Appendix L. Greater Glasgow Health Board - Starting Fresh (Smoking Cessation)
Topics: Substance Misuse
Background
Unmet needs funding was used, along with additional resources that became available concurrently, to support the development of the "Starting Fresh" (smoking cessation) Programme. This meant that the unmet needs funding was mainstreamed into a comprehensive smoking cessation service.
The unmet needs bid identified 4 principle areas of development for smoking cessation services and the two key areas of development are summarised below.
Funding allocation
The pilot was allocated £400,000
Aim(s)
To support the ongoing development of the smoking cessation service within Greater Glasgow, ensuring developments were targeted to both areas of deprivation and vulnerable client groups.
Methodology
Two key areas of development for smoking cessation services were identified. These were:
- Extension of the "Starting Fresh" pharmacy network within areas of deprivation
A key feature of the Starting Fresh pharmacy programme is the support offered to community pharmacists by the Community Pharmacy Health Promotion Facilitator Network. Pharmacy advisers undertake a number of roles including providing a link between the community pharmacies, acute smoking cessation advisors/pharmacist and smoking cessation advisors in primary care.
Evidence shows that pharmacy services have succeeded in creating a high volume of access to smoking cessation services in Greater Glasgow. However, cessation rates for clients within the pharmacy service are lower than those achieved within more intensive smoking cessation interventions.
- Development of secondary care in-patient services
Unmet needs funding was used to further develop the existing integrated stop smoking services and to accommodate patients who had been given intensive support and prescribed NRT (nicotine replacement therapy) in the acute hospital setting. This was done by funding two of five hospital cessation adviser posts in Glasgow. The advisers were used as part of a smoking cessation protocol that was devised for hospital in-patients. This protocol included those wanting to make a quit attempt receiving intensive support from a smoking cessation advisor, the provision of NRT on discharge and additional support and NRT from a preferred "Starting Fresh" pharmacy.
Key results
- Extension of the "Starting Fresh" pharmacy network within areas of deprivation
Of the additional 52 pharmacies recruited, 60% were located in areas of deprivation (Depcat 5-7). There is clear evidence that users are being drawn into the service from the most deprived parts of Glasgow's population, with 57% residing in the two quintiles that are associated with higher areas of deprivation. However, the impact of reducing inequalities is limited as it was found that smokers living in more deprived areas had lower levels of cessation than smokers living in more affluent areas. Therefore, more intensive support achieving higher cessation rates is required.
- Development of secondary care in-patient services
The service reached the target group of heavily addicted smokers from socially deprived areas. 212 patients accessed the service and 48% were not smoking at a one month follow-up. Of the 212 patients, 61% were from Depcats 5-7.
Conclusions
The unmet needs programme supported the ongoing development of the smoking cessation service with Greater Glasgow ensuring that developments were targeted at areas of deprivation and vulnerable client groups.