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Joint Working Project between NHS England (on behalf of Greater Manchester Health & Social Care Partnership) and Pfizer

Accelerating the Conversation-Understand-Replace-Experts (CURE) Project - Curing Tobacco Addiction in Greater Manchester

 

Background

The Greater Manchester Health and Social Care Partnership’s tobacco control plan Making Smoking History, published in July 2017, has set ambitious targets for the health economy to reduce smoking rates across the health economy. To achieve these will require a strong and widespread focus on different populations in which smoking is prevalent. This project aims to support this by:

  • Building on an existing secondary care smoking cessation provision to offer a more comprehensive service to the patients of Manchester University NHS Foundation Trust Wythenshawe Hospital site
  • Supporting the target of reducing smoking in the population by one third by 2020
  • Increasing stop smoking attempts to 40% (now 30%)
  • Sustaining short-term quit success at 20%

 

Project

This project intends to pilot and evaluate a redesigned smoking cessation pathway for one hospital site, Wythenshawe Hospital and consists of the following stages:

Engagement

  • Stakeholder mapping
  • Development of a stakeholder engagement event to identify concerns and gain buy in
  • Mapping current pathway
  • Training and support for adoption of new pathway
  • Communications plan to include internal and external

 

Training

  • Development of a three-level training programme for hospital staff and clinicians:
    • Level 1: Very brief advice
    • Level 2: Pharmacotherapy
    • Level 3: Behavioural change skills
  • Implementation plan for training programme
  • Rollout of training programme

 

Access to pharmacotherapy in line with national and local guidance:

  • Assessment of impact of pathway on current medication prescribing and supply
  • Evaluation to determine cost-effective and timely means of ensuring necessary supply
  • Implementation  of pharmacotherapy supply programme

 

Standardised internal hospital documentation:

  • CURE pathway proforma
  • Tobacco dependency assessment
  • Management guidance
  • Discharge information on tobacco dependency and care plan

 

Smoking cessation services:

  • Development of Consultant Smoking lead role within the hospital
  • Smoking cessation specialist nurses at Wythenshawe Hospital trained to lead CURE programme
  • Healthcare professionals trained in behavioural change skills in key specialties – respiratory, oncology, cardiology, stroke
  • Patient follow up by telephone post discharge

 

Evaluation

  • Baseline mapping and costs evaluation of current service provision for Wythenshawe Hospital
  • Monthly evaluation reports
  • Six month interim evaluation to determine success of initial pilot phase
  • Feasibility and recommendations for scaling of CURE across all GMHSCP hospital sites
  • End of project report

 

 

Objectives:

  • 100% of Health Care Professionals trained in level 1 smoking cessation
  • Sustained 20% quit rate among intervention group
  • Reduction in 30 day and 12 month readmissions among smokers receiving secondary care smoking cessation treatment
  • Reduction in 12 month mortality among intervention group
  • Reduction in Emergency Admissions among the intervention group

 

 

Benefits include:

For patients:

  • For patients that smoke receiving treatment within this project, reduced likelihood of being readmitted to hospital within 30 days and therefore an improved quality of life
  • For patients that smoke receiving treatment within this project, lower chance of experiencing a cardiovascular event following hospital visit
  • Shorter length of hospital stay for smokers
  • For patients that smoke who successfully quit, improved long term health and reduction in symptoms of smoking-related illness
  • Improved financial position for patients that have successfully stopped smoking and their families due to lower expenditure on tobacco

 

For the NHS:

  • Reduction in hospital lengths of stay, releasing capacity within the hospital to treat more patients
  • Reduction in number of A&E attendances, allowing for more planned activity to take place and for staffing and resources to be planned more accurately
  • Improved outcomes following hospital visit, meaning a reduction in follow-up activity and readmissions
  • Upskilled workforce to reduce the burden on specific staff of delivering smoking cessation advice to patients, and to enable the smoking cessation service to be provided to a greater number of patients. Increased number of staff being trained to deliver stop smoking advice and thereby reducing burden on existing service and increasing reach
  • Lower cost of care per head for treated population

 

For Pfizer:

  • Development of strategic relationship with Greater Manchester Health & Social Care Partnership by demonstrating company capabilities to support further collaborations.
  • Improved understanding of smoking cessation within secondary care settings

 

PP-GIP-GBR-3066 | April 2018