NHS in Gloucestershire considers ‘Stop Before the Op’ Smoking Policy
27/09/2007
PCT Board members discussed and approved plans to develop a ‘Stop Before the Op Policy’ aimed at reducing risks through surgery and maximising the chances of successful treatment at the PCT Board meeting earlier this week.
The policy is designed to support smokers in efforts to quit before they are referred by their GP for possible hospital surgery for non-urgent medical conditions.
The NHS has stressed that any policy would not apply to patients being treated for cancer, patients who require other forms of urgent treatment or if their doctor advises that exclusion is required.
GPs and hospital doctors would have a key role to play in discussing with patients who smoke the importance and benefits of quitting before an operation and providing them with ‘Stop Before the Op’ information. The PCT will now work with the doctors to put in place the clinical pathway and support for patients including referrals to GSAS.
If consent is agreed, and the GP and hospital doctor believed that it would be beneficial to the patient’s health, a full support programme provided by the GP, pharmacist or the Gloucestershire Smoking Advice Service would be arranged to help the patient to give up prior to their treatment.
The policy would not force smokers to give up or deny access to treatment, but would actively support them in making a choice to reduce their risk of post operative complications and improve their overall health.
If the GP or hospital doctor believed that delaying treatment would be detrimental to the patient’s health then referral and treatment would still take place following further discussion of the risks.
Evidence shows that giving up smoking at least eight weeks before surgery could reduce the length of time a patient needs to spend in hospital, improve healing and reduce lung and heart complications.
The PCT is currently discussing the policy with local clinicians and plans to hold further talks with patient representatives before implementing it later this year.
Acting Director of Public Health, Dr Shona Arora said:
“There is clear evidence that smoking increases the risk of ill health and death and there is also an increasing body of clear evidence that shows smoking reduces the benefits of surgery.”
“This is not about denying access to treatment, but trying to ensure that people know that giving up smoking can benefit their health both before and after surgery.”
“Giving up smoking at least eight weeks prior to hospital admission has been shown to reduce complications such as heart problems and breathing difficulties and improve healing. It can also reduce the length of time a patient needs to spend in hospital.”
Chair of the PCT’s Professional Executive Committee and Tetbury GP, Dr Tony Walsh said: “I strongly support the development of a policy. This is a time when a patient might be reflecting on their health more than they would normally and it makes perfect sense to ensure that the best possible professional support is available to help people to give up.”
The aim is for the policy to be supported across the health community with GPs, hospital doctors as well as pharmacists, playing a key role.
Dr Tony Walsh added: “Discussions have already begun across the health community and it is very positive to see primary care and hospital doctors working together in this way.”
Medical Director for the Division of Surgery at Gloucestershire Hospitals NHS Foundation Trust and Consultant Surgeon in Gloucester, Mr Jonothan Earnshaw said: “We strongly support the principle of helping people to stop smoking and the development of a policy that the whole health community can sign up to.”
“We feel it is important to reinforce the advice to patients after they have been referred, including implications for their health and also signposting them to the specialist support services in place.”
The Primary Care Trust is confident that there is sufficient capacity within Gloucestershire to deliver any potential increase in demand for smoking cessation support.
