The NHS Health Check service targets adults aged 40-74 to assess their risk of CVD and offer early preventative advice and support to reduce this risk.  As part of the NHS Health Check people are asked about a range of health behaviours, including smoking status, and are referred to appropriate local services (including SSS).  The NHS Health Check in Hackney is commissioned by the council’s Public Health Team and delivered primarily through GP practices; in the City, it forms part of an integrated lifestyle service and is delivered through the one GP practice in the City as well as a number of outreach locations (for residents and City workers).

Smoking status is also assessed in primary care on a regular basis in people with long-term conditions (and on GP disease registers) or identified to be ‘at risk’ of CVD or diabetes.  Locally, there are incentives in place for GPs to refer identified smokers to SSS.

Nationally recognised training on VBA is also available locally through Hackney’s SSS model (see below), for all health professionals and organisations working in the City of London and in Hackney.  Examples of staff groups trained in the past two years include outreach workers in the substance misuse team, community wardens and staff working in supported accommodation.

City and Hackney Public Health Team and City and Hackney Clinical Commissioning Group worked together to develop a new smoking CQUIN for 2016-17 with Homerton hospital.B In addition to setting performance targets on proportion of staff trained to deliver VBA, the CQUIN also aims to ensure a robust and consistent data collection system which can identify smokers and/or those at risk of CO exposure in the maternity service – in particular, providing a more reliable source of data on smoking status at delivery. Performance targets include the proportion of pregnant women with smoking status recorded by a CO monitor at booking and between 36 and 38 weeks. It also includes targets on the proportion of women identified as smokers at time of booking referred to local SSS.

Notes

  1. CQUIN stands for ‘commissioning for quality and innovation’. The system was introduced in 2009 to make a proportion of healthcare providers’ income conditional on demonstrating improvements in quality and innovation in specified areas of patient care.
  2. CQUIN stands for ‘commissioning for quality and innovation’. The system was introduced in 2009 to make a proportion of healthcare providers’ income conditional on demonstrating improvements in quality and innovation in specified areas of patient care.