Smoke Free Bexley

In December 2023, Bexley commissioned the GP Federation to take over the Smoke Free Bexley service. The commissioning process ensured that the service was picked up and delivered in the same way as it had been previously, and that the same level of aid is still offered to Bexley residents. As the crossover period begins to come to an end, the GP Federation has begun to expand its workforce in order to offer a greater range of services to our local communities. More face to face sessions will be able to take place in GP surgeries, which will allow for a closer working relationship between the service and GP’s, further aiding those who need nicotine replacement medications. Additional access points have also been planned in the north of the borough for 2024/25, with the GP Federation having requested 1,000 vapes to be freely provided to those who require help to quit in the areas of highest smoking prevalence.

0 to 19 Children’s Public Health Service

The updated Bexley 0 to 19 service specification (commencing February 2024) has incorporated a dedicated section on Smoking Cessation, highlighting the fact that addressing smoking in the home should be one of the key roles for Health Visiting Teams. Health visitor staff are trained in NCSCT VBA (National Centre for Smoking Cessation and Training - Very Basic Advice), and this will be regularly reviewed and updated as required. The promotion of smoke free homes starts from the first visit after the birth of a baby, at which time the Health Visitor will ask if there are any people who smoke in the household and signpost or refer them to smoking cessation services as necessary. Health Visitors will work with a family from when the child is 10 to 14 days old up until they are 5 years old, at which point the school nursing service takes over. School nurses support schools to undertake an annual school health profile which collects data on the number of students with asthma or other conditions that may be worsened by people who smoke at home, as well as gauging how many students smoke themselves. They can use this data to determine whether extra informative sessions from external services should be provided to students in PSHE lessons or assemblies regarding stop smoking services. This data will be further enhanced by the introduction of the School Health Education Unit (SHEU) survey from May 2024 which will collect a range of self-reported health information from students in Year 10, including information on smoking and vaping.

Adult Substance Misuse Service

All service users engaged with Bexley’s Adult Drug and Alcohol Treatment Service, The Pier Road Project, are screened for their smoking status. The clinical note system used by the provider is set up to generate referrals to Bexley’s stop smoking service. New guidance requires substance misuse services to also screen for smoking and Bexley’s service already has this in place. Bexley’s substance misuse partnership is focussing on training and upskilling the wider workforce in 2024/25 to increase the identification and referral of those using drugs and/or alcohol. An increase in referrals will also ensure increased access to stop smoking support for those who are also smoking. A new specification for Bexley’s adult substance misuse treatment service is currently being prepared and it will include further detail on the expectations for the service in supporting service users to give up smoking.

Smoke free School Gates

School Superzones have been implemented by many London boroughs to protect children’s health and enable healthy behaviours at a young age, addressing health inequalities issues in the areas around schools. In 2022, Bexley became the first London borough to include any type of tobacco control measures in their School Superzones Scheme, proposing the implementation of voluntary smoke free school gates. Smoke free gates prohibit smoking throughout all the school grounds, outside and around the school gates, and sports fields at all times. The aim is to protect children, parents, and staff from exposure to second-hand smoke, to support de-normalising smoking, and reduce smoking litter. The policy is voluntary, and schools are provided with tools to engage with staff, parents, and the wider school community in the development of and adherence to the policy. These are unenforced areas in which it is heavily suggested that smoking does not take place, leaving the responsibility on parents and guardians to keep second hand smoke away from children. The scheme has been piloted in partnership with 2 schools in Bexley so far, with the posters due to be put up later this year, which has prompted another school to get in contact requesting information on the programme. Bexley has produced a ‘Smoke Free School Gates Toolkit’ for schools which outlines how to write and implement a smoke free school gates policy. Piloting the approach in School Superzones schools has provided useful learning that will inform how the project could be rolled out to other schools in the borough.

Making Every Contact Count

Starting in 2024/25, there will be a renewed emphasis on the benefits of making every contact count (MECC), embedding the message around tobacco control and smoking cessation throughout the Bexley system. By collaborating with partners in the voluntary sector and health care system, we aim to raise the profile of MECC and provide appropriate training for front line staff, so that they are able to signpost our smoking cessation services and spread our tobacco control message through every daily interaction with our residents.