“Government has ‘no sense of direction’ in reducing devastating alcohol harm” | Lord Brooke

After Welfare, the cost of Health is the second biggest charge which Chancellors of the Exchequer have to deal with. Yet if one examines Budget speeches it rarely gets a mention, although in fairness to Phillip Hammond it did this year because of the crisis in Care which is directly linked to Health.

Health costs continue to grow at around 4% per annum but the economy is down around 2%. So with an aging population,the ‘health service car crash’ as one recent ex health service minister described it, every action must be taken or at least explored to avoid further injury or collapse.

That is what is at the heart of my debate – seeking changes that will reduce not only burgeoning public health costs but lead to healthier, happier and longer lives. As part of that, the Government must confront the stark challenge that alcohol abuse presents for the NHS in terms of financial costs, resources and impact on staff time and welfare.

Alcohol is estimated to cost the NHS around £3.5bn per year, which amounts to £120 for every taxpayer!

Even though drinking has declined marginally, there is a growing burden of alcohol related admissions and “activity” as our NHS tries to deal with the consequences of harmful drinking. This is not surprising when Public Health (England) recently reported:-

  • Alcohol is now the leading cause of death among 15 to 49 year olds.
  • There are now more than a million alcohol-related hospital admissions a year.
  • Alcohol caused more years of life lost to the workforce than from the 10 most cancers.
  • In England more than 10 million are drinking at levels that increase the risk of harming health.

There are 23,000 deaths related to alcohol in England each year, meaning that alcohol accounts for 10% of the UK burden of disease and death and is one of the three biggest avoidable risk factors of them.

Evidence indicates that the ease of access, availability and persistently cheap alcohol perpetuates these problems with deprivation and health inequalities particularly prevalent amongst men from lower socio-economic groups.

Alcohol is 60% more affordable today than it was in 1980. Affordability is one of the key drivers of consumption and harm: cheaper alcohol invariably leads to higher rates of death and disease.

David Cameron and the Coalition Government recognised this back in 2012 when they produced their progressive Alcohol Strategy. In its foreword he wrote”..and a real effort to get to grips with the root cause of the problem.That means coming down hard on cheap alcohol”

That hasn’t happened. Other aspects of the strategy have disappeared. There seems to be a vacuum with no discernible sense of direction. I will be pressing for one – the NHS certainly needs it.

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Lord Brooke of Alverthorpe is a Labour peer in the House of Lords.

Original post here: Politics Home

Tobacco Control in England: Reducing Inequalities and Improving NHS Sustainability

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Public Health England and NHS England are hosting three one-day events with a practical focus on the current challenges and how they can be met, discussing implementation of tobacco control interventions and how the NHS can make its contribution, to the benefit not only of millions of smokers but its own sustainability.

London – Tuesday 4 April

Leeds – Wednesday 26 April

Birmingham – Thursday 4 May

Smoking rates in England have been declining steadily in the general adult population in recent years (17%), falling further and faster among young people (8%). However, hidden behind this success is slower progress among certain population groups, including individuals with mental health problems and those on lower incomes. Large geographical variations also remain, including amongst women who smoke during pregnancy.

Smokers from all groups are likely to be high users of healthcare services, with significant financial and capacity related implications. Addressing this will be key to ensuring NHS sustainability.

Reducing smoking is key to ensuring NHS sustainability and with the new national CQUIN for addressing risky behaviours (alcohol and tobacco) and local Sustainability and Transformation Plans, there is a fresh impetus for collective action to reduce the health inequalities caused by smoking.

Aim:

  • to explore opportunities for action across the local system to engage with smokers and support them to quit, tackling health inequalities and reducing the burden on the NHS and social care of smoking-related disease.

Objectives:

  • identify key areas for joint action to tackle smoking and reduce health inequalities
  • understand where smokers are accessing the healthcare system and how this impacts on primary and secondary care services
  • consider the ways in which healthcare professionals can integrate treatment for tobacco dependence into routine care and support smokers to quit

Who should attend?

  • local authority and NHS commissioners
  • CCG leads for acute care, mental health and maternity
  • healthcare and service providers
  • those with responsibility for managing: Commissioning for Quality and Innovation (CQUINS), delivery of Sustainability and Transformation Plans (STPs), implementation of the stillbirth reduction care bundle
  • regional strategic leads for health improvement and clinical networks

More information and registration!

MAJOR NEW REPORT  – UK HOSPITALS FAIL TO MEET NATIONAL STANDARDS IN EITHER HELPING PATIENTS QUIT SMOKING OR PROVIDING ‘SMOKE-FREE ENVIRONMENTS’

 

According to a major new report launched today (7/12/16) by the British Thoracic Society (BTS), NHS hospitals across UK are falling ‘woefully short’ of national standards on helping patients to quit smoking and enforcing smoke-free premises.

Experts f1-mediumpresenting the findings at the British Thoracic Society (BTS) Winter Meeting, will state that many NHS hospitals are missing out on a ‘golden opportunity’ to provide what is often the most effective front-line treatment for smoking patients who are sick  –  support and medication to help them quit tobacco.

The BTS Report ‘Smoking cessation: policy and practice in NHS hospitals’ is
unique in its scope and size; reviewing the smoking cessation & smoke-free policies and practices of 146 hospitals across UK between April and May 2016 – including the analysis of 14,750 patient records.

The main findings of the report are as follows:

  • Over 7 in 10 (72%) hospital patients who smoked were not asked if they’d like to stop
  • Only 1 in 13 (7.7%) hospital patients who smoked were referred for hospital-based or community treatment for their tobacco addiction
  • Over 1 in 4 (27%) hospital patients were not even asked if they smoke
  • Only 1 in 10 hospitals completely enforce their fully smoke-free premises. Rates of enforcement were even lower for hospitals which provided areas where smoking was allowed. The report highlights the importance of a smoke-free NHS – to trigger and support quit smoking attempts for patients and reduce second hand smoke exposure for children, staff and the public
  • Provision of nicotine replacement therapies and other smoking cessation treatments were ‘poor’ in hospital pharmacy formularies
  • Only 26% of hospitals had an identified consultant ‘lead’ overseeing their smoke-free and smoking cessation plans
  • 50% of frontline healthcare staff in hospitals were not offered training in smoking cessation

In the study, 25% of hospital patients were recorded as being ‘current smokers’ – which is higher than rates in the general adult population (19%)   Other studies have shown that approximately 1.1 million smokers are admitted to NHS hospitals a year.

The Society is using the report findings to call for all hospitals to deliver NICE Guidelines in this area (PH48) and that national regulators such as the Care Quality Commission (CQC) hold Hospital Boards accountable for the delivery of smoke-free and smoking cessation hospital policies.

The report also highlights a number of key activities that all NHS hospitals should deliver to help more of their patients quit smoking:

  1. Offer a prescription for Nicotine Replacement Therapy to all patients who smoke to help them cope with their tobacco dependence whilst in hospital
  1. Refer all patients who smoke in hospital to specialised stop smoking support services to explore the option of quitting smoking. Patients can opt out if they like – but the NHS should try to offer the most effective treatment and support whatever the illness – and with many smoking-related conditions such as chronic obstructive pulmonary disease (COPD), support and medication to help people quit smoking are the best front line treatments
  1. Employ an appropriately skilled senior clinician within the hospital to oversee, drive forward, and be accountable for the hospital’s smoking cessation service
  1. Employ smoking cessation practitioners in every hospital – this was recommended by NICE in 2013 but the report shows patchy delivery across the country
  1. Hospital Board involvement in delivering plans is key. Delivering smoke-free hospital grounds – as part of a wider smoking cessation policy – requires Hospital Boards to work together including the chief executive, director of human resources, director of facilities and the medical and nursing directors – in partnership with the ‘smoking cessation lead’ at the hospital

The Society is also encouraging more health professionals to become BTS ‘Stop Smoking Champions’ in their hospital. There are over 160 at present and they deliver a range of vital activities to champion stop smoking service provision.

For further information, contact stopsmokingchampions@brit-thoracic.org.uk or to see a video about the initiative go to: https://www.brit-thoracic.org.uk/standards-of-care/quality-improvement/smoking-cessation/bts-stop-smoking-champions/

Dr Sanjay Agrawal, Consultant Lung Specialist & Chair of the British Thoracic Society’s Tobacco Group, who led the audit said:

“Our report shows that many NHS hospitals are woefully failing to meet national guidance on delivering smoking cessation services and smoke-free premises. This is a dangerous situation that is costing the country dear in both health and economic terms. We must do better. Critically, hospitals are missing out on a golden opportunity to help supply often THE most effective treatment for illnesses that smokers are admitted with – support and treatment for their tobacco dependence.  If patients in other disease areas were not offered, by default, the most effective way to treat their condition – there would probably be an uproar. Nevertheless, this happens all too frequently with people with smoking-related illnesses. Many hospital boards need to sort out their leadership, plans and resources on this issue – so they can deliver some simple but life-changing steps: identify patients who smoke, ask them if they’d like to quit – and give effective treatment and support to help them stop.”

Dr Lisa Davies, Consultant Respiratory Physician at Aintree University Hospital and Chair of the British Thoracic Society Board, said:

“Being admitted to hospital should be a real window of opportunity for smokers to quit – given that smoking should be prohibited on the premises, tobacco use may be linked to their health condition, and expert stop smoking advice and therapies are potentially ‘on tap.’ This report shows, however, that we need to fund, plan and deliver smoking cessation work in hospitals far better – so we can fully deliver on this opportunity for our patients.

At a wider level, there is a real fight going on for the future of stop smoking support services in this country.  Many local authorities, facing overall budget reductions, have cut funding for community-based stop smoking services – meaning that people who need support may have nowhere to go.

The NHS must urgently work together, alongside local authorities, to plan and fund these vital services – to ensure no-one who needs treatment and support to stop smoking falls through the net.”

British Thoracic Society – UK hospitals fail to meet national standards in helping patients to quit smoking

British Thoracic Society, Smoking Cessation Audit Report:

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External news sources:

AOL – Hospitals ‘woefully failing’ to crack down on smoking

The Guardian – A third of children hospitalised with asthma ‘exposed to cigarette smoke’

Birmingham Mail – Number of patients forced to wait for hospital bed ‘rockets in five years’

NHE – All STPs urged to help patients quit smoking

The BMJ – NHS hospitals must help patients quit smoking, says British Thoracic Society