‘Implementing Shared Decision Making within a

Stop Smoking Service’

James Curtis Service Manager

Gloucestershire NHS Stop Smoking Service

20th February 2015

Introduction to the Service • Gloucestershire NHS Stop Smoking Service (GSSS) offers smoking

cessation medications and behavioural support for people who want to quit smoking

• Since 2001 GSSS has helped over 36,000 people to quit smoking • We have 7 Specialist Advisers that work around Gloucestershire

seeing people in 1:1 and group formats • Our service offers a patient centred service based on a motivational

interviewing approach • Over the years GSSS has prided itself on looking at news ways to

improve the service

Service Improvements Problem • It is well known within Smoking Cessation that there is a lack of knowledge of

the existence smoking cessation service • Only 6% of smokers access smoking cessation services • Many new service users have very little (if any) knowledge about what the

service we provide and the wide variety of pharmacotherapy options available to them

Solution • Development of a new website – www.stopsmokingglos.nhs.uk • Implementation of a digital marketing strategy • Implement Shared Decision Making within the Service

http://www.stopsmokingglos.nhs.uk/

Partnership working • GSSS teamed up with Thames Valley Health Knowledge Team to be

the first smoking cessation service to implement Shared Decision Making within their respective service

• Thames Valley Health Knowledge team provided team training to GSSS staff around SDM principles. They also provided invaluable help in managing the project from design

• Pfizer provided funding for the printing of resources and logistical support

http://www.google.co.uk/url?url=http://www.policymed.com/2012/08/harvard-and-pfizer-announce-industry-academic-partnership.html&rct=j&frm=1&q=&esrc=s&sa=U&ei=RWTkVNiFLsHtO4HzgNAP&ved=0CBgQ9QEwAQ&sig2=lEjS56XAHG6f-OVlGalQaw&usg=AFQjCNF7JraQ0MgIVFFtBNmnJdoBQEus5Q

How was SDM used within the service

There were a number of ways

that GSSS could implement SDM in the service

• Options of how to quit • Choosing different quit plans

– abrupt cessation or cut down to quit

• Pharmacotherapy options

Pharmacotherapy options

• Pharmacotherapy options chosen as the area of focus • A large percentage of the first consultation (5-10 minutes) is taken up by

explaining the medications to a client and the options. • Whilst it is patient led, patients might not choose the best option for them • By improving knowledge of the products the service aimed to: -

• Make service users central to the decision making process • Increase adherence to medication • Decrease medication switching • Decrease the amount of time dedicated to explaining medication

options

Stop Smoking Service Website

Shard Decision Making Leaflet

The Journey Phase 1 • Project outlined and scoped – October 2013 • Team training in Shared Decision Making approaches – November 2013 • Website implemented and photos of medication and SDM wording

included – January 2014 • Leaflets designed and printed – Spring 2014

Phase 2 • Script and story board devised for the SDM video – July 2014 • Video produced – December 2014 • Implemented on website – February 2015

Evaluation • Before SDM was implemented, GSSS used SURE Questionnaires to

provide a baseline measurement • Pre results very positive • No different in post results regarding SURE score • However anecdotal evidence from Specialist Advisers has found: -

• SDM resources as a whole has helped new service users to feel more informed when asked in consultations

• Greater number of clients report they know what medication they want to use

• Advisers report having more time to talk to dedicate to other important areas of the consultation

• The video gives us far greater presence on digital platforms and more interactivity on the website

Conclusion

• The service has undoubtedly benefited from the implementation of SDM within the service

• The new website adopted the SDM principles within the wording of the pages. The website gives a clear message that is the patients choice and brief pros and cons of each option. We have been commended by fellow health professionals and service users on the quality of the website and the balanced nature of the content.

• The leaflet has been crucial for use in promotional purposes or sending out to new referrals to the service

Conclusion (continued)

• The video has given us a great platform to advertise our service whilst conveying the patient centred approach the service adopts.

• The video, when built into the website, will give us more interactivity on the medication options page of the website.

• The help from Thames Valley Health Knowledge Team and Pfizer were invaluable. We have a high quality video and information leaflets with very little resource commitment needed. All problems were ironed out quickly and efficiently. I would have no hesitation with GSSS working on another project such as SDM in the future.

Thanks to…. Elaine Watson – Head of Health Improvement, GCS Joanna Glasscock – Lead Specialist Adviser, GCS James Steed – Pfizer Georgina James - Pfizer Yvonne Frewin – Programme Manager, Thames Valley Health Knowledge Team Andy Barker - Creative Director, InTouch Marketing

Shared Decision Making Video

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