"Smoking at Wishaw General"

Dear Scottish

Firstly, can I say how sorry I am to hear of you and your wife’s experience whilst visiting Wishaw General Hospital. To give you some background to NHS Lanarkshire’s no smoking policy, we introduced the policy which banned smoking on all our grounds and vehicles in 2008 and it was updated in 2014 to include e-cigarettes. The policy was implemented in an attempt to build on the good work of the national smoking ban in public places in 2006, protect people from second hand smoke, prevent young people from starting to smoke and offer specialist support for those who want to quit.

A considerable effort has been, and is still being made, to inform staff, patients, visitors and the general public about our policy to help improve compliance with it.

Some of the steps we have taken to address the matter of smoking on hospital grounds include:

• Installing updated no smoking signs on all NHS Lanarkshire sites.

• Rolling out a system which ensures that all patients who smoke have their smoking status assessed when they are admitted to hospital to allow these patients to be managed appropriately either for temporary abstinence or total cessation.

• Offering stop smoking support at each of our three acute sites through the NHS Lanarkshire Stop Smoking Service, which offers advice and support in conjunction with free nicotine replacement therapy and Varenicline from trained nurse advisors.

• Brief intervention training for our staff, providing them with the basic knowledge and skills necessary to deliver brief opportunistic advice to smokers and how to refer smokers to stop smoking support services.

• Employing a dedicated stop smoking mental health nurse specialist to provide support to mental health facilities staff and patients by offering support, advice and guidance around stopping smoking.

• Discussions with our local authority partners to identify any additional enforcement activity that can be taken forward by our environmental control staff.

• A public information campaign to make smokers aware of our policy and encourage them to smoke off our grounds.

While these steps have encouraged many smokers to respect the policy, to our frustration others don’t and persist in smoking on grounds, particularly outside hospital entrances, despite the inconvenience this causes the majority of others. The policy has been difficult to enforce as, unlike the 2006 smoking ban in public places, it is not a statutory requirement by law. However, the Scottish Government has recently confirmed that it is to bring in legislation and this will help support health boards to enforce their no smoking policies.

I hope this information helps to reassure you that NHS Lanarkshire is taking the matter of enforcing our smoking policy very seriously. While we are well aware that some smokers persist in smoking on our grounds despite our policy, we are confident that the steps we are taking as well as the future legislative change will help us to reduce this over time.

I appreciate you taking time to feedback your experience and feelings.

Dear Scottish

Thank you for raising this issue.

Our aim is to move towards a Scotland where choosing not to smoke is the norm, and I am clear that the NHS has to show leadership in creating health promoting environments. This includes providing smoke-free environments and supporting those who want to quit smoking. In 2013, the Scottish Government launched a new tobacco control strategy, Creating a Tobacco-Free Generation, which contained a specific action that ‘all NHS Boards will implement and enforce smoke-free grounds by March 2015’. We launched a national TV and radio campaign in March 2015 to raise awareness of this policy. While all NHS Boards now have full grounds smoke-free policies in place, the issues you raise are important and we are working with Boards to gain full compliance from everyone on hospital grounds. Like you, we take this issue very seriously and so have proposed a new offence of smoking outside a hospital building on NHS hospital sites. This is currently being considered by the Scottish Parliament.

I hope this goes some way to answering your question and if you have any further suggestions that you think might help we would be interested to hear from you.

Thanks again for raising this issue and for using Patient Opinion.

Paul Gray,

Director General Health & Social Care and Chief Executive NHS Scotland