Abstract
More than 65% of our network patient population meets CORE20 criteria against an ICB average of 7.8% and our smoking rate is one of the highest in the UK, which led us to use a Core20plus5 approach to prioritise our smoking cessation service to where we could have the most impact.
Working with system partners we mapped our whole Primary Care Network network of smokers against the Core20plus5 framework, then by demographic profile and then again by language, of which the largest number were from the Polish, Czech and Slovak community. Through this work, and by consulting with wider system partners, we realised there was a gap in commissioned services for people who speak English as a second language and would benefit from tobacco dependency support. This led to a trial of an in-house Polish speaking smoking cessation coach.
The core aim of the project is to increase the number of quit attempts/confirmed quits for the 784 Polish, Czech and Slovak speaking patients in the Primary Care Network.
For all patients in this category, we will:
•make 3 contact attempts with the aim of having a coaching style conversation about tobacco dependency.
•Take referrals from clinicians within the PCN.
•Offer smoking cessation at a time, pace, flexibility and level of support that suits patients needs.
•Share all QI learning outcomes and data with wider system partners.
Within the Primary Care Network we have access to the smoking status and health data of all our patients. This allows us to be very pro-active, targeted and cost effective.
This unique position allows us to reach people who are not regularly presenting at the hospital or GP surgery, and may not even be thinking about quitting. Through coaching style conversations and motivational interviewing, the advisor is able to build rapport with patients and help them see that change is possible.
So far, in just 3 months of active service – working part time, our advisor has contacted almost 200 patients. We have around 40 patients who have accepted support and are making their way through the programme.
Key learnings so far:
•We have found that not everyone who need services will ask to access them or present to the system to be offered support. Proactive work does generate results – 30% of patients contacted who were not looking to stop smoking went on to accept support and make a quit attempt.
•The power of coaching, supporting and advising patients in their own language and accommodating cultural nuances is critical.
•Patients need flexibility. The majority of Polish speaking patients answer the telephone, or accept an appointment, for slots in the evenings or weekends.
•It is crucial to allow the time, space and resource to build solutions that really meet the needs of our local population.
•Support from the Integrated Locality Partnership in Gloucester City in including this work as part of its priorities, is fundamental in this work spreading to other areas of the city.