Greater Manchester First Stop Health Bus

1. Greater Manchester First Stop Health Bus Wendy Kirkpatrick, Heath Development Manager Paul Finch, Senior Health Improvement Worker Salford Health Improvement Service

2. Our Partners

4. Background Smoking prevalence in Greater Manchester (GM) has fallen in recent years; still significantly higher than the national average 2007-2009 research, branding and mobile unit interventions carried out across GM Approach was deemed cost effective by GMPHN following previous pilots using a mobile unit carrying out brief interventions Pfizer Ltd agreed to a partnership with GMPHN to create a dedicated mobile clinic to provide a uniform Stop Smoking Service across GM

5. Objectives Deliver a service that achieves quitters; contributing to the 10 GM PCT’s Vital Signs 4-week quit targets Reduce the prevalence of smoking by provision of evidence based cessation, support and advice Engage with smokers to provide services that are responsive and needs-led Offer smokers effective, flexible and quick access to support Assist in reducing health inequalities as measured by mortality targets

6. Objectives Raise awareness of the harms associated with smoking Work in partnership across local authority and health economy Work in partnership with other health lifestyle programmes Provide accurate data and activity monitoring information as required by DoH and locally

7. Delivery Goals 800 X 4 week quitters in 2012/13 95% CO validation Operation 48 weeks of the year One different location/day in GM 5 days/week (changed to 6 days/week when CVD screening commenced 8 and 12 week cycles operated (5 Cycles) Working hours Monday-Saturday; 8 hours/day between 10am – 8pm

8. Targets

9. Planning Operational and Strategic Management Groups at GM level Local Delivery Group Bus staff identified from current HIS staffing Band 5 staff with smoking cessation and local community experience Bus driver trained in Level 2 BI and then as a Level 2 adviser HIS Manager identified as lead for delivery as well as liaison with GMPHN and local SSS

10. Planning Client pathway mapping carried out Business continuity plan completed Bad weather protocol and policy developed and agreed with all partners Admin support and time identified and ring-fenced Database changes to accommodate GM wide data collection and reporting Staff training on systems and to carry out mini health MOT

11. Implementation 2 X Band 5 advisers on board at all times At least one front of house staff working there and outside of bus Bus driver included as team member Close joint working with CVD screening and assessment team to ensure client journey as easy as possible 5 Cycles of 12 weeks X 2; and 8 weeks X3 Site visits & risk assessments carried out by GMPHN, Manchester Community Transport; HIS

12. Implementation & Delivery Liaised with local supermarkets; markets; shopping precincts to advertise, flier etc Website appointment system available Clients have up to 30 minute appointment 10 different voucher schemes in use One ‘Gold Standard’ monitoring form used Client assessment and note form kept by advisers to aid follow-up Clients encouraged to return for at least 4 weeks Choice of telephone or F2F follow-up

13. Delivery Clients seen and assessed on the bus Client led service – support and treatment plan Some referred directly on to local services for varenicline (no bupropion requested) access and support All clients offered support on bus initially ;referred on if requested or if identified by adviser as requiring intensive quit support e.g. Pregnancy, unstable chronic disease, on medication requiring monitoring

14. The Results - Targets 2115 (2000) smokers treated 284 (1000) referred on to local services 1543 or 73% (560) lived in area of deprivation 695 (800) four week quits achieved 128 of these were CO validated 31% (40%) quit rate achieved 106 (40) clients were from BME populations 299 (560) clients were from routine and manual groups

15. The Results–Client Evaluation >85% of people found out about the bus when they saw it (visual impact) >70% of people attended because they wished to stop smoking >85% were either very or extremely satisfied with the overall service; expertise of staff; quality of advice given; waiting time; location; cleanliness of the bus >62% found the service very helpful 98% of clients said they would recommend the GM First Stop Bus service to others >68% of clients indicated that they had not previously accessed any NHS stop smoking service

16. Our Challenges ICT for use with QWU database Appointment system Running groups Managing voucher schemes for 10 different areas Transition of clients from bus to local services Bus locations and siting Weather

17. Our Successes Fully functional ICT systems Majority of targets have been met Additional stop smoking services provided to those who do not normally access services and for specific target groups Gold standard voucher developed (now in use in Salford) Dedicated bus staff – 2 staff now work full time on the bus Delivering stop smoking services on a Greater Manchester footprint

18. The Future 6 month extension from 7 May -1 November 2013 2 x full time staff, regular and easier to manage CO validation monitoring relaxed for Year 2 Cycles shortened to 5, 6 and 8 weeks Delivery times constant at 10am-6pm Review of bus locations 8 of the 10 GM Boroughs took up the opportunity for a second phase New Commissioner, now managed by one of the boroughs rather than at GM level

19. Thank you Wendy Kirkpatrick Health Development Manager Email: wendy.kirkpatrick@salford.gov.uk Telephone: 01617933 499 or Mob: 07795013372 • Paul Finch • Senior Health Improvement Worker • Email: paul.finch@salford.gov.uk • Telephone: 07810756310