Greater Manchester First Stop Health Bus

Wendy Kirkpatrick, Heath Development Manager

Paul Finch, Senior Health Improvement Worker

Salford Health Improvement Service

Our Partners

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

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

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

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

Targets

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

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

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

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

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

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

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

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

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

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

Thank youWendy 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