Document type: / Policy document
Staff group to whom it applies: / All staff, service users/patients and visitors, contractors and volunteers on Trust premises
Distribution: / The whole of the Trust
How to access: / Intranet and Internet
Issue date: / December 2015
Version: / 2.2
Next review: / November 2017
Approved by: / EMT
Developed by: / Smoke Free Steering Group
Director leads: / Medical Director
Contact for advice: / · Dr A Berry (Medical Director)
· Sue Hastewell-Gibbs (Nursing/HR Directorate)
· Yorkshire Smokefree
· 0800 612 0011- free from landlines
· 0330 660 1166 - free from most mobiles
Contents
Section / Page1 / Introduction / 4
2 / Purpose and Scope / 5
3 / Duties & Responsibilities / 5
4 / Principles / 6
5 / Secondhand Smoke / 7
6 / Staff / 7
7 / Service Users/Patients / 8
8 / Visitors, Contractors and Volunteers / 9
9 / Vehicles / 9
10 / Equality Impact Assessment / 9
11 / Process for Monitoring Compliance of this Policy / 9
12 / Process for Reviewing and Approving this Policy / 10
13 / Dissemination, Implementation and Access to this Policy / 10
14 / Associated Documentation / 10
15 / References / 10
Appendicies / Page
1 / Guidance for Community Staff Making Home Visits / 11
2 / Smokefree NHS: A Short Guide for Service Users, Carers and Visitors / 15
3 / Smokefree Information for People Receiving Home Visits / 17
4 / Stop Smoking Advice / 19
5 / Equality Impact Assessment Tool / 21
6 / Checklist for the Review and Approval of Procedural Document / 23
7 / Version Control Sheet / 25
1 Introduction
1.1 The Public Health White paper, Choosing Health, made a requirement that the NHS became Smokefree by the end of 2006.
1.2 Smoking is also a health and safety issue and under section 2 (2) of the Health and Safety at Work Act 1974 employers have a duty to:
‘provide and maintain a safe working environment which is, so far as is reasonably practical, safe, without risks to health and adequate as regards facilities and arrangements for their welfare at work’.
1.3 The Trust works with partners to implement NICE Public Health Guidance PH10 (2008) and its partially updated guidance PH45 (June 2013).
1.4 Secondhand smoke – breathing other people’s tobacco smoke – has now been shown to cause lung cancer and heart disease in non-smokers, as well as many other illnesses and minor conditions.
1.5 The Trust is a health promoting organisation and acknowledges that breathing other people’s smoke is both a public health hazard and a welfare issue. Therefore, the following Policy has been adopted to meet the requirements of the White Paper, Choosing Health and the relevant Health and Safety Legislation and applies at all the Trust’s premises (buildings, grounds and assets).
1.6 Smoking is the biggest single cause of ill health and premature death in the country. As an employer, the Trust has a duty to its staff and service users/patients to protect them from the health hazard that smoking represents and is doing everything it realistically can to promote the importance of the no smoking message.
1.7 It is part of the Trust’s values to implement National Guidance and acknowledge the NICE Public Health Guidance PH48 (November 2013) smoking cessation – acute, maternity and Mental Health Services which aims at supporting smoking cessation, temporary abstinence from smoking and smoke free policies in all secondary care settings. The Trust aims towards the implementation of this guidance by continuing to undertake necessary consultation, communication and providing a range of support services to service users.
1.8 This Policy also gives a commitment to support and advise staff and service users/patients to quit smoking.
1.9 The Policy was developed with the involvement and engagement of stakeholders, particularly staff and service users/patients.
2 Purpose and scope
2.1 For the purposes of this Policy, smoking refers to tobacco and tobacco related products.
2.2 For the purposes of this Policy smokefree means that smoking is not permitted anywhere within the Trust's buildings, grounds and/or assets.
2.3 The current stance of the Trust is that electronic cigarettes/vaporisers are subject to this policy.
2.4 The aim of this Policy is to ensure a smokefree Trust which:
§ Protects and improves the health of staff
§ Protects and improves the health of service users/patients, visitors and contractors
§ Protects both smokers and non-smokers from the danger to their health of exposure to secondhand smoke
§ Sets an example to other employers and workforces, particularly in health-related locations
§ Supports and assists staff and service users/patients to quit smoking.
2.5 This Policy applies to all staff (including contract, agency and bank staff), service users/patients, visitors, contractors, volunteers and other persons, who enter Trust owned, rented buildings and grounds for any purpose whatsoever.
2.6 The Policy extends to cars leased from the Trust during business usage, however it does not apply to the interior of cars owned privately and not being used for business purposes.
2.7 The Trust also recognises the importance of protecting staff from exposure to smoke when making home visits and the Policy addresses this issue.
3 Duties and Responsibilities
3.1 The Chief Executive is responsible for ensuring the policy is implemented and sufficient resources are available for compliance.
3.2 Responsibility for day to day implementation rests with all Directors and Senior Managers, clinical and non-clinical.
3.3 All Trust managers are responsible for ensuring all staff who report to them fully comply with the Policy.
3.4 All ward/service managers and equivalent are responsible for ensuring smoking status is addressed as per the Policy for service users/patients on admission.
3.5 All ward/service managers to report unresolved issues to line manager.
3.6 All prescribers are responsible for ensuring the prescribing of related products is at an appropriate level and use of the product is adequately explained.
3.7 Human Resources Department will ensure all appropriate recruitment documents and literature refer to the Trust’s smokefree policy.
3.8 Facilities Department will ensure appropriate signage throughout Trust sites.
3.9 Procurement Department will ensure all tenders and contracts with the Trust stipulate adherence to this Policy as a contractual condition.
3.10 Training Department will ensure appropriate sessions, for example corporate induction and fire lectures refer to the Trust’s smokefree policy.
3.11 All staff have a responsibility to comply with the Policy.
4 Principles
4.1 The Trust will implement national good practice and guidance related to smoke free and smoking cessation and harm reduction from smoking.
4.2 Smoking products will be treated by the Trust as a banned item. Each service area will refer to local protocol. (See Searching Patients and Their Property policy – Appendix A Banned Items Searching Patients policy)
4.3 The Trust would wish to encourage its employees to refrain from smoking outside the times and circumstances set out in this policy, both in their own interests and as representatives of a major public body, whose purpose is to improve health.
4.4 To ensure that everyone entering Trust sites understands that smoking is not allowed in the buildings and grounds, clear signs will be displayed.
4.5 Smoking whilst on Trust business away from Trust sites, for example community visits is not permitted by staff during their working hours.
4.6 Tenders and contracts with the Trust stipulate adherence to this Policy as a contractual condition.
4.7 Job advertisements, and/or information include reference to the non-smoking policy and indicate that the adherence will be contractual.
5 Secondhand Smoke
5.1 This Policy recognises that secondhand smoke adversely affects the health of all employees. It is not concerned with whether anyone smokes, but with where they smoke and the effect this has on service users/patients, visitors, smoking and no-smoking colleagues and other members of the wider health community. It is also concerned with the presence of preventable carcinogenic substances in the locality of health sites.
6 Staff
6.1 The Policy applies to all staff, without exception and as such all staff are required to fully comply with the Policy.
6.2 Staff cannot smoke/vape in buildings or grounds owned by the Trust, or in leased cars belonging to the Trust or when they are on Trust duty.
6.3 If individual staff challenge their manager on their right to smoke/vape, the manager should refer to these points:
· An employee cannot challenge the employer’s right to introduce healthier and safer working practices.
· The Policy is concerned with where someone smokes/vapes.
6.4 If staff need to go ‘off-site’ to smoke/vape during their break, the following applies:
· Under the European Working Time Directive, where staff work for longer than six hours they are entitled to a break of a minimum of 20 minutes, which is encouraged.
· In most health and social care workplaces, breaks are taken in a manner consistent with maintaining minimum staffing levels. Managers need to plan effectively for staff who leave the premises on breaks for any reason. In relation to smoking/vaping ‘off-site’, managers will need to liaise with their human resources managers to assess the impact on staffing levels and the expected/required availability of staff.
· Extra time should not be given to smokers to allow for smoking/vaping breaks. Time should be consistent with usual breaks taken and determined by departmental managers.
· Staff should not be identifiable as NHS employees to members of the public when smoking/vaping.
· Staff should not smoke/vape directly outside the main entrance of any Trust site.
· Staff need to be mindful of the lingering smell of cigarettes and are encouraged to be considerate of service users/patients and colleagues.
6.5 Under no circumstances should a confrontational attitude be adopted or allowed to develop. All staff who experience difficulties with the application of the Policy should seek support from their line manager in the first instance to discuss the issues and support available.
6.6 Persistent failure to comply fully with the Policy may result in the Trust investigating the matter under the Trust’s disciplinary policy.
6.7 All staff visiting or treating service users/patients in their own homes are entitled to the same level of protection against secondhand smoke as those working on Trust premises. See Appendix 1 for guidance for community staff and service users/patients.
6.8 The Trust would wish to encourage its employees to refrain from smoking outside the times and circumstances set out in this policy, both in their own interests and as representatives of a major public body, whose purpose is to improve health. Access to smoking cessation services is available, see Appendix 4.
7 Service Users/Patients
7.1 This Policy applies to all service users/patients. Service users/patients who are distressed for any reason should be comforted but the Policy still stands.
7.2 Polite signage and reminders are usually sufficient to deter smoking, but service users/patients should also be informed at pre-admission or on admission.
7.3 Smoking status should be discussed with all service users/patients, at initial assessment and where the service user/patient says they do smoke, referral to smoking cessation services and nicotine replacement therapy should be offered.
7.4 Service users/patients will not be escorted for the purpose of smoking/ vaping by staff.
7.5 A similar rationale applies as for staff with regards to smoking:
· The Trust has a duty to its service users/patients to protect them from the health hazards that smoking represents.
· Nicotine replacement therapy (NRT) will be available.
Appendices 1,2 and 3 provide guidance and information.
8 Visitors, Contractors and Volunteers
8.1 This Policy applies to all visitors/contractors/volunteers, irrespective of their circumstances.
8.2 Visitors who are distressed for any reason should be comforted, but the Policy still stands.
8.3 Contractors/volunteers who contravene the Policy should be reported to the person responsible for monitoring the conduct of contractors on site.
8.4 Visitors/contractors and volunteers may wish for advice on stopping smoking and should be given details of the local NHS Stop Smoking Service.
9 Vehicles
9.1 The Policy extends to vehicles leased from the Trust during business usage. It does not apply to the interior of cars owned privately and not being used for business purpose, or during business hours.
9.2 Vehicles contracted for Trust business are also covered by the Policy.
9.3 Privately owned vehicles being used for Trust business are not covered by the Policy.
10 Equality Impact Assessment
The organisation aims to design and implement services, policies and measures that meet the diverse needs of the service, population and workforce, ensuring that none are placed at a disadvantage over others. The Equality Impact assessment tool has been utilised to ensure equality has been assessed within this procedural document. See Appendix 5.
11 Process for monitoring compliance of this policy
The processes for monitoring compliance and effectiveness with this policy include:
· Monitoring Datix incidents reported that are related to smoking/attempts to smoke by BDU’s.
· Biennial audit of a sample of care plans undertaken by BDUs.
12 Process for reviewing and approving this document
This document will be reviewed by the appropriate Director Lead and their appropriate forum/group biennially or whenever national policy or guidelines changes are required to be considered (whichever occurs first).
13 Dissemination, implementation and access to this document
This Policy will be disseminated throughout the organisation immediately following approval and will be published on the Trust’s intranet and internet sites. Staff will be alerted to changes to the Policy through the Trust’s management briefing process.
14 Associated documents
This Policy links to other policies, procedures and clinical practice within the Trust, the key ones being:
· Physical Examination for Service Users Policy
· Clinical Risk Assessment, Management and Training Policy
· Care Plan Approach and Care Coordination policy and procedures
· Protocol for the use of Symptomatic Relief for Patient Areas.