NHS trust to trial smoking cessation referrals from maternity services to community pharmacy

Patients accessing maternity services at Nottingham University Hospitals NHS Trust could be offered smoking cessation treatment at a community pharmacy under a new NHS pilot.

The scheme builds on the ‘NHS community pharmacy smoking cessation advanced service‘ — which rolled out nationally in England on 10 March 2022 — through which hospitals can refer patients to participating community pharmacies after discharge to continue with stop smoking treatment that they started in hospital.

According to a service specification published by NHS Business Services Authority, the programme will enable the maternity service team at Nottingham University Hospitals NHS Trust to identify patients, or members of their household, who smoke and refer them to a local community pharmacy for tobacco dependence treatment.

These patients can start smoking cessation treatment in hospital if they are inpatients or the treatment can be initiated by the community pharmacy.

“All individuals receiving support through this service [will] receive both behavioural support and supply of nicotine replacement therapy (NRT),” the service specification says, adding that regular progress checks using carbon monoxide monitoring are recommended every one or two weeks, following the initial appointment.

Contractors will be paid £30 for the initial appointment, £10 for providing regular progress checks and £40 for a successful ‘quit’, verified with a carbon monoxide test.

“The pharmacy will be reimbursed for the NRT supplied and remunerated for dispensing NRT products and providing carbon monoxide monitoring,” the specification adds.

The pilot will run from 31 March 2022 to 31 March 2023.

The scheme follows the national rollout of the ‘NHS community pharmacy smoking cessation service’, which was piloted in Oldham, Greater Manchester, and in Southwark and Lambeth, South London, from November 2020.

In March 2022, NHS England published a case study of the pilot on its website, highlighting that “187 patients were referred to 12 pharmacies in a 12-month period” in Oldham.

Some 81 patients received 281 smoking cessation consultations over 12 weeks, with a reported quit rate of 57% after 4 weeks, NHS England said. Of patients who recorded a 4-week quit, 37% went on to record a 12-week quit.

There has been a decline in local authority-commissioned smoking cessation services provided by community pharmacies, with The Pharmaceutical Journal revealing in 2018 that almost a fifth of local authorities in England had decommissioned pharmacy-led smoking cessation services in the previous three years.