Wednesday, 1 December 2010

Tactful and proportionate hospital smoking policies needed, so what happened?

Extract from minutes of Scottish Workforce and Staff Governance Committee, 14 May 2010 at Victoria Quay, Edinburgh
Mary Cuthbert and Lorna Renwick presented an update to the Committee on recent guidance regarding workplace anti-smoking policies in NHS Scotland. Cooperation with staff on the issues involved were agreed to be a priority for any effective lasting progress. It was pointed out that the NHS Healthy Working Lives Criteria [link added] would need to be adjusted, most usefully by considering the relevant rules of the European Network of Smoke-free Hospitals (ENSH),which considers a very holistic view of patient and staff data.
It was emphasised by the Committee that this area of debate is necessary to approach with care, not least because of the estimated 40,000 NHS Scotland employees who smoke and would be affected by any change to national or Board level guidelines. It was expressed that in practice whole-hospital-grounds smoking bans were in the main impossible to police and undeliverable. [emphasis added]
The need for staff to be treated consistently across NHS Scotland was underlined. The particular difficulty of dealing with care-in-the-community guidance was discussed. It was generally concluded that Board Policy for Staff on Premises needed to be re-examined. The Committee expressed firm, unanimous support for the principle of reduction of staff smoking levels, but reiterated that regulations would need to be both tactful, proportionate and implementable. The need to balance employee rights with any drive towards smoking cessation was emphatically asserted by all members. [emphasis added]
All this commendably prioritises the need for a consensual approach, and several weeks ago I would have thought it spelled good news. Yet three months after this meeting we had this story about NHS Grampian, this story about Ninewells Hospital Dundee, and yesterday this story about the Carstairs State Hospital. Why, when the health service staff and managers tell Scottish Government representatives unanimously and 'firmly' that smoking bans in hospitals don't work and cannot be implemented, and that equality, proportionality and tact are as important as smoking cessation, do we get more health boards insisting that smoking must cease in the grounds of hospitals (and probably just as much pressure on the issue of smoking cessation)?

More on Freedom to Choose (Scotland)'s challenge to smoke-free mental health services here.

Meetings of the group are listed here. Minutes of more recent meetings (August and November) don't appear to have been posted yet.


Anonymous said...

At last we see the 'authorities' acknowledge the uselessness of their dictatorial control of smokers. The desire of these control freaks to drive forward their agenda of running other people's lives is frightening and can, must and WILL be frustrated, though as pointed out in the article, some persist in their evil scheme undeterred.

Personally, I have no problem with government encouraging people to stop smoking; I have major problems with anybody persecuting smokers or anybody else over their lifestyle choices. At my workplace there is an equal opportunities policy which specifically prohibits prejudicial treatment on such a basis, if this fails smokers it fails us all.

Some hospitals might try to use bully boy tactics to implement their policies but, as a Freedom To Choose spokesman pointed out on STV recently, they have no basis in law to enforce these restrictions. As for staff, they signed a contract when they took the job, they must not be bullied into accepting changes in contracts against their will.

subrosa said...

ENHS? I don't believe it. Madness.

Belinda said...


You've lost me!

Eddie Douthwaite said...

European Network of Smokefree Hospitals.(ENSH)

ENSH Code to develop a Tobacco Free Health Care Service

1. Engage decision-makers. Appoint a working group and reject tobacco industry sponsorship.

2. Develop a strategy and an implementation plan. Inform all personnel, patients/residents and the community.

3. Set up a training plan to instruct all staff on how best to approach tobacco users.

4. Organise cessation support facilities for patients/residents in the organisation and ensure continuity of support after discharge.

5. Develop the organizations campus (grounds) to be tobacco free. If smoking areas remain, they should be clearly indicated.

6. Display clear tobacco free signage. Ban all incentives to use tobacco.

7. Develop personnel management policies and support systems to protect and promote the health of all that work in the organisation.

8. Promote tobacco control activities in the community setting.

9. Renew and broaden information to maintain commitment to the tobacco free policy. Ensure follow-up and quality assurance.

10. First convince, then constrain considering legislation if needed. Have patience!

Version: 10/05/2010


Smoke Free Hospitals

The European Network for Smoke-Free Hospitals(ENSH) is a European partnership of 20 country members. The ENSH provides assistance to health care services in successfully implementing the smoke free policy and the attainment of a completely smoke-free environment. Scotland has already implemented its smokefree legislation and some hospitals are now working towards smokefree grounds. The Chief Executive’s letter (14) Health Promoting Health Service also requires all hospitals to implement smoking cessation interventions and the award system for Healthy Working Lives.
· Therefore, to avoid duplication of effort, Health Scotland are offering support for the HPHS CEL(14) as well as incorporating the ENSH self audit questionnaire within the HWL smoke free policy assessment tool to support the successful implementation of a smokefree environment.