This Contract Constitutes an Agreement Between Staffordshire and Stoke on Trent Partnership

INTRODUCTION

This Contract constitutes an agreement between Staffordshire and Stoke on Trent Partnership NHS Trust (the “Authority) in their capacity as provider of the Stop Smoking Service and Xxxxxx Xxxxxx (the
“Provider”) for the provision of the Stop Smoking and Stop Smoking in Pregnancy services in accordance with the provisions of this document.

2. PURPOSE OF THE CONTRACT

This Contract forms an integral part of the delivery of Staffordshire’s stop smoking services, including the ability to meet targets set out by the Department of Health and locally to deliver 4 & 12 week quits and post delivery quits for pregnant women.

This document outlines the service specification, performance requirements and roles and responsibilities required by theAuthority (Appendix 1) and theProvider (Appendix 2) in order to deliver these services across Staffordshire.

AIMS OF THE SERVICE

Stop Smoking Services are a key part of tobacco control and health inequalities policies at a local and national level. Evidence based stop smoking support is highly effective both in cost and clinical terms. It should be seen in the same way as any other clinical service and offered to all smokers.

The Stop Smoking Service therefore aims to:

Support the reduction in smoking prevalence across the locality
Reduce the inequalities in health of smokers in Staffordshire
Support the achievement of Staffordshire’s quit targets
Increase access to the NHS Stop Smoking Service
Deliver services in accordance with best practice recommendations for Stop Smoking Services issued by The National Institute for Clinical Excellence (NICE) and the Department of Health (DH)

The Authority and the Provider agree to work cooperatively to deliver a high quality service that meets national quality standards and best practice guidance as identified in the NHS Community Services Contract Service Specification; DH Service and Monitoring Guidance and NICE Guidance. Both parties have the roles and responsibilities and accountability for the service, as set out in Appendix 1 and 2 of this document, and shall work cooperatively to develop and continually improve the service. See Appendix 1 and Appendix 2.

CONTRACT PERIOD

This Contract shallcontinue in force for a period of 9 months from 1st July 2015 to 31st March 2016, with the ability to continue the Contract for a further period of twelve months upon mutual agreement of the Parties at the anniversary date.

CONTRACT PAYMENT

The Authority agrees to make the following payments to the Provider on the achievement of the successful outcomes as detailed below.

Stop Smoking Service
Outcome / Payment
4 week quit / £50
12 week quit / £75
Stop Smoking in Pregnancy Service Outcome / Payment
4 week quit / £110
Post-delivery or 12 week quit (whichever is furthest from the quit date) / £210

Throughout the life of the Contract, the Provider shall make every effort to target hard to engage groups in order to reduce health inequalities. For the purposes of this Contract, these include: ethnic minorities; routine and manual groups; the unemployed; people living in postcode areas in the 20% most deprived super output areas; young people aged less than 18 years and people with severe mental health difficulties.

Payments to the Provider are dependent upon full and accurate completion and submission of the Stop Smoking monitoring forms in accordance with Appendix 1.

Due to the Authority’s budgeting restrictions 4 week monitoring forms submitted by the Provider later than 14/05/16 will not be paid and12 week monitoring forms submitted by the Provider later than 31/07/16 will not be paid.

SERVICE SPECIFICATION

The service shall be delivered by the Provider in accordance with the Service Specification detailed in Appendix 1 for the Authority and Appendix 2 for the Provider.

The Provideris responsible for ensuring that all Advisors are appropriately trained, CRB checked (enhanced), that the environment and any equipment used is suitable for the delivery of the services and that there is sufficient maintenance, quality control and calibration of any equipment and consumables used in the provision of this service, throughout the life of the Contract and any extension periods.

PERFORMANCE CRITERIA

The Provider will be expected to deliver this service in accordance with the Terms of Contract and Service Specification detailed in Appendix 1.

In line with Department of Health best practice guidance, the Authority expects GP practices to treat a minimum of 5% of their practice population of smokers in the course of a year. To work most effectively services should focus on increasing access from targeted groups as identified on page 3.

Performance will regularly be reviewed by the Authority andwhere performance issues are identified an initial offer of additional support shall be offered to the Provider by the Authority. The Authority shall remain within their rights to deal with singular or repeated occurrences of low performance through clause 14 of this Contract.

9.MONITORING

The Provider is required to complete accurately and in full the Stop Smoking monitoring form for each “treated smoker” accessing the service as defined in the Stop Smoking Service Monitoring Guidance. A summary of this is available from SSOTP and shall be provided to all advisers by the Authority at Contract commencement. All completed monitoring forms shall be returned to SSOTP via the courier service provided on a monthly basis by the Provider on the 1st of each month in accordance with the Service Specification at Appendix 1.

It shall remain the responsibility of the Authority to input all the necessary monitoring data for submission to Staffordshire County CouncilPublic Health as stated in Appendix 2.

10. SPECIALIST SUPPORT

The Authority shall provide all necessary resources and specialist support to the Provider, including training; performance monitoring; data monitoring; audit; payments; advisor support and mentoring; resources; marketing and promotions as set out in Appendix 2.

11. CONFIDENTIALITY

Each party must protect personal data in accordance with the provisions and principles of the Data Protection Act (1998) and ensure the reliability of its staff that has access to the data. Data held and processed for the purposes of this Contract shall be registered under the relevant provisions of the Data Protection Act (1998). The parties shall therefore not disclose, at any time, any such information or permit information to be disclosed to any third party or to use or copy any such information except with the relevant party’s written consent or as may be reasonably necessary for the proper provision of these services.

CONTRACT VARIATIONS

The Provider will endeavor to meet changing business needs where feasible and achievable. Necessary and material changes to the cost, quality or volume of services provided shall be discussed and this Contract so amended, with neither party to withhold their agreement unreasonably.

Under this Contract any service changes brought about by NHS policy initiatives or statutory changes are considered mandatory and shall therefore need to be incorporated into the working arrangements. The Providershall take full responsibility to implement such changes efficiently and effectively.

BREACH OF THE CONTRACT

The Provider agrees to deliver these services on behalf of the Authority for the whole period set out at clause 5 of this Contract.

In the event a dispute arises between the parties, the following shall apply:

-The Provider shall continue to deliver Services under this Contract in line with the service and performance requirements set out at Appendix 1, unless the Authority requests in writing that the Provider does not do so.

- Both Parties shall make every effort to communicate and cooperate with each other with a view to resolving the dispute.

- In the event that a resolution cannot be reached between the Parties than each shall refer the matter to their Executive Director to reach a conclusion on the dispute.

- Where Executive Director intervention fails to resolve the dispute then mediation shall be entered into with the Centre for Effective Dispute Resolution, with each party bearing their own costs, to provide a final conclusion.

TERMINATION OF THE CONTRACT

The Authority may terminate this Contract at any time on giving three months’ notice in writing to the Provider. Neither party shall have claims against the other arising out of the termination of thisContract, In the event of any termination, any equipment supplied to the Provider shall be returned immediately to the Authority including but not limited to CO monitors and promotional material. Any remaining service users wishing to access services can be referred to the Authority to ensure alternative support services are made available.

15. EXCLUSIVITY

At no time during the life of the Contract is the Provider permitted to sub contract, either in whole or in part, this agreement unless permitted to do so in advance and in writing by the Authority.

APPENDIX 1

Provider Service Specification / Roles and Responsibilities

Training

All Stop Smoking Advisors to achieve the following training.

Stage 1(knowledge based) online at

Stage 2 (skills based)online at

Stage 2 (face to face) training delivered locally by SSOTP

Online training needs to be completed before attending face to face training
Attend 2 yearly update training - ½ day.
Other staff not directly involved in the face to face delivery of stop smoking interventions may want to access Very Brief Advice Training where possible. This is also available at as well as training on second hand smoke.
Additional speciality modules in pregnancy and mental health are available via

CRB Requirements

All advisors delivering stop smoking interventions are required to have a current CRB (enhanced) disclosure check. Evidence of this is to be made available to the subcontractor. Providers are required to fund their own checks.

Performance Criteria

Deliver the service in accordance with the service specification detailed in the contract and best practice guidance (DH, NICE).
Where performance is less than the minimum standards additional support will be offered by the Subcontractor on an individual needs basis. See Appendix 2.

GP Practices

Should aim to treat a minimum of 5% of the practice population of smokers in the course of a year in line with best practice guidance (DH, NICE).

Pharmacies

Should aim to promote the service as widely as possible and in particular to link in with national campaigns such as No Smoking Day and Stoptober.

One to One Intensive Advice and Support

One to one intensive advice and support to be offered face to face to all smokers motivated to quit for up to 12 weeks if successfully quit at 4 weeks.
Interventions should provide weekly support for at least the first four weeks of a quit attempt. Total potential contact time with the client should be a minimum of 1.5 hours duration from pre-quit preparation and during the four weeks post quit to ensure continued monitoring, client compliance and ongoing access to medication.
Smokers can be referred or self-refer into services. Providers must contact clients within 7 days of receipt of an enquiry or referral offering an appointment within 2 weeks of first contact. Where there are delays referrals should be passed to SSOTP in order for them to offer an alternative clinic or service.
Where smokers have relapsed re-treatment should be offered to motivated smokers as soon as possible.

Prescribing and Advising on Pharmacotherapies

To optimise success all three pharmacotherapies approved by NICE (2008) including Nicotine Replacement Therapy (NRT), Varenicline (Champix) and Bupropion (Zyban) should be offered as a first line option if medically suitable. Varenicline and Bupropion are contraindicated in pregnancy.
Prescriptions should be made in accordance with the manufacturers SPC following an assessment of the patients’ needs. Other considerations include personal preferences, previous experience of the product, any potential contraindications, availability of support and potential compliance.
NRT combination therapy should be used if needed for highly nicotine dependent smokers where appropriate in accordance with NICE (2008) guidance and the appropriate Patient Group Direction. This also includes pregnant women.

Monitoring

All providers should adhere to the current service monitoring criteria and definitions when recording the numbers of smokers entering treatment and the numbers successfully quit at 4 weeks / 12 weeks / post delivery for pregnant women.
Completion of a Stop Smoking monitoring form is required for each “treated smoker” in accordance with the current guidance (DH). A “treated” smoker is defined as a smoker who has received at least one session of a structured multi session intervention delivered by a stop smoking advisor who consents to treatment and sets a quit date. All monitoring forms including quits, non quits and lost to follow up (LTFU) should be completed fully and accurately and returned to the SSOTP service by the 1st of every month using the internal courier service. At the end of the financial year any 4 week monitoring forms submitted later than the 14/05/2016 or 12 week forms submitted later than 31/07/2016 will not be paid.
All 4 week / 12 week / post-delivery quit rates should fall between 35% and 70% in accordance with current guidance from DH. Where rates fall outside this range SSOTP reserve the right to audit performance.
CO validation should be attempted in at least 85% of all “treated” smokers in accordance with service guidance (DH).

4 Week / 12 Week Follow Up

Follow up at 4 weeks should be attempted for all “treated” smokers and at 12 weeks if the individual has successfully quit at 4 weeks.
A client is counted as a 4 week quit if he / she has started treatment and been completely abstinent from smoking in the third and fourth week after the quit date. This acknowledges the fact that some smokers struggle in the initial 2 weeks post quit date. Contact should be made with the client within 25 - 42 days post quit date, to establish their 4 week smoking status.
A client is counted as a 12 week quit if he / she has started treatment and been completely abstinent from smoking during weeks three to twelve post quit date. Contact should be made with the client within 79 -105 days post quit to establish their smoking status.

Service providers will attempt, wherever possible, to confirm the smoking status of all service users self-reporting as having quit smoking at 4 weeks / 12 weeks with the use of a Carbon Monoxide (CO) Monitor. Please note: 12 week quit status can now be CO verified at 10 weeks and confirmed with the client at 12 weeks either face to face or via telephone.
Service providers must complete the relevant monitoring form in full and return to SSOTP following agreement of quit date and completion of the 4 week / 12 week follow up. Forms should be returned to SSOTP by the 1st of every month. Incomplete or incorrectly completed forms will be returned for completion / amendment to providers. Any Advisor consistently returning incomplete monitoring forms may be asked to attend refresher training.
Three attempts should be made to contact service users by phone / letter if they do not attend the 4 week /12 week follow-up appointment within the timescales required. If there is still no response the service user is classified as lost to follow-up (LTFU) and should be discharged from the treatment programme and the monitoring form returned to SSOTP.

Pregnancy Follow Up

Follow up at 4 weeks and post-delivery (or 12 weeks whichever is furthest from the quit date) is required for pregnant smokers. Contact should be made with the client within 25 - 42 days post quit date to establish their 4 week smoking status.
To determine their delivery quit status the pregnant woman should have quit at 4 weeks and remained abstinent from smoking post-delivery or twelve weeks whichever is furthest from the quit date. Smoking status to be documented within 3 weeks following the delivery date. Payments will be based on the pregnancy tariff payment.
A pregnant client is counted as a 4 week quit if she has been completely abstinent from smoking in the third and fourthweek after the quit date. Contact therefore should be made with the client within 25 - 42 days post quit date to establish their 4 week smoking status.
Service providers will attempt, wherever possible to confirm the smoking status of all service users self-reporting as having quit smoking at 4 weeks / 12 weeks / post-delivery with the use of a Carbon Monoxide (CO) Monitor.
Service providers must complete the relevant monitoring form in full and return to SSOTP on completion of the 4 week / 12 week / post-delivery follow up. All forms should be returned to SSOTPby the 1st of every month for processing and payment. Incomplete or incorrectly completed forms will be returned for amendment. Any Advisor consistently returning incomplete monitoring forms may be asked to attend refresher training.
Three attempts should be made to contact service users by phone / letter if they do not attend the 4 week /12 week / post delivery follow-up appointment within the timescales required. If there is still no response the service user is classified as lost to follow-up (LTFU) and should be discharged from the treatment programme and the completed form returned to SSOTP.

Client Satisfaction Questionnaire

Service providers are encouraged to complete and submit the Stop Smoking Service Client Satisfaction Questionnaire for every service user within 4 weeks of the end of the treatment episode, this will help to review client feedback.

Identifying Smokers and Marketing Services

All providers are required to promote and advertise the availability of the service and to link in with national campaigns such as No Smoking Day and Stoptober. Resources and support for these can be provided by SSOTP.
Promotional posters leaflets and referral cards should be displayed and or be available in house to ensure awareness of the service.
Providers are to ensure NHS smokefree literature and branding is used on all stop smoking service literature and resources in order to conform to the DH “Code of Practice for Promotion of NHS Services”.

GP practices

GP Practices providing the service will be required to identify and record the number of smokers aged over 16 years from their practice lists in order to target their smokers with stop smoking messages / information.
Letter templates can be provided to send to smokers in order to encourage them to attend the surgery for stop smoking support.

Pharmacies