NHS England Advanced Community Pharmacy Smoking Cessation Service - Royal Wolverhampton NHS Trust (October 2022 – January 2023)

Background

NHS England (NHSE) wanted to implement an adapted Ottawa Model of Smoking Cessation in secondary care trusts in England enabling patients to receive inpatient smoking cessation treatment and support as part of routine care.  NHSE commissioned NHS Midlands & Lancashire to support implementation by working with various stakeholders within secondary care, primary care & local authority (this case study highlights implementation in Wolverhampton).

Action

A 3-stage process was mapped out for a local trust/system to go live
Stage 1 - Scoping & Mapping (engagement with Public Health, Local Authority (council), acute trust tobacco control teams as well as Integrated Care Board teams)
Stage 2 - Pathway Agreement - Agree pathway (including funding) and method of sending of sending referrals to community pharmacies from secondary care (this included NHS ML developing a NHSE approved resource pack for stakeholders to use to develop the service)
Stage 3 - Community Pharmacy engagement - Working closely with Local Pharmaceutical Committees to host webinars to showcase service and facilitate training of the pharmacies to be ready to receive referrals and treat patients

Impact

We successfully helped Royal Wolverhampton Trust go live with the service in Jan 2023.  This was incredibly vital in Wolverhampton as the locally available smoking cessation service had recently been decommissioned due to funding. Over the period of Jan-Dec 2023 433 patients were referred to community pharmacy for smoking cessation support.  Of those referred 75% engaged and accepted a supported quit attempt with their chosen pharmacy.  Forty seven percent achieved a 28-day quit rate (NHS standard measure) this figure was comparable to national NHS stop-smoking statistics.

As with any new service there had been some teething problems with the referral pathway and delivery by the community pharmacy teams.  NHS ML as well as trust tobacco teams and the LPC were proactive in supporting pharmacies to adopt this new service.  NHS ML shared learning and lessons learnt from other systems and secondary care trusts who has gone live with the service before Wolverhampton and gave expert input in minimising issues to the service.  ML also supported post go-live by attending regular meeting with stakeholders and hosting drop in Q&A webinars for pharmacies to bring their issues and questions this was also supported by the NHSE national smoking cessation lead.

Finally from the national referral data, The Royal Wolverhampton NHS Trust was the leading referring trust to community pharmacy for smoking cessation support in the whole of England."

The Tobacco Dependency Service is incredibly valuable and vital. It has been a huge success in ensuring our patients are managed appropriately and followed up. Thanks for all your help.

Shamma Khan – Senior Pharmacist, Cardiac Services. Royal Wolverhampton NHS Trust