Smoking Cessation Advanced Service

Smoking Cessation Advanced Service

This page contains information about a new Smoking Cessation Advanced Service for people referred to pharmacies by a hospital, which will be commissioned from January 2022.

Work is still underway to finalise the service specification and other details; additional information, guidance and support materials will be made available to contractors in due course.

Page last updated on 23rd August 2021.


Click on a heading below for more information

Introduction

The 5-year Community Pharmacy Contractual Framework (CPCF) agreement reached in July 2019 included the proposal that stop smoking support for those beginning a programme of smoking cessation in secondary care and referred for completion in community pharmacy should be piloted.

NHS England and NHS Improvement (NHSE&I) have started a pilot in several hospitals and following the initial findings of the pilot, the Department of Health and Social Care (DHSC) and NHSE&I proposed the commissioning of a new Stop Smoking service, as an Advanced service, in the Year 3 negotiations.

The policy background

Smoking rates have fallen significantly in the last 10 years, but smoking still accounts for more years of life lost than any other modifiable risk factor.

Around 5.7 million people or nearly 14% of the adult population in England were reported to smoke in 2019. Smokers see their GP over a third more often than non-smokers, and smoking is linked to nearly half a million hospital admissions each year.

The NHS Long Term Plan set a goal that by 2023/24, all people admitted to hospital who smoke will be offered NHS-funded tobacco treatment services. The plan committed to the adoption of the Ottawa model for smoking cessation (OMSC), which has been evidenced across Canada to improve smoking quit rates by 11%.

As part of the OMSC, the smoking status of all admitted patients, is identified, followed by brief advice, personalised bedside counselling, timely nicotine replacement therapy and/or pharmacotherapy, and follow-up support for smoking cessation post-discharge.

To achieve successful smoking cessation, collaboration and an effective transfer of care are needed between secondary and primary care for all patients supported by the OMSC. Community pharmacy contractors have the potential to deliver this primary care smoking cessation support, and to be part of this wider aim for the NHS which will significantly benefit the patients referred.

Service description

This service enables NHS trusts to refer patients discharged from hospital to a community pharmacy of their choice to continue their smoking cessation care pathway, including providing medication and behavioural support as required; in line with the NHS Long Term Plan care model for tobacco addiction.

To start with, the service will only be provided by pharmacists, however if changes to the VAT rules can be agreed between DHSC, HM Revenue and Customs and HM Treasury, to ensure pharmaceutical services provided by other staff, but under pharmacist supervision are VAT exempt, the service will be modified to allow better use of skill mix.

PSNC is working with DHSC and NHSE&I to finalise the service specification, which will be published as soon as possible.

In the meantime, contractors wanting to understand more about the service can review the documentation being used in the NHSE&I pilot:

NHSBSA website information on the pilot (including service specification and toolkit for pharmacy teams)

CPPE learning resources used in the pilot

Funding

The following fees have been agreed:

  • A set-up fee of £1,000;
  • A fee for the first consultation of £30;
  • A fee for each interim patient consultation of £10; and
  • A fee last consultation of £40.

If changes to the VAT rules can be agreed between DHSC, HM Revenue and Customs and HM Treasury, to ensure pharmaceutical services provided by non-pharmacists, but under pharmacist supervision are VAT exempt, the service will be modified to allow aspects to be provided by the wider pharmacy team and the fees will be amended to reflect the greater use of skill mix within the service.



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