Dscn 40 2001.pdf

DSC Notice: 40/2001
Data Standards:
Supporting revised Cessation of Smoking
Monitoring Requirements
Implementation Date: Immediate
DATA SET CHANGE CONTROL PROCEDURE
This paper gives notification of changes to be included in the NHS Data Dictionary & Manual and
the NHS CDS Manual as appropriate. These will be consolidated into the publications in due
course.
Summary of Changes:
Changes to the NHS Data Dictionary and Manual to support revisions to the smoking cessation monitoring requirements returns. Change Proposal
Reference No: CP 37/01
The NHS Information Standards Board (NHS ISB) is responsible for approving information standards. The NHS ISB is supported by the Management Information Standards Board, the Clinical Information Standards Board and the Technical Standards Board. The packaging of standards documentation is under review. Any changes will be notified in due course. Data Set Change Notices are located on the Internet in the Electronic Library at
http://www.standards.nhsia.nhs.uk/library/index.htm and on the NHSnet at
http://nww.standards.nhsia.nhs.uk/library/index.htm
DATA SET CHANGE NOTICE 40/2001
Reference:
Subject:
Cessation of Smoking: Monitoring Requirements Type of Change:
Changes to NHS data standards to support central requirements Effective Date:
Reason for Change:
Revisions made to the central return for monitoring arrangements for smoking cessation services in Health Authorities for 2001/2002 Background:
The Tobacco White Paper Smoking Kills, published in December 1998, highlighted helping people quit smoking as a key area of the new policy on smoking; it is also key to the success of Our Healthier Nation targets for reduction in mortality from cancer and heart disease. The NHS Plan, published in July 2000, restates these targets and affirms the Government’s commitment to a major expansion in smoking cessation. There have been a number of changes to the monitoring form taking account of experience in operation, current requirements and comments from the NHS and Department of Health. Overall, the monitoring requirements have been simplified. The annual return has been dropped. The annual total is now the cumulative total of the four
quarterly forms, with some information (e.g. ethnicity) previously collected annually to be
collected quarterly instead. This change was introduced at the request of Regional Smoking
Leads and the Department of Health to lessen workload and avoid discrepancies between
quarterly and annual data.
The quarterly return continues to give details of individual clients setting quit dates and success
rates. Summary data for people receiving Nicotine Replacement Therapy (NRT) and/or
bupropion (Zyban) is included for the first time. Carbon monoxide (CO) validation of all
smokers self-reporting as having quit at 4 week follow-up is also requested (previously only for
specialist services).
The distinction between intermediate and specialist services has been dropped, though there is no objection to the continuing use of these terms locally. This is because the emphasis should be on the quality of service offered, rather than on what category it fits into. Similarly, central monitoring data on 52 week follow-up of clients setting a quit date in 2000/01 onwards is not required, however, follow-up at the 52 week stage is still recommended as good practice to establish long-term success rates and this information should still be collected locally. The staffing table has been simplified. Information is now sought on only two categories of staff involved in smoking cessation; the coordinator (as before) and staff responsible for the co­ordination of smoking cessation services for pregnant women. The proposal to collect information on staff working on pregnant women reflects new policy initiatives. Summary of Changes: Entity Definitions PERSON SMOKING CESSATION EPISODE SMOKING CESSATION SERVICE Attribute Definitions
FREE NICOTINE REPLACEMENT THERAPY FREE PRESCRIPTIONS NON SMOKING CONFIRMED AT 4 WEEKS NON SMOKING CONFIRMED AT 52 WEEKS OUTCOME AT 4 WEEKS OUTCOME AT 52 WEEKS PHARMACEUTICAL SMOKING CESSATION AID PREGNANCY STATUS SMOKING CESSATION POST TYPE SMOKING CESSATION SERVICE NAME SMOKING CESSATION SERVICE TYPE Model View Diagrams CM130 Model View Diagram Overview Change Type:
Change entity type description and attributes PERSON SMOKING CESSATION EPISODE
A period of time during which a PERSON sets a quit date and attempts to stop smoking. During this time, it is expected that the PERSON will set a QUIT DATE. The episode starts when the PERSON presents themselves to the SMOKING CESSATION SERVICE and ends either when it is confirmed that the person has stopped smoking, or has ceased to attempt to give up smoking the outcome after a year has been recorded or when the person re-started smoking, whichever is the earlier. HSC 1999/087 New NHS Smoking Cessation Services, April 1999 Department of Health Monitoring Return: Smoking Cessation Services, Jan April 20001 FREE NICOTINE REPLACEMENT THERAPY FREE PRESCRIPTIONS only required for specialist smoking cessation services only required for specialist smoking cessation services O OUTCOME AT 4 WEEKS FOLLOW-UP O OUTCOME AT 52 WEEKS FOLLOW-UP only required for specialist smoking cessation services The remaining attributes and relationships are unchanged. Change Type:
Change entity type description and attributes SMOKING CESSATION SERVICE
A service set up by a HEALTH AUTHORITY to help people give up smoking and to monitor the service. To be designated as an NHS SMOKING CESSATION SERVICE requires that minimum quality standards should be met. To meet these minimum quality standards all advisers should: have received appropriate training for their role, carry out the 4 week follow-up promptly, in accordance with the current guidance, complete the minimum data set (the individual client data monitoring forms) for each client, fully and accurately, and return the information required to the coordinator in good time, offer weekly support for at least the first four weeks of a quit attempt, attempt to confirm smoking status of all clients self-reporting as having quit at 4 week follow-up by use of a CO monitor, except where follow-up is carried out by telephone. The majority of services will operate broadly on the “Maudsley” model of a clinic providing intensive support, usually on a group therapy basis, to the most dependent smokers. The service should also continue to be supplemented by a range of services in various settings in primary care, secondary care and the community. Central monitoring of data regarding 52 week follow-up is no longer required, however, follow-up at the 52 week stage is still recommended as good practice to establish long-term success rates and this information should still be collected locally. HSC 1999/087 New NHS Smoking Cessation Services, April 1999 Department of Health Monitoring Return: Smoking Cessation Services, Jan April 20001 A service set up by a HEALTH AUTHORITY to help and monitor people giving up smoking. HEALTH AUTHORITIES will provide three types of smoking cessation service reflecting the intensity of the intervention. Monitoring information in respect of clients using the services is required centrally only for specialist smoking cessation clinics/services and "intermediate" interventions. Specialist smoking cessation clinics/services are run by a smoking cessation specialist(s) who has received training for this role. The clinic/service will offer intensive treatment in the form of group support over the course of 5 to 6 weeks, including the use of Nicotine Replacement Therapy aimed at the small percentage of motivated dependent smokers at high risk of tobacco morbidity, and those who have failed to quit through other means. Clients may also receive treatment one-to-one if for any reason group sessions are judged not to meet their needs. Such a clinic/service may be situated in a major hospital, although it could be based in a community setting, have outreach clinics or operate on a peripatetic basis. "Intermediate" interventions are usually provided on a one-to-one basis by specialist practitioners who will have undertaken some form of accredited/recognised training. These practitioners are likely to be paid to provide services, 'registered' with the local smoking cessation coordinator, and authorised to provide clients with free Nicotine Replacement Therapy or Nicotine Replacement Therapy vouchers. Examples might include the following, although this list is not exhaustive: a practice nurse trained to provide specialist smoking cessation support in a GP practice or health centre; a nurse/counsellor providing specialist smoking cessation advice to patients in a hospital; a one-to-one service provided by a trained health professional for pregnant women; a youth worker or school nurse trained to provide smoking cessation advice for young people in a youth club or educational setting; a specialist smoking cessation advisor working in a community centre; a pharmacist trained to provide support to clients, where he/she provides specialist advice and support on the lines of that provided by other health professionals in the examples above. (The advice and support provided by a pharmacist when selling Nicotine Replacement Therapy in the normal course of his/her work would not qualify as an intermediate intervention.) Brief interventions may also be provided by GPs or other health professionals. These are provided in the normal course of the professional's duties rather than comprising a "new" SMOKING CESSATION SERVICE, and monitoring information about clients in receipt of such interventions is not therefore required centrally. SMOKING CESSATION SERVICE NAME SMOKING CESSATION SERVICE TYPE This entity type has no attributes. Change Type:
FREE NICOTINE REPLACEMENT THERAPY Change Type:
FREE PRESCRIPTIONS
Change Type:
NON SMOKING CONFIRMED AT 4 WEEKS
An indicator of whether non-smoking status has been confirmed, was attempted but not confirmed, or confirmation was not attempted, by carbon monoxide (CO) validation at 4 weeks follow-up after the QUIT DATE. A machine called a carbon monoxide monitor or Smokelyser is used to detect the amount of carbon monoxide in the breath and therefore to detect whether someone is still smoking. For the purposes of CO validation, any CO reading of less than 10 ppm should be taken as an indication that the client is not smoking at the time. Non-smoking status confirmed by CO validation Not confirmed – CO validation attempted Not confirmed – CO validation not attempted Change Type:
NON SMOKING CONFIRMED AT 52 WEEKS
An indicator of whether non-smoking status has been confirmed, was attempted but not confirmed, or confirmation was not attempted, by carbon monoxide (CO) validation at 52 weeks follow-up after the QUIT DATE. A machine called a carbon monoxide monitor or Smokelyser is used to detect the amount of carbon monoxide in the breath and therefore to detect whether someone is still smoking. For the purposes of CO validation, any CO reading of less than 10 ppm should be taken as an indication that the client is not smoking at the time. Non- smoking status confirmed by CO validation Not confirmed – CO validation attempted Not confirmed – CO validation not attempted Change Type:
OUTCOME AT 4 WEEKS FOLLOW-UP
The description remains unchanged. Change Type:
OUTCOME AT 52 WEEKS FOLLOW-UP
The description remains unchanged. Change Type:
PHARMACEUTICAL SMOKING CESSATION AID
A classification used to identify whether a PERSON received a PHARMACEUTICAL SMOKING CESSATION AID during a PERSON SMOKING CESSATION EPISODE. For monitoring purposes the PHARMACEUTICAL SMOKING CESSATION AIDS are Nicotine Replacement Therapy (NRT) and/or bupropion (Zyban). It should be taken that a PERSON received such an aid regardless of the method by which a PERSON might obtain their relevant aid – whether through prescription, purchase, or supply free of charge, including through a voucher scheme where this is still in operation. Received both NRT and bupropion (Zyban) either concurrently or consecutively Did not receive either NRT or bupropion (Zyban) Change Type:
PREGNANCY STATUS
An indicator of whether or not the subject of a radiology SERVICE ORDER, or PERSON SMOKING CESSATION EPISODE, is pregnant. The Version 1.0 Trial NHS Standard EDIFACT Messages for Radiology Requests and Reports, Department of Health Monitoring Return: Smoking Cessation Services, April 2001 Change Type:
SMOKING CESSATION POST TYPE
The type of post funded by smoking cessation monies. A classification of staff being monitored by the quarterly Smoking Cessation returns. Professional development staff/trainer Smoking cessation services coordinator for pregnant women Change Type:
SMOKING CESSATION SERVICE NAME
Change Type:
SMOKING CESSATION SERVICE TYPE
Change Type:
Change model view diagram overview text Community � CM130
� Overview Text
The PERSON SMOKING CESSATION EPISODE ends either when it is confirmed that the person has stopped smoking, or has ceased to attempt to give up smoking the outcome after a year has been recorded or when the person re-started smoking, whichever is the earlier. Please address enquiries about this DSCN to:­

Source: http://www.isb.nhs.uk/documents/dscn/dscn2001/402001.pdf