Greater Manchester First Stop Health Bus

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Greater Manchester First Stop Health Bus

• Wendy Kirkpatrick, Heath Development Manager
• Paul Finch, Senior Health Improvement Worker
• Salford Health Improvement Service

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Our Partners
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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

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Objectives

• Deliver a service that achieves quitters
  contributing to the 10 GM PCTs 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

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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

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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

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Targets
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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

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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

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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

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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

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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

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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

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The ResultsClient Evaluation

• gt85 of people found out about the bus when they
  saw it (visual impact)
• gt70 of people attended because they wished to
  stop smoking
• gt85 were either very or extremely satisfied with
  the overall service expertise of staff quality
  of advice given waiting time location
  cleanliness of the bus
• gt62 found the service very helpful
• 98 of clients said they would recommend the GM
  First Stop Bus service to others
• gt68 of clients indicated that they had not
  previously accessed any NHS stop smoking service

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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

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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

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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

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Thank you

• Wendy Kirkpatrick
• Health Development Manager
• Email wendy.kirkpatrick_at_salford.gov.uk
• Telephone [phone] or Mob [phone]

Paul Finch Senior Health Improvement
Worker Email paul.finch_at_salford.gov.uk Telephone
07810756310