Stop Smoking Service – Hertfordshire Health Improvement Service (HHIS)


Hertfordshire Health Improvement Service (HHIS) provides stop smoking support to anyone who lives or works in Hertfordshire. HHIS provide support to community pharmacies commissioned to provide the stop smoking services commissioned by Public Health Hertfordshire.

The stop smoking service provided by community pharmacy is commissioned by Hertfordshire County Council. The 2017 – 2020 service specification is available although please note that changes to the service will be implemented from 1 April 2020. The current annexes to the specification are available within the resources section below.

Please note that the provision of NRT via a voucher scheme/letter of recommendation is a non-contractual element of the Public Health contract and therefore community pharmacies may not hold a contract to provide a Level 2 stop smoking service but can continue to provide NRT to clients who present with a valid NRT voucher code. All community pharmacies in Hertfordshire will need to use the PharmOutcomes template if someone is receiving treatment elsewhere but presents at your pharmacy with a valid voucher code. Full information can be found in the NRT Voucher Protocol.  To view the NRT voucher accreditation process please click here.

If you would like to sign up or have any service queries please contact Hertfordshire Health Improvement Service on 01442 453 071 or email: HealthImprovementService@hertfordshire.gov.uk. If you are already commissioned for the service you can also contact your Health Improvement Locality Specialist:

East & North Herts:

Sharon O’Connor 01438 844733 sharon.oconnor@hertfordshire.gov.uk 

West Herts (Herts Valleys): 

Lauren Arthur : 01438 845924 lauren.arthur@hertfordshire.gov.uk

COVID-19 updates

**Update from HHIS 4 June 2020**

Alert – Disruption to the supply of Zyban (Bupropion)

Zyban® (bupropion hydrochloride) 150mg prolonged release tablets will be out of stock from week commencing 15th June 2020 until the end of November 2020. 

 We rarely use Zyban in supporting our patients to stop smoking, but please ensure the following actions are undertaken where relevant:

  •      Patients taking Zyban® as a smoking cessation aid, clinicians should consider alternative pharmacotherapy options (see further advice below).
  •      Defer initiating new patients on Zyban® 150mg prolonged release tablets until the supply disruption is resolved.
  • Champix® (varenicline tartrate) tablets, which are licensed for the treatment of nicotine dependence, remains available.
  • Various nicotine replacement therapies (NRT) are also unaffected.

 

**IMPORTANT COVID-19 UPDATE

Smoking and increased risks associated with COVID-19

Evidence has been published that indicates people who smoke are at significantly increased risk of contracting COVID-19. They are also more likely to have severe symptoms and 2-3 times more likely to be admitted to intensive care, need mechanical ventilation or die compared to non-smokers.

This will have implications for Hertfordshire and the capacity of NHS services to cope as nearly 110,000 adults continue to smoke across the county.

Please identify ALL SMOKERS and give brief intervention advice on the increased risks of smoking and COVID-19.  If you have capacity, please prioritise all those who are over 70 or have any of the following conditions: organ transplants, diabetes, treatment for cancer, the immunosuppressed, those who have respiratory or cardiac disease or are pregnant. The full list of conditions which increase vulnerability is below.

Please use this message to structure your conversation with your customers:

If you smoke, you have an increased risk of severe illness with COVID-19. Your doctor would like you to stop smoking as soon as possible. Contact Hertfordshire Health Improvement Service on 0800 389 3 998 OR text quit4covid to 80818 for telephone support and medication to quit smoking.

There is also a referral form on the LPC website to directly refer smokers that you are in contact with or know to be at risk.

If you are struggling to maintain a stop smoking service at your pharmacy or need further information, please email: HealthImprovementService@hertfordshire.gov.uk

Further information on  the increased risks of smoking and COVID-19:

http://www.tobaccoinduceddiseases.org/COVID-19-and-smoking-A-systematic-review-of-the-evidence,119324,0,2.html

https://www.gov.uk/government/publications/guidance-on-shielding-and-protecting-extremely-vulnerable-persons-from-covid-19/guidance-on-shielding-and-protecting-extremely-vulnerable-persons-from-covid-19

https://blogs.bmj.com/bmj/2020/03/20/covid-19-the-role-of-smoking-cessation-during-respiratory-virus-epidemics/

https://www.ncsct.co.uk/usr/pub/COVID-19%20bulletin%2018:03:20.pdf

 

Training Dates 2020

The stop smoking service training dates for 2020 have now been published.

Please be aware that Level 2 Trainings have changed to ONE DAY trainings and delegates are required to complete the learning needs analysis online with the NHS Centre for Smoking Cessation and Training (NCSCT). Training information is provided after registration.

Make Every Contact Count (MECC) online training

To register for any training or for more information on training please contact HHIS.

Payments and Claims

Changes to the Stop Smoking service payment April 2019
A change to the service specification specifically relating to the financial arrangements for the provision of the Stop Smoking Service applying to both GP Practices and Community Pharmacies was implemented on 1 April 2019.

  • £75 for each patient who sets a quit date and quits smoking for at least four weeks, and
  • £150 for each pregnant patient who sets a quit date and quits smoking for at least four weeks

The change was communicated by the LPC and was sent out to all commissioned pharmacies via a PharmOutcomes message from Public Health Hertfordshire. A change control notice was sent to Providers, giving 3 months’ notice of this change.

As before, no payments will be made for non-quits, patients lost to follow up, patients without a set quit date or for incomplete data.
Access to NRT for the cost of a prescription (unless the service user is except from prescription charges) can be made by generating an NRT voucher through PharmOutcomes. Service users are free to present this voucher to any pharmacy participating in the NRT voucher scheme. Providers will continue to be paid quarterly on completion of quit status on PharmOutcomes.

The LPC was informed of this change in November 2018. The LPC encourages all pharmacy contractors to review their own business model and whether it is financially viable to deliver the service. We would encourage contractors to remain engaged with the service and would remind you that encouraging Medicines Counter Assistants to act as the trained advisors, if they are not already, is one way in which to potentially make the service financially viable.

 

4 week quit status query report
The query report will allow all service providers to view whether you have any clients with a pending or overdue outcome.

Pending means that it is time for clients to have their 4 week quit status recorded (after quit date with 25-42 days) on template 3.
Overdue means that it has been after 42 days since client set quit date therefore they are out of the outcome recording period.

However it can be adjusted with back dating template 3 in order to record a valid outcome.

Please follow Query/Engagement report pathway to find your outstanding clients and record an outcome for them. Please find pathway among attachments. If the 4 Week Quit Status is not recorded then service providers will not be paid for any valid quits.

 

PharmOutcomes Invoicing Procedures
For Community Pharmacy service providers, 3 items are claimable.

  1. Successful 4 week quits,
  2. NRT provided to clients accessing internal L2 service,
  3. NRT provided as part of the NRT e-voucher processing template

You can preview your claims at any time to date by clicking on ‘Claims’ tab and then clicking on ‘Preview Claims’ button on the bottom left hand side. This action will pop up a window underneath the ‘Preview Claims’ button which you can click on when it becomes green. When you click on it your invoice will open and you can see all payments in different lines according to services you are entitled to claim for.

Under ‘Claim Amounts’ section if you click on link you can find out about rules and deadlines for payment and how invoices are set up.
After invoices are approved by HHIS they will be visible on the right hand side under ‘Previous Claims’ title. You can view your invoice by clicking on links on the right hand side.

Common Queries:

  1. Please ensure that you are entering the correct quantity of products. For NRT this is the number of individual products in the pack and not the number of packs. For example, please record 14 patches not 2 packs. If an incorrect product number is entered PharmOutcomes will produce an alert;
  2. Invoice dates: Any updates to clients 4 Week Quit Status made after the claim run date for that quarter can be awarded payment (if applicable) in the following quarter. Please contact HHIS if you record is shown as ‘Unclaimable’ to investigate it and get your payment in the following quarter.
  3. Invoice generated for £0 and comment ‘Do not generate payment: Claimable’: This means that you have recorded 4 week outcome status however it was not Valid Quit and Self-reported Quit therefore it did not qualify for payment.

IMPORTANT CO monitor request - updated processes

There has been an amendment to the provision of how CO monitors will be distributed and serviced from 20 January 2020 by HHIS. HHIS will only be able to provide and administer CO monitor enquires after submission of a CO monitor task request form.

Providers need to complete the CO monitor task request form (no specific login or access is required) for the following request types:

  • New CO monitor for stop smoking advisor
  • Calibration of allocated CO monitor
  • Reporting loss/faulty CO monitor and exchange
  • Other – description of enquiry will be requested.

The following delivery options are available:

Ordering NEW CO monitor

  • Order & Collect from HHIS Apsley Office
  • Order and Collect at Level 2 / Level 2 Update Training (option when registered to attend)
  • Order and Delivery by post (recorded delivery)

In case of calibration or exchange of CO monitor due to fault

  • Drop & Collect – HHIS Apsley Office
  • HHIS open days for calibration and training
  • Drop & Collect – Level 2 Update Training (option when registered to attend)
  • Send & receive by post (sending covered by provider’s own cost, recorded delivery and proper packaging required for safety)

Community pharmacy Varenicline Patient Group Direction (PGD)

Hertfordshire Health Improvement Service (HHIS) launched a PGD for the supply of varenicline to clients receiving support to stop smoking on 1 December 2016. Only those community pharmacies that have a current contract with Hertfordshire Public Health to deliver stop smoking service and pharmacists that have attended an accreditation event run by HHIS are able to deliver the service.

The Varenicline PGD is valid from 1 December 2018 to 30 November 2020 for the supply of varenicline.

As part of the PGD pharmacies must have a Standard Operating Procedure in place. The LPC  developed the following template SOP in 2016 in order to support pharmacies.

Following a recommendation made by Hertfordshire Medicines Management Committee (HMMC), the patient’s GP must be informed of the supply of varenicline to any of their patients by using the template letter. This is to manage any risk to receiving the medicine if there are clinical concerns which do not come to light during the patient assessment. This can be sent by secure email or fax and must occur at the time of initial supply.

Resources

The Hertfordshire Health Improvement service resources catalogue is on the professional website for Health in Herts.

Smoke Free Hertfordshire has published their Tobacco Control Strategic Plan for Hertfordshire 2019-2022.

University of East Anglia (UEA) has published a ‘staying switched’ leaflet. This gives practical, simple advice to vapers on how to stay stopped from smoking. If possible please let UEA know where it is shared so that they can attempt to keep track. Copies of the leaflet are available free to stop smoking services (email addiction.research@uea.ac.uk).

 

Specification annexes