The Trust became a smoke free organisation in June 2016.
Smoke free means that patients, carers, staff and other visitors to Trust premises will not be allowed to smoke on any of our sites, including all wards, buildings, grounds and vehicles. There will no longer be designated areas where smoking is allowed.
If you smoke, we will support you to make a quit attempt, or to temporarily abstain whilst in hospital.
ople with mental health problems are more likely to smoke, and to smoke more heavily, than the general population. This is one of the reasons that they tend to have poorer physical health and a lower life expectancy. We want to do all we can to tackle the smoking culture in mental health care, by supporting our patients and staff to quit or reduce their smoking and enjoy the best possible health. The benefits of not smoking go much further than improved physical health. We know that many patients spend a significant proportion of their income on tobacco products too.
Nurses on our inpatient wards devote a lot of time to escorting patients to designated smoking areas and we'd like this time to be spent on more therapeutic activities.
Our decision is also supported by recommendations from the National Institute for Health and Care Excellence (NICE), who raise the need for all NHS premises to become completely smoke free.
The Trust will not be preventing patients from smoking, however we will be prohibiting smoking on our premises. Those patients who are able to leave Trust premises will still be able to go off site and smoke. However, if you are detained under the Mental Health Act this might not always be possible. In these circumstances staff will offer a range of nicotine replacement therapy to support you to abstain from smoking.
All ward staff will be trained to offer basic advice and support to abstain from smoking. However, a number of staff on each ward will also be able to offer the full range of stop smoking interventions.
All patients will be asked about their smoking when they are admitted to hospital. Whilst some patients may want to make a quit attempt, there will be others who don't but who are required to temporarily abstain from smoking. This might be for a number of reasons such as being legally detained in hospital.
We recognise that stopping smoking can be very difficult and want to do all we can to manage withdrawal effects. Consequently all patients who are making quit attempts, or who are unable to go and smoke, will be offered Nicotine replacement and/or other support to help them to manage this. We know that these measures significantly increase the chances of people quitting smoking, or managing to abstain whilst in hospital.
Wherever possible patients will be advised that smoking is not permitted on our premises and they will be offered support to temporarily abstain or quit. This will include Nicotine Replacement Therapy (NRT) and behavioural support.
If a patient attempts to smoke on Trust premises they will be reminded of our policy and asked to refrain. We appreciate that some patients might find it difficult to stay smoke free. In such circumstances ward staff will review their care plan and consider how best to support the individual not to smoke on Trust premises.
Respecting our smoke free premises applies to everybody, including visitors, contractors and our staff. Staff will also be supported to make a quit attempt or will have to leave Trust premises if they want to smoke. This will only be able go off site to smoke during unpaid breaks.
The decision to go smoke free was made in the autumn of 2015. During the preparation to going smoke free the Trust publicised its intention to stop smoking on its premises. A project team consisting of staff and service user representatives were involved in moving the organisation towards becoming smoke free. The group looked at the best evidence available and best practice from other mental health Trusts that have gone smoke free.
A series of events were held across inpatient wards, involving both staff and patients. These afforded people an opportunity to find out more and contribute towards how this will be implemented.
E-cigarettes are battery powered devices that produce vapour. Devices come in many forms, sometimes resembling cigarettes, but others resemble pens or gadgets. Some products are disposable whilst others are rechargeable and refillable via cartridges or liquids.
E-cigarettes do not contain tobacco but usually deliver nicotine. The use of vapour means that the user is not exposed to all of the poisonous gases that are in tobacco smoke.
There are arguments both for and against e-cigarettes. Based on the best evidence currently available, as well as feedback from our staff and patients, the Trust will normally allow the use of e-cigarettes within outdoor areas. However, this decision will regularly be reviewed to ensure it remains in line with national guidance.
There may be circumstances when it is unsafe for a service user to have an e-cigarette. This will be managed on an individual basis by offering alternatives such as nicotine replacement.
The Trust is not banning people from smoking. It is simply prohibiting the use of tobacco on its premises. The Trust's position is supported both in law and by the NHS.
It is not an infringement of a patient's human rights for the Trust to be smoke free. This argument has been legally tested and was upheld by the Court of Appeal in 2008 after Rampton Hospital in Nottinghamshire went smoke free. It ruled that a hospital is not the same as a home environment and is instead a place that should support the promotion of health and wellbeing. Therefore patients can be prevented from smoking for health and security reasons.
The Trust is initially focussing on helping our inpatients to quit or abstain from smoking, however we hope that many will want to continue their quit attempts once they are discharged from hospital. Patients can continue to supported by community based smoking cessation services once they leave the ward.
We will also consider how we might increase smoking cessation support to other community patients. The Trust is currently involved national research offering a bespoke 'stop smoking' service to those who have a diagnosis of schizophrenia and bipolar disorder, who want to cut down smoking or give up for good.