In Services development

Follow this topic

Bookmark

Record learning outcomes

With No Smoking Day on the horizon, you should be considering how to adapt your smoking cessation service against a backdrop of market changes. Mimi Lau, Numark’s director of pharmacy services, provides some advice

We all know that pharmacists are in a great position both to highlight the dangers of smoking and help smokers to make the changes needed to cut down or stop for good. And we know that opportunistic interventions help smokers get ready to quit. The wider NHS is heavily burdened by smokers, your smoking community needs your support to quit and your business will benefit as a result. If you can help just one person to become a non-smoker, then you have achieved something to feel very good about.

Previously, smoking cessation services were commissioned by Primary Care Trusts based on local need and would include both pharmacy and GP services. When the NHS structure was changed in April 2013, local authorities were given responsibility for commissioning public health services including tobacco control.

Although there has been very little change in the past 18 months since local authorities took over from PCTs, we are starting to see new commissioning models emerging and in some instances a change in the service specification. Examples include:

• In Tower Hamlets, expressions of interest were invited from pharmacy contractors in October to provide a package of services which included stop smoking, sexual health and substance misuse. The service would be for a minimum of three years with very little change to the current service specification.
• In Nottingham, the previous smoking cessation contract is being rolled over until April 2016 to give commissioners sufficient time to fully evaluate and scope out a new service based on outcomes and value for money.
• In Leicester the service is being extended to include Champix PGD using the current network of pharmacies, and they are also conducting a pilot using electronic cigarettes as well as NRT.

Keep your ear to the ground

Against this backdrop, it is important that pharmacists keep their ear to the ground and proactively find out the intentions of these new commissioners. They can do this

It is important that pharmacists keep their ear to the ground and proactively find out the intentions of these new commissioners

by asking their LPC as well as making direct contact with the relevant department within the local authority. It is also useful to register for tender alerts on a local government tender or contracts website.

It goes without saying that, if you are fortunate to have an NHS service in your area, the service should be delivered effectively and consistently. Furthermore, outcome data should be collected so that you can prove the success of your programme. This is particularly important in order to secure ongoing payment. If pharmacies don’t engage, they may find the service pulled from underneath them.

Pharmacists can help customers get the most from smoking cessation products by offering a support service, including education and advice around lifestyle. Make sure that the service is well advertised – if customers don’t know about it, they won’t use it!

It may be worth running group sessions as well as one-to-one coaching to offer more choice. For example, a drop-in clinic on a Saturday morning may attract more people as it’s a weekend and seen as a support group. Consider taking the service out of the pharmacy to expand its reach, for example to health clubs, working men’s clubs, etc.

Electronic opportunities

The decision surrounding e-cigarettes is ultimately one that you will make based on your own judgement, but taking into account the local market and the potential for profit. E-cigarettes represent a massive commercial opportunity and they are widely available from specialist stores, mail order companies, grocers and petrol stations.

Although e-cigarettes are not yet licensed products, and therefore cannot be relied upon to be safe, their popularity and growing presence in the market cannot be ignored by pharmacy. People who do not want to, or cannot, stop smoking are turning to e-cigarettes as an alternative.

Where they are sourced from reputable manufacturers they have to be a better, safer alternative to ordinary cigarettes. Pharmacy stockists are in a position to monitor sales of the products to the consumer and, where necessary, provide appropriate advice around stopping smoking completely. Although they are not currently included in an NHS smoking cessation programme, we are aware of one local authority piloting their use and, once licensed, we predict that there will be more interest in them.

Whatever your decision about stocking e-cigarettes, you will need to be prepared to answer questions about them, so it is worthwhile keeping up-to-date with the debate. Further research is published on a regular basis at the moment and your customers will hear about it in the news.

The smoking cessation market is changing. Don’t assume you can continue to offer the same service you have in the past. Review what is on offer locally, talk to GP practices about what they believe is needed and check commissioners’ views. Designing a service that responds to changing customer needs will help them become healthier, save money for the NHS and, importantly, provide a lucrative income stream for you.