Regulators plan smoking ban across all NHS sites

The proposal is set out in a consultation on the NHS standard contract for 2020-21, published yesterday.

An addition to the proposed contract, which is the template produced by national leaders to be used between commissioners and providers, states: “The provider must use reasonable endeavours to ensure that the provider’s premises are smoke-free at all times.”

Around two-thirds of providers are thought to have implemented smoke-free policies already, which is in line with guidelines from the National Institute of Health and Care Excellence. But there are concerns around the practical difficulties in enforcing them.

NHS Providers said trusts without a smoke-free policy often have a good reason for it, while the Unison union said a ban would need careful handling.

It can be particularly difficult for mental health trusts to deploy effective smoke-free policies if they have patients in secure units.

In May this year, Public Health England said more than two-thirds of acute trusts in England had banned smoking on their grounds and called on the remaining third to do so.

Research by anti-smoking charity Action on Smoking and Health, published in October, suggested at least 42 out of 52 mental health trusts had introduced a smoke-free policy. However, almost all the trusts that responded to the ASH survey reported various levels of non-compliance.

Trusts were asked to estimate how often patients on an average adult mental health ward were found smoking. Nearly half the trusts with a smoking ban reported patients were found smoking in bedrooms or bathrooms at least once a week. Patients were found smoking in the wider grounds every day, on average, in more than half the trusts.

The standard contract is subject to a consultation, which began today.

Miriam Deakin, NHS Providers’ director of policy and strategy, told HSJ today: “Where they can, trusts are already putting in measures to try and encourage staff, visitors and patients not to smoke on their sites.

“A national directive to ensure all NHS trusts and foundation trusts are smoke-free could be a step in the right direction to support trusts to change behaviours.

“However, it is important to bear in mind there will often be good reasons why some trusts will have struggled to implement and enforce these policies – for example, smoking is much more prevalent in some places than others.”

Sara Gorton, head of health at Unison, said: “A total ban needs careful handling. Hospitals must train employees and support those who’ll be enforcing this new policy.

“Managers should also ensure patients and visitors are made aware. Otherwise, there’s a risk staff will be left struggling to deal with angry smokers.”

 When approached for comment, NHS England highlighted the NICE guidance and PHE recommendations.

 Supplementary documents say the rule would “not apply at this stage to e-cigarettes”.