Our experience of delivering a smoking cessation service

Tahir Patel speaks to Rachel Carter about Marsden Road Pharmacy's smoking cessation service.

Service type: Smoking cessation (NHS).

Name of pharmacy: Marsden Road Pharmacy, Bolton.

Name of pharmacist: Tahir Patel.

Why did you start offering the service?

We do all the NHS services here, so we apply to offer any that are rolled out. It’s been in place since the NHS service started, so four or five years at least.

How much did it cost to set up the service?

No set up costs - all the equipment was supplied to us.

What, if any, training did you or other team members have to undergo?

Online training with the CPPE and a workshop with Bolton Council.

In a nutshell, what does the service involve?

The service specification that we offer means the patient can either have nicotine replacement therapy (NRT), such as patches, gum or Champix.

We have a conversation with the patient, and based on that, we recommend either one. With the NRT, for the first four weeks there is a weekly meeting with the patient to discuss any issues they have and take a carbon monoxide reading - this enables us to determine whether the patient has actually quit. If they haven’t quit after the first four weeks, we have to take them off the service. If they continue after the four weeks, we see them once a fortnight.

If they have Champix, it is the same procedure at the beginning in terms of discussing whether it’s going to be suitable or not. Patients come in for a supply of the product on weeks 1, 3, 7 and 11. At each meeting we speak to patients about how they are getting on and do the carbon monoxide reading. At the third week we would do a check on the patient and if they haven’t quit we would again have to take them off the service. Patients must come in at the specified weeks to get restock of the product, but we always say that if they feel like coming in before or after, just because they need a chat or some more support, then they are free to come in whenever they like.

The service lasts for 12 weeks. If patients make it to the end of the 12 weeks, we provide any relevant information - such as they can continue using the NRT if they feel that they need to - and then our involvement ceases.

We fill out the paperwork and enter our information onto PharmOutcomes. At the endof every month that system automatically generates an invoice, and then Bolton Council pay us a fee. If you sign someone up in the beginning there is a higher fee for that, and then for each week the patient comes in, we receive a lower fee. We are also reimbursed for the cost of the drugs.

Are there any opportunities to sell over the counter or prescription products during the consultation or after it?

We can only give one product - the only time we are allowed to give two is if a patient is pregnant, to give that extra support. Some patients might also choose to purchase an additional NRT product alongside what they’ve had through the scheme, but they would have to pay for that over the counter.

How have patients responded to the service?

We do find that we have a lot of patients who came for a few weeks and then disappear, but I think you would probably find that in most places. I would say that if we have 10 patients, three or four will last the full 12 weeks.

If patients reach the 12 weeks then we do get good feedback - a lot of the time what happens is patients say that due to stress they haven’t been able to go the full 12 weeks - but aside from that it’s very good feedback.

Roughly how often each month do you carry out the service?

In terms of new patients, we probably see two each month.

How much do you charge for the service?

If patients pay for their prescriptions, the charge would be £9 for each supply of products, but if the patient gets free prescriptions there is no charge.

Roughly how much a month do you make from offering the service?

Figures not available.

Would you recommend offering this service to other contractors?

Yes - as pharmacists helping people quit smoking is something we would expect to do anyway, so I’d definitely recommend it. We can also offer more time for a conversation with patients than GPs can, and people have the option of dropping in to see us in between appointments too.