit compared to 240,000 of those over 50. This data is one important silver lining from an incredibly difficult time.
As part of the NHS Long Term Plan, we are committed to work with local authorities and Public Health England to make England a smoke-free society.
Register to provide the service
You can register for this service if:
- you're one of the specific pharmacies within the specified primary care networks (PCN) piloting this service
- you intend to provide the service between 14 September and 31 March 2021
Pilot areas include:
- Oldham - Greater Manchester
You must register your pharmacy’s details with NHS England. As this is an online signup, there is no need to return a signed SLA to NHS England.