Elaine Young Senior Manager Public Health

Development of a ten-year tobacco control strategy using outcome-focussed planning

within NHS Ayrshire and Arran

Elaine YoungSenior Manager

Public Health

What I am going to talk about….

• Why strategies are important

• What relevance strategies have to practitioners

• How we approached writing our strategy

• Lessons learned from writing our strategy

Why strategies

are important

Why strategies are important

“A journey of a thousand miles begins with a

single step” Lao Tzu

Why strategies are important

“By not acting, we are killing people”.

Nicola Roxon, Minister for Health

in Australia, who championed plain

packaging

What relevance strategieshave to practitioners

• Variety of posters and presentations here today from Ayrshire and Arran, but why are we working on these areas?– Prison – using Varenicline– Hospital – respiratory opt out project– Hospital into community – follow up– Veterinary practices – second hand smoke

What relevance strategieshave to practitioners

…because - they are part of our strategy - practitioners’ objectives flow from this strategy- we can clearly show budgetary spending

How we approached writing our strategy

• Our director had a vision….


• ….about using outcome focussed planning i.e. looking at

– long term, intermediate and short

term outcomes for tobacco control– how these connect to the national outcomes – the local actions required to meet these

outcomes along with appropriate performance measures


• Step 1: We formed a Tobacco Leadership group with members from Public Health and Policy, Planning and Performance Department

• Step 2: We developed a project plan and Volume 2 – fact file describing epidemiology, current services, local issues “where are we now in relation to tobacco control”


• Step 3: We held an initial stakeholder event:


Outcomes triangle

Logic models

Multiple results chains

Tobacco – all sectors

Inputs

Activities

Outputs

Reach

Short - term outcomes

Intermediate outcomes

High level outcomes

Inputs

Activities

Outputs

Reach

Short - term outcomes

Intermediate outcomes

High level outcomes

NHS

NRT + Brief advice

Smoking cessation services

Adult smokers

Increased quit rate

NHS

NRT + Brief advice

Smoking cessation services

Adult smokers

Increased quit rate

Voluntary orgs

NRT + Brief advice + support

Outreach SC services

Hard to reach smokers

Increased quit rate

Voluntary orgs

NRT + Brief advice + support

Outreach SC services

Hard to reach smokers

Increased quit rate

School health teams

(joint delivery)

Brief advice

Outreach services for YP

Young irregular smokers

Reduced frequency of

smoking

LAs: School health teams

(joint delivery)

Brief advice

Outreach services for YP

Young irregular smokers

Reduced frequency of

smoking

Local authorities

Enforcement of laws on underage

sales

Tobacco retail sales

Under 18s

Compliance with laws

Local authorities

Enforcement of smoking ban

Smoke free public places

General public


Local authorities


sales


Under 18s


Local authorities


sales


Under 18s


Local authorities



General public


Local authorities



General public


Behaviour Reduced adult smoking rates

Reduced uptake of smoking by young people

Improved mental wellbeing Reduced inequalities in healthy life expectancy

Reduced inequalities in CHD and cancers

Environments Reduced exposure to second - hand smoke

Reduced availability of tobacco to under 18s

Behaviour Reduced adult smoking rates

Reduced uptake of smoking by young people

Improved mental wellbeing Reduced inequalities in healthy life expectancy

Reduced inequalities in CHD and cancers

Environments Reduced exposure to second - hand smoke

Reduced availability of tobacco to under 18s

EXAMPLE


• We discussed how we might wish to change these national logic models to reflect our local situation

• We then spent some time in workshops collating activities/actions which we thought would result in these locally agreed short term outcomes


• Step 4: Brought together a multi-disciplinary strategy development task and finish group who used the information from the stakeholder event to develop our draft strategy and action plan over a period of 3 meetings


• Step 5: We engaged widely with community planning partners and the public on our draft strategy and action plans and amended the documents accordingly


• Step 6: We took the draft strategy and action plan through our management structures to the NHS Board requesting that it was endorsed for a period of formal consultation

Digital Story: My smoke free family


• Step 7: We consulted on the draft strategy and action plans in a more targeted way, using focus groups etc

• Step 8: We took the consultation report and amended strategy back to the NHS Board in Feb 12 and it was endorsed for implementation


• Next steps:

– Multi-agency Tobacco Strategy

Implementation Group– Actions and monitoring via covalent –

performance management system– Working with North, South and East CHPs– Leadership group continues, working with

Health Scotland


• Next steps:

– Poster at Public Health Conference– Presentation at national Smoking Cessation

Conference– Benchmarking against National Strategy and

altering our action plan if required

Lessons learned from writing our strategy

• It takes longer than you think• The tendency is to be over ambitious• Engagement and consultation are vital to

producing a document which is owned by partners and the public

• The process has been useful in raising the profile of smoking and smoking related issues

• We have created a template for the development of other strategies

Contact details

[email protected]

01292 885914

mailto:[email protected]

Documents

Elaine Young Senior Manager Public Health