Agenda item

This report presents options for the Council’s Yorwellbeing Service to help people stop smoking, in the light of the findings of a recent scrutiny review of the service and national guidelines on the most effective way of helping smokers to quit.

Resolved:  (i)      That Option 2 be approved and Varenicline be included in the council’s Yorwellbeing Service support to stop smoking offer, with a hardship fund provided to cover the first 2 weeks of Nicotine Replacement Therapy (NRT) or the first 4 weeks of Varenicline for those in financial hardship and the complete costs of 12 weeks’ NRT continuing to be covered for pregnant women accessing the service.

Reason:     To enable the service to support more people to stop smoking, thereby improving the health of York’s resident population, within the existing financial envelope.

                   (ii)      That an update report on the progress of the stop smoking support service, within the broader context of the work of Yorwellbeing overall and of national policies in relation to tobacco and health, be brought back to the Executive Member in six months’ time.

Reason:     In order to monitor the progress of the service and to address the issues raised in the motion on Access to NHS Services approved at Council on 15 December 2016 and at the subsequent meetings of the Health and Adult Social Care Policy & Scrutiny Committee and the Health, Housing and Adult Social Care Policy & Scrutiny Committee held on 29 March 2017 and 20 June 2017 respectively. 

The Executive Member considered a report which set out options for the Council’s Yorwellbeing Service to help people stop smoking, in the light of the contents of a report to the Health, Housing and Adult Social Care Overview & Scrutiny Committee on 20 June and National Institute for Health and Clinical Excellence (NICE) guidelines on best practice. 

The following options were presented:

Option 1 – continue with the current policy of funding Nicotine Replacement Therapy (NRT) for the whole 12 weeks of a quit attempt for pregnant women, with a hardship fund to cover the first 2 weeks for people on benefits. As noted in the report to Scrutiny, a lack of pharmacotherapy support under this policy had led to a decline in the number of people using the service.

Option 2 – include Varenicline in the service offer, with financial support for pregnant women and those on benefits as in Option 1.  This was the recommended option, as it would comply with NICE guidelines at a cost likely to be well within the £27k budget allocated to cover pharmacotherapies.

Option 3 – continue to fund the whole cost of a quit attempt for pregnant women and fund the first 4 weeks of pharmacopatherapies for all other clients.  This would comply with guidance but take the cost over the allocated budget.

The Director of Public Health set the report in context, explaining that it had been written in response to a resolution of the Health, Housing and Adult Social Care Policy & Scrutiny Committee on 20 June 2017, asking the Executive Member to review her original decision to approve the current policy (Minute 8 of that meeting refers). This re-affirmed an earlier resolution made by the precursor of that committee on 29 March, when they considered a report arising from a motion to Council on 15 December 2016.

The Executive Member acknowledged the broader concerns that had been raised by Scrutiny, particularly with regard to the drop-off in referrals and access to the service, and indicated that these should be addressed in a further report.

Resolved:  (i)      That Option 2 be approved and Varenicline be included in the council’s Yorwellbeing Service support to stop smoking offer, with a hardship fund provided to cover the first 2 weeks of Nicotine Replacement Therapy (NRT) or the first 4 weeks of Varenicline for those in financial hardship and the complete costs of 12 weeks’ NRT continuing to be covered for pregnant women accessing the service.

Reason:     To enable the service to support more people to stop smoking, thereby improving the health of York’s resident population, within the existing financial envelope.

                   (ii)      That an update report on the progress of the stop smoking support service, within the broader context of the work of Yorwellbeing overall and of national policies in relation to tobacco and health, be brought back to the Executive Member in six months’ time.

Reason:     In order to monitor the progress of the service and to address the issues raised in the motion on Access to NHS Services approved at Council on 15 December 2016 and at the subsequent meetings of the Health and Adult Social Care Policy & Scrutiny Committee and the Health, Housing and Adult Social Care Policy & Scrutiny Committee held on 29 March 2017 and 20 June 2017 respectively.