Tobacco Policy

TOBACCO POLICY

February 2009 Consultation Draft

Co-ordinator:

Tobacco Policy Review Group /

Reviewer:

Grampian Area Partnership Forum /

Approver:

NHS Grampian Board

Signature

/

Signature

/

Signature

Identifier:

NHS/POL/8/HR /

Review date:

This policy will be reviewed annually by the Grampian Area Partnership Forum. /

Implementation date:

September 2009
UNCONTROLLED WHEN PRINTED
Approvedby the Board for Consultation

This policy is available in large print and on computer disk.

Other formats and languages can also be supplied on request. Please contact NHS Grampian Corporate Communications Team on 01224 554400 or email for a copy.

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NHS Grampian Tobacco Policy, Consultation Draft February 2009

Contents

1. Introduction

1. The Policy

1. Scope

1. Responsibilities

• NHS Grampian Board

• NHS Grampian Directors

• NHS Grampian Managers

• NHS Grampian Staff

• Patients and Visitors

1. Smoke-free Environment

1. Employment, Contracts and Communication

1. Non-Compliance

Appendix 1: Support for people who wish to stop smoking

1) Introduction

1. NHS Grampian is subject to numerous pieces of legislation which are designed to save lives and prevent diseases caused by second hand smoke: the Smoking, Health and Social Care Act 2005, the Health and Safety at Work Act 1974, the Prohibition of Smoking in Certain Premises (Scotland) Regulations 2006,and the Safety and health of Pregnant Workers Directive (92/85 EEC).

1. In line with this legislation the organisation has developed a Tobacco Policy which will mean that employees, patients and visitors using NHS Grampian facilities will not be permitted to smoke on NHS Grampian premises or grounds.

1. NHS Grampian considers that all patients/clients, visitors and staff have a right to be in a totally smoke-free environment when on any of its premises or grounds. The purpose of this policy is therefore to enable and promote health and safety for all.

1. Information on the harmful effects of smoking on the health of smokers and on people exposed to second-hand smoke (i.e. ‘passive smokers’) is widely available.

1. The Scottish Government (SG) seeks to promote a smoke-free NHS. It should be noted that NHS premises are also public places, not just workplaces.

2) The Policy

1. NHS Grampian’s policy is that smoking is not allowed by any person on any premises or grounds operated by the NHS Grampian nor by any employee whilst engaged in the business of the organisation.

1. NHS Grampian is committed to ensuring a safe and healthy working environment for its employees and service users. It recognises its responsibilities under the Health and Safety at Work Act 1974 for the health, safety and welfare of its employees. It also acknowledges the well-recognised dangers of passive smoking and takes into account the potential effects of this on patients/clients, visitors and staff.

1. In addition, NHS Grampian is a provider of health care services and health-promoting advice and should be seen to be so.

1. The Board therefore has decided that smoking should not be permitted by anyone when on premises operated by NHS Grampian. In addition, staff identifiable as NHS Grampian employees must not smoke during their working hours or when wearing their NHS Grampian uniform or badge. Staff must also not smoke when representing NHS Grampian on or off NHS Grampian premises.

1. This policy is intended to:

1. Comply with the smoke free legislation and is a revision of the NHS Grampian Tobacco policy planned and introduced in partnership with the staff through the Grampian Area Partnership Forum with effect from June 2005
2. Ensure a safe and healthy working environment for all patients/clients, visitors and staff.
3. Eliminate exposure of non-smokers to passive smoking on premises used by NHS Grampian.
4. Assist smokers who wish to stop smoking.
5. Demonstrate to everyone that as a health-promoting organisation, NHS Grampian does not support smoking, because it is one of the most significant causes of avoidable illness and death.

3) Scope

This policy applies:

1. To all premises and grounds of NHS Grampian, to all common areas, restrooms, foyers, or other public areas, whether enclosed or substantially enclosed or not. with the exception of a specific smoking room in living quarters in NHS Grampian owned residential accommodation

1. To all people present on premises and grounds, including all staff, bank and agency staff, contractors, patients/clients and visitors. (More information about publicising NHS Grampian Tobacco Policy can be found in section 6 and 8).

1. To all people travelling in NHS Grampian -owned vehicles or in a lease car during working hours;

1. To all staff wearing NHS Grampian uniform or NHS Grampian badge at any time, or representing NHS Grampian on or off NHS Grampian premises during their working hours, providing services to patients/clients for NHS Grampian in any place, including a patient’s/client’s home. This is because this could be interpreted as people working in or otherwise associated with a health care organisation believing that smoking did not have a significant deleterious effect on health or health care.

1. To staff, bank and agency staff, contractors, patients/clients and visitors not just when they are on premises operated by the NHS Grampian.

NHS Grampian will work in partnership with Local Authority Enforcement Officers who may visit NHS Grampian sites. They may levy fines for infringements of the Smoking, Health and Social care (Scotland) Act 2005.

4) Responsibilities

NHS Grampian Board

1. The NHS Grampian Board is responsible for ensuring that this policy is fully adhered to by all staff and that there are sufficient resources available to enable its full implementation

NHS Grampian Directors

1. All NHS Grampian Directors on behalf of the Board are responsible for ensuring that managers enable staff to comply fully with this policy and that they have appropriate resources to do so

NHS Grampian Managers

1. All NHS Grampian line managers are responsible for ensuring that the staff who report to them adhere fully to this policy.

1. Line managers are responsible for fully supporting staff who bring this policy to the attention of any person in breach of it, by reinforcing the no smoking message and by intervening in situations that become difficult for the staff member to handle.

1. Line managers are responsible for supporting all members of staff who wish to quit smoking by discussing and agreeing with them reasonable time during normal working hours for them to receive relevant treatment and/or counselling. This includes the provision of adequate cover when staff members attend such sessions so that NHS Grampian work, and especially clinical care, can continue uninterrupted.

NHS Grampian staff

1. All staff members have a duty to comply fully with this policy

1. Staff members are asked to take alternative, safe sources of nicotine with them when on duty or NHS Grampian business, if they need them to relieve the discomfort of not smoking.

1. Where people are noticed smoking on NHS Grampian grounds and premises, staff members are encouraged to inform them that NHS Grampian has a Smoke Free Policy and that smoking is not permitted.

1. NHS Grampian staff should not put themselves at any risk of abuse by informing people about the smoke free policy.

1. Should any NHS Grampian staff member have a complaint made against them simply for politely pointing out NHS Grampian’s Tobacco Policy to anyone who is smoking, they will have NHS Grampians’ full support for taking such action, which will be in compliance with this policy.

1. NHS Grampian staff members have the right to be protected from smoke during the course of their duties. If, when seeing a patient/client or colleague on NHS Grampians’ business but not on premises ( in a patient/client/colleague’s home) the person with whom they are meeting or someone accompanying them, is smoking or begins to smoke, the employee may ask them to refrain from smoking. NHS Grampian will support any member of staff who does so.

1. If a person refuses to stop smoking, NHS Grampian will support any member of staff wholeaves that person smoking because they fear for their personal health and safety. Appropriate action should be taken should be taken to ensure that the smoking does not present a risk to others. (for example by calling for support)

1. A patient/client or person accompanying them may persistently refuse to refrain from smoking even after being advised of the reasons for the request not to smoke. In such circumstances where an employee of NHS Grampian is providing care for them, they should be advised that unless they do adhere to the no smoking rule alternative care arrangements may be made for them and these alternatives may include the possible withdrawal of service.

1. No patient, visitor or member of staff should be exposed to tobacco smoke against their will. For that reason, a member of staff may decline to work in any area where they believe that their health is being put at risk from passive smoking, having ensured that patients are not left in danger.

1. The decision to withdraw staff or withdraw care will only be an action of last resort. The following protocol should be observed:

• A risk assessment of the impact must be carried out.

• Alternative care arrangements should be put in place, including an effective review process.

• The decision should be approved by the senior manager of the service before any change is made to the level of care.

1. NHS Grampian recognises that in exceptional circumstances it may not be appropriate for staff to ask some distressed patients or visitors not to smoke. Efforts should be made to ensure that the smoking does not present a risk to others. (for example by seeking advice/support as required).

Patients and Visitors

All patients and visitors are:

1. Expected not to smoke when using NHS Grampian services or visiting premises and grounds

1. Expected to treat NHS Grampian staff respectfully if requested to stop smoking. Angry or aggressive behaviour towards staff will be dealt with under existing policies.

1. Expected to provide a smoke-free environment for NHS Grampian staff who visit them at home.

1. Asked to take alternative, safe sources of nicotine with them when using NHS Grampian services and premises if they need them to relieve the discomfort of not smoking.

1. Entitled to be treated supportively by NHS Grampian staff when addressing these issues.

Inpatients are asked not to bring tobacco products when admitted to hospital.

Visitors are asked not to take tobacco products onto NHS Grampian premises or grounds for patients to use.

5) Smoke-free environment

1. All NHS Grampianpremises and grounds are NO SMOKING AREAS at all times

1. All NHS Grampian vehicles are NO SMOKING AREAS at all times.

1. No smoking materials of any description will be sold on NHS Grampian premises or grounds.

1. Independent, autonomous organisations that share any premises should implement smoke free policies that are equivalent to that of NHS Grampian.

1. There will be no additional breaks for smoking over and above normal work break entitlement.

1. NHS Grampian recognises that some people, patients and staff, will experience discomfort when deprived of the nicotine they habitually use through tobacco smoking. NHS Grampian does not wish to cause these people distress but cannot support tobacco smoking.. NHS Grampian will support the taking of nicotine in safe, clinically approved ways to relieve the discomfort of people who habitually use it.

1. NHS Grampian grounds and premises are made accessible to meet the needs of people with a disability. If a patient who wishes to smoke is not able to leave a site due to illness or disability, an alternative, safe source of nicotine will be provided.

1. Signs and information that explain the smoke free policy will be available in a range of formats and languages to meet the needs of all patients, visitors and staff.

6) Employment, contracts and general communication

1. Recruitment material and contracts of employment will contain the following clause:

“NHS Grampian has a Tobacco Policy and staff members are expected to comply with this policy. Smoking is not permitted on any NHS Grampian premises or grounds or in any NHS Grampian -owned vehicle. Applicants should be aware that it will not be possible to smoke throughout working hours or whilst in uniform on the business of NHS Grampian.”

1. This policy, and local implementation details, will be covered in the employees induction programme.

1. Invitations to tender and contracts with external organisations (for example, to provide building works) will include a statement that NHS Grampian operates a Tobacco Policy. Contractors or their subcontractors will be expected to comply with that Policy.

1. Service level agreements with external bodies (for example, to provide patient services) should state that individuals supplying a service to NHS Grampian are required to comply with the Tobacco Policy whilst on NHS Grampian premises and grounds.

1. All NHS Grampian correspondence, for example letters and appointment cards, and all NHS Grampian literature, leaflets and general publications, will contain a short, standard statement from September 2009 that NHS Grampian operates a Tobacco Policy throughout its premises and grounds.

1. ‘No Smoking environment’ and ‘no-smoking’ signs will be displayed widely on NHS Grampian sites.

1. Information about the NHS Grampian Tobacco Policy will be provided in the patient and staff handbooks, in all recruitment literature and job offers, and in departmental safety policies.

7) Dealing with staff non-compliance with this policy

1. Every effort will be made to assist those who have difficulty in adhering to the policy; however failure to comply may be treated as a disciplinary offence and handled in accordance with the appropriate NHS Grampian Policy.

Appendix 1: Support for people who wish to stop smoking

1. The NHS Grampian Smoking Advice Service offers effective support to staff who wish to quit smoking. To help smokers who may wish to reduce or to quit smoking, support will be provided to help them adjust to the change in lifestyle. For more information ring the NHS Grampian Smoking Advice Service Freephone 0500 600 332 or contact your local community pharmacist.'

1. Staff are encouraged to call the NHS Grampian Smoking Advice Service to discuss how the service might be able to help them to stop smoking, including Smoking Cessation Support.

1. NHS Grampian staff may use the services of the NHS Grampian Smoking Advice Service during normal working hours with their line manager’s agreement. All NHS Grampian line managers are responsible for fully supporting all members of staff who wish to quit smoking themselves by providing adequate time during normal working hours for them to receive relevant treatment and/or counselling. This includes the provision of adequate cover when staff members attend such sessions so that the NHS Grampian work, and especially clinical care, can continue uninterrupted.

1. NHS Grampian will provide suitable information to all patients detailing the policy.

1. NHS Grampian will provide assistance to patients who require help to stop smoking.

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NHS Grampian Tobacco Policy, Consultation Draft February 2009