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Supporting the NHS long-term plan: An evaluation of the implementation and impact of hospital-based tobacco services.

This project is linked to the NIHR ARC National Priority Consortium for Prevention, including Behavioural Risk Factors

Visit the Prevention Including Behavioural Risk Factors Consortium homepage for more information

Project title: Supporting the NHS long-term plan: An evaluation of the implementation and impact of hospital-based tobacco services.

What does the project aim to achieve?

In 2019, 14.1% of adults in the UK smoked, and over 500,000 hospital admissions were due to smoking in 2020. The NHS Long Term Plan – a government policy – aimed to tackle smoking through delivering a new service to support smokers to quit, in three settings: acute hospital, mental health inpatients and maternity services. The government wanted to provide smokers who are admitted to any of these settings in England access to a new ‘stop smoking service’ that includes both behavioural support and medication to help them to quit.

Our project aims to investigate how this new service is delivered, and if it is effective. We will achieve this through four studies in five regions in England:

  • Interviewing those who design, fund, and provide the service
  • Surveying and interviewing NHS staff about their experiences of providing this service. We will also interview service users who have been offered the new service to understand their opinions and experiences of it.
  • Using hospital records to find out the number of smokers who have been offered and used the service, and how effective the new service is based on the number of people quitting smoking.
  • Using hospital records and other data to calculate the costs of providing the service and find out whether it provides value in helping people who smoke.

The findings from this study will support NHS Trusts by giving information how to improve this stop smoking service for the future from the perspectives of service users, healthcare professionals, and others. We aim to write several articles which will be shared widely; for example, with healthcare professionals, policymakers, researchers, and members of the public.

Project update: You can now download research briefings from Phase One of our study, below.

Briefings are available for service commissioners, healthcare professionals, and members of the public

Who will be interested in this project?

This study will be relevant and of interest to NHS Trusts who are participating in this study where they will receive interim findings, those NHS Trusts who are not; NHS and Local Authority partners for policy development; and academics within the tobacco dependence area.

This study has the potential to impact all NHS healthcare professionals; commissioners of smoking services; Local Authority Stop Smoking Services; NHS Trusts delivering the service; current smokers; partners and significant others of smokers

Why is this project important?

By evaluating the rollout of the new NHS-funded tobacco dependence service it will allow us to understand how it is being delivered, how effective it is in aiding smokers to have a successful quit, and how cost-effective the new service is for the NHS. Having an in-depth understanding of these key areas will enable future decision making to be based on evidence of what worked well, what could improve and any other factors that were influential in the successful rollout of the new NHS-funded tobacco dependence service.

Brief summary of Ethical Considerations

As part of this evaluation, routinely collected personal information – collected by the NHS Trusts, will be shared with Newcastle University. This data will be analysed to help improve stop smoking services in both your local area and nationally.

The lawful basis for carrying out this study under GDPR is Task in the Public Interest, (Article 6,1e) as research is cited as part of the University’s duties. The lawful basis for processing any special categories of personal data is Scientific Research (Article 9,2j).

The personal information collected and processed will include but not limited to: age; ethnicity; gender; postcode; NHS number; smoking status; use of tobacco dependence service; quit status. The data collected will be retained for 5 years. The data will be transferred to and analysed by a small team of researchers at Newcastle University.

You can opt-out of your personal information being used. If you wish to opt-out of the sharing of your personal information with Newcastle University, please contact your local NHS Trust – follow this link for further info and contact details.

If you have any questions or would like to make a complaint regarding the evaluation, please contact: Dr Ryc Aquino (programme manager) [email protected]

Please follow this link for further details of the Ethical Considerations

Further project information

Duration: 1 September 2021 – 31 August 2023

Funding total: £ 369,628

Funded by NIHR ARC Prevention, including Behavioural Risk factors National Priority Consortium. Led by ARC North East and North Cumbria collaborating with ARC Greater Manchester, ARC West Midlands, ARC Yorkshire and Humber, ARC West, ARC Oxford and Thames Valley, ARC West, ARC South London, ARC North Thames, ARC Kent Surrey and Sussex.

Project update – June 2023

So far, we have achieved numerous tasks we had set out to achieve. We received favourable ethical opinion from Newcastle University for the first part of the study. We have conducted 23 interviews with key informants (i.e., frontline healthcare professionals, local authority public health consultants, OHID public health and strategic smokefree managers) in the five regions under investigation (North East and North Cumbria; Yorkshire and Humber; Greater Manchester; West Midlands; West). We collected 31 documents, and analysed 25 (eliminating six documents that did not meet the criteria). We have analysed all the data and are currently writing a journal article for publication and wider communications for a varied audience (i.e., policy makers and commissioners; frontline healthcare professionals and the wider public).

We have received ethical approval from NHS Health Research Authority (HRA) and Confidentiality Advisory Group (CAG) for the next part of the study. We have started surveying staff in three of the nine participating NHS trusts, started recruiting staff for interview in one participating NHS trust, and recruiting smoking patients in two of the nine participating NHS trusts. We have started collecting patient data from hospital records in three of the nine participating NHS trusts.

Next steps

We will:

  • Continue to collect more survey responses from the remaining six participating NHS trusts
  • Start recruiting staff for interview in all other participating NHS trusts
  • Conduct interviews with staff across the five regions
  • Recruit smoking patients to interview from participating NHS trusts
  • Conduct interviews with smoking patients within the five regions
  • Plan analysis workshops with our public members

Research findings/outputs to date

Implementation of the NHS-funded tobacco dependence services in England: a qualitative study to understand the contexts of implementation – The Lancet (meeting abstracts), November 2022

Lead contacts for the project: Professor Eileen Kaner and Professor Sheena Ramsay ([email protected])

Co-investigators

Dr Maria Raisa Jessica (Ryc) Aquino, ARC NENC Research Fellow (Prevention), Newcastle University

Dr Kerry Brennan-Tovey, ARC NENC Research Associate, Newcastle University

Dr Mackenzie Fong, ARC NENC Research Fellow (Prevention), Newcastle University

Dr Adam Todd – Academic Pharmacist, Newcastle University

Dr Theophile Bigirumurame – ARC Research Fellow (Methodologies) and biostatistician, Newcastle University

Dr Angela Wearn – ARC NENC Research Fellow (Public Involvement and Community Engagement), Newcastle University

Dr Tomos Robinson – ARC Research Fellow (Methodologies) and health economist, Newcastle University

Professor Paul Aveyard – Professor of Behavioural Medicine, University of Oxford

Professor Marcus Munafò – Professor of Biological Psychology, University of Bristol

Dr Angela Attwood – Senior Lecturer, University of Bristol

Dr Debbie Robson- Senior Research Fellow, Kings College London

Professor Kate Jolly – Professor of Public Health and Primary Care, University of Birmingham

Dr Sarah Damery – Research Fellow, Institute of Applied Health Research, University of Birmingham

Professor Jane West – Bradford Institute for Health Research

Sally Bridges – Bradford Institute for Health Research

Dr Matthew Franklin – Senior Research Fellow, University of Sheffield

Professor Chris Armitage – Professor of Health Psychology, University of Manchester

Professor Jamie Brown – Professor of Behavioural Science and health and Director, Tobacco and Alcohol Research Group – University College London

Evaluation sites

ARC North East and North Cumbria

ARC Yorkshire and Humber

ARC Greater Manchester

ARC West Midlands

ARC West

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