<p> PUBLIC HEALTH LOCAL SERVICES AGREEMENTS 2016/17 SERVICE SPECIFICATION SIGN-UP</p><p>Stop Smoking Service</p><p>Contract expiry date: 31 March 2017</p><p>Specific Training/Accreditation: All staff involved in SSS delivery must be trained to the NCSCT training standard and should obtain full NCSCT certification. In addition to the completion of the national online training, it is also recommended that practitioners receive face-to-face training from the East Sussex Stop Smoking Service, QUIT 51, and participate in a period of shadowing and observation before providing support unsupervised.</p><p>GP Practice/Pharmacy name: Pharmacy registration code: GP Practice Branch Code: Pharmacy OCS code: GP Practice PPA Code:</p><p>I declare that I am competent to provide this service. Name and designation:</p><p>Signature:</p><p>To be signed only by the contractor or authorised person</p><p>For and on behalf of EAST SUSSEX COUNTY COUNCIL County Hall, St Anne’s Crescent, Lewes, East Sussex BN7 1UE</p><p>Signed …………………………………………………….. Authorised Signatory </p><p>1 Payment: The following payments will be made in relation to partner activity delivered through this agreement:</p><p>Activity Payment Completion of an intervention which meets the following minimum criteria £20 (non quitters):  The patient has received brief advice regarding their smoking  The patient has set a quit date  CO readings have been taken during any support session they receive and results have been recorded  Client service data has been submitted detailing the support the patient has received and the outcome of the intervention (not quit/Lost to follow-up)</p><p>This payment will be made for all patients who do not quit (as long as the minimum criteria has been met). Completion of an intervention which meets the criteria described above £95 and where the outcome of the intervention is a successful 4-week quit This payment is subject to the completion of a 12-week review. However, payment will be made at 4-week monitoring stage</p><p>How to claim: </p><p>Gold Standard Monitoring data to be input to the Quit 51 data web reporting system. Contact: Graham Thomas [email protected] Public Health Local Service Agreement 2016/17</p><p>This service specification should be read in conjunction with the Public Health Local Service Agreement (PHLSA) contract document. In addition to the service specific elements set out in this specification all Terms and Conditions set out in the PHLSA must be adhered to by providers delivering this service</p><p>GP Practice and Community Pharmacy Stop Smoking Service</p><p>Contract length: This service specification runs from 1 April 2016 up to 31 March 2017</p><p>Content</p><p>1 Summary p4 2 Introduction p6 3 Background and evidence p8 4 Aims and outcomes p9 5 Service outline and standards p10 6 Referrals p16 7 Eligibility p17 8 Equipment and premises p17 9 Safeguarding p18 10 DBS Check requirement p18 11 Accreditation and training p18 12 Payment and cost p19 13 Monitoring, audit and reporting p20 14 Contacts p22 15 Appendices p23 1 1 Summary This section highlights some of the key elements of this Public Health Local Service Agreement.</p><p>Aim To enable GP Practices and Pharmacies to provide SSSs to their patients which:  Offer choice of treatment options appropriate to clients  Offer the most effective evidence based treatments available  Support people to successfully quit smoking  Achieve high levels of client satisfaction</p><p>Outcomes The service will support people to successfully quit smoking for 12 weeks. Quitting will be measured at 4 weeks (and payment based on 4 week quitters) and follow up will occur at 12 weeks. It is anticipated that many clients will permanently stop smoking and as a result, will have improved health outcomes and lower levels of healthcare utilisation.</p><p>Service description Interventions should have clear structure and content as detailed below. An optimum session frequency is described as follows</p><p>One-to-one behavioural support sessions (support for the first six weeks may be delivered through a combination of telephone or face to face support) Session Minimum time allocated (minutes) Session 1: Pre-quit 30 Session 2: Quit date 20 Session 3: 1 week post-quit 15 Session 4: 2 week post-quit 15 Session 5: 3 weeks post-quit 15 Session 6: 4 weeks post-quit 15 Total 1 hour 50 minutes</p><p>Total minimum contact time equates to 1 hour 50 minutes (from pre quit prep to four weeks after quitting). This may be delivered through a combination of face to face or telephone intervention. Providers are expected to attempt CO monitoring at the 4 week quit review session with a minimum of 85% of cases. The local protocol outlines the stages that should be undertaken to support a smoker to quit. Service providers should:  Offer weekly support for at least the first four weeks of a quit attempt  Ensure carbon monoxide (CO) verification is attempted  Ensure advisors are aware of other local health partners that clients can access and how to signpost/refer e.g. weight management and drug and alcohol treatment services.</p><p>Service standards  All primary care stop smoking advisor staff working within participating stop smoking services must adhere to the guidelines of this service.  Providers should systematically offer VBA in line with national guidelines.  The Provider will ensure that the Russell Standard is followed (clinical) for assessing performance in NHS Stop Smoking Services.  Each service user should receive weekly support for at least the first four weeks of a quit attempt  CO readings should be taken and recorded at each of the weekly sessions  The Provider shall ensure that staff providing a SSS have received certification -NCSCT Assessment of core knowledge and practice skills training (previously known as stage 1 and 2 SSS training) from the NCSCT and are fully aware of how East Sussex Stop Smoking Services operate.  Providers are normally expected to record all service data on the Quit Manager system provided by Quit51. If this is not possible, requests to continue on paper system will be considered by the Commissioner, on an individual basis. All paper client data monitoring forms must be returned to East Sussex Stop Smoking Service, Quit 51, within five working days following the four week review and 12 week follow up. Forms should be sent to the following address:</p><p>Quit51 FF19-25 Imex Business Park Shobnall Road Burton on Trent Staffs DE14 2AZ</p><p> All invoices relating to service activity must be supported by evidence from client data monitoring forms. Incomplete forms and forms returned outside of specified timescales and deadlines, as outlined in section 11 and Appendix 5, may result in delayed or missed payment. Repeated late returns of paperwork or submission of incomplete paperwork will be investigated by the Commissioner.  Those involved in delivering smoking cessation support will have the necessary skills and competencies,  To ensure that competence is maintained practices are required to adhere to the NCSCT Competency Framework. Practitioners are normally expected to attend one update session per year (where this is not possible practices should liaise with the specialist stop smoking service on alternative arrangements).  Where a client/patient relapses during a quit attempt (and does not wish to begin a new treatment episode), no further pharmacotherapy should be provided until such a time as the client is motivated to make another quit attempt.  Ensure a minimum of three attempts to follow up DNA clients by telephone, text, letter (ensure attempts are recorded) before coding ‘lost to follow up’. </p><p>Payment The following payments will be made in relation to partner activity delivered through this agreement: Activity Payment Completion of an intervention which meets the following minimum criteria (non quitters): £20  The patient has received brief advice regarding their smoking  The patient has set a quit date  CO readings have been taken during any support session they receive and results have been recorded  Client service data has been submitted detailing the support the patient has received and the outcome of the intervention (not quit/Lost to follow-up)</p><p>This payment will be made for all patients who do not quit (as long as the minimum criteria has been met). Completion of an intervention which meets the criteria described above and where the £95 outcome of the intervention is a successful 4-week quit This payment is subject to the completion of a 12-week review. However, payment will be made at 4-week monitoring stage 1 2 Introduction</p><p>This specification describes the scope and requirements for the provision of stop smoking services by General Practices and Pharmacies. </p><p>Over 1000 people died from smoking related disease in East Sussex in 2013 (East Sussex JSNA, 2014). Smoking is the single greatest cause of death in England today. There are approximately 84,000 smokers in East Sussex and most (66%) want to quit (DH, 2012; East Sussex JSNA, 2014). The most effective method for stopping smoking is via NHS approved Stop Smoking Services. Most smokers attempt to quit using the least effective method – cold turkey (unaided) (DH, 2012). Since April 2014 upper tier local authorities are responsible for public health services including stop smoking services. </p><p>To ensure smokers have access to the most effective method of quitting East Sussex County Council (ESCC) has commissioned a specialist stop smoking service of qualified and skilled advisors whose role is supporting quitting attempts through 1-2-1, group, phone and web behavioural support through Quit 51. This service specification sets out additional stop smoking services to be provided by General Practices (GP) and pharmacies to their patients. GP and pharmacy providers will be supported to undertake this role by the East Sussex Specialist Stop Smoking Service (ESSSS). </p><p>ESCC will ensure that clients have the opportunity to access the service that best suits their needs through provision of stop smoking services using both specialist and primary care providers, such as practice nurses and community pharmacists, National Centre for Smoking Cessation and Training (NCSCT) certified in line with national training standards.</p><p>Very Brief Advice (VBA) Stop smoking interventions delivered by health and social care professionals (HSCPs) that advise on the best way of quitting and offer referral to stop smoking services are clinically effective and cost-effective. Despite the effectiveness of stop smoking services, rates of take-up remain low. Traditionally, brief interventions have been recommended to trigger quit attempts. However, it is not enough to only provide advice to stop; in order to be effective, brief interventions also need to include an offer of help. Smokers, who are offered help by their GP rather than only advice to stop, are twice as likely to make a quit attempt. The importance of recommending both support and treatment is further highlighted by a study which showed that compared with no advice or advice only from GPs to smokers, the odds of quitting are 68% higher if stop smoking medication is offered and 217% higher with the offer of support (PHE, 2014).</p><p>Figure 1: Very Brief Advice VERY BRIEF ADVICE ON SMOKING - 30 Seconds to save a life</p><p>ASK AND RECORD SMOKING STATUS Is the patient a smoker, ex-smoker or a non-smoker?</p><p>ADVISE ON THE BEST WAY OF QUITTING The best way of stopping smoking is with a combination of medication and specialist support.</p><p>ACT ON PATIENT’S RESPONSE Build confidence, give information, refer, prescribe. They are up to four times more likely to quit successfully with support. REFER THEM TO THEIR LOCAL NHS STOP SMOKING SERVICE</p>