NHS Long Term Plan

Lord Rennard Excerpts

Thursday 31st January 2019 Lords Chamber

[Lord Rennard (LD)]

My Lords, I refer to my interests in the register. As an officer of the APPG on Smoking and Health, I am delighted to see that support for smokers accessing NHS services to quit is a key feature of the long-term plan’s commitments on preventive healthcare. Smoking remains the leading cause of preventable, premature death in England, killing nearly 80,000 people a year and costing the NHS an estimated £2 billion.

I welcome the plan’s commitments to fund new support for smokers to quit when in hospital, for long-term users of specialist mental health and learning disability services, and for pregnant women and their partners. The noble Lord, Lord Ribeiro, has already referred to how measures have been seen to work effectively using the Ottawa model for smoking cessation. Where this model is applied in Canada, smoking status is recorded on admission to hospital, with staff delivering brief advice and providing medication to all smokers. Smokers are then followed up both in hospital and post discharge to provide them with specialist behavioural support. Rates of quitting with this model have improved dramatically, and those in the programme were also 50% less likely to be readmitted to hospital. The plan states that this support will be in place across all hospitals by 2023-24. Like the noble Lord, Lord Ribeiro, I hope that the Minister may today give us an indication of when that rollout will begin and what funding will be made available for this programme over the life of the plan.

The plan’s commitments to support smokers who are long-term users of specialist mental health services, both in hospital and in the community, is also very welcome, but this will rely on upskilling a workforce that is already under great pressure. A survey by Action on Smoking and Health and the Mental Health and Smoking Partnership recently highlighted the very variable training and infrastructure in place to support smoke-free policies in different trusts. We need best practice in all of them.

I also welcome the explicit commitment in the plan for the option to switch to e-cigarettes, in line with guidance from Public Health England and the recommendations from the Science and Technology Select Committee last year. This option will be included in the support available to smokers in in-patient mental health services.

The plan also addresses the issue of smoking and pregnancy. Women who live with a smoker are six times more likely to smoke throughout their pregnancy. I hope the Minister may be able to tell us how additional support for partners, alongside that for pregnant women themselves, will be delivered and whether this will continue during postnatal appointments to maximise the chance for all children to grow up in a smoke-free home.

Successful implementation of the plan’s commitments to smoking cessation is clearly threatened as local authority public health budgets continue to be squeezed, reducing the funding for and availability of community stop-smoking services. I concur with the words of many others by saying simply that, without properly addressing the issues of social care and integration with local authorities, this plan will fail.