1. Service improvement in a community setting – the experience in Glasgow Cathy Williamson Health Improvement Practitioner

2. East Dunbartonshire Partnership Working Smokefree Community Service established in 2002 Became aware of number of clients attending support who disclosed were engaged with mental services Identified low referral rate from mental health teams Developed partnership working with Larkfield CMHT 2009 Identified gap in knowledge of CMHT staff of SFS

3. Health Audit 2009 Health Audit developed to explore need of service users Audit showed that 11 of 13 smokers who tried to stop smoking did not use any support. Question – was this choice or lack of information ? Community Mental Health referral form and pathway established Smokefree awareness sessions delivered to CMHT staff Increased referral rate

4. Client Journey New client self-referred – March 2015 –Stated motivated and wanted to stop that week –Smoking 60 cigarettes per day –Smokes throughout the night (does not sleep well) –Stated aware of challenge to change his habits –Disclosed currently engaged with CMHT and Clozepine usage –Client requested OTO support citing anxiety issues HIP liaised with client’s CPN re: Clozepine reduction protocol CPN advised that client was provided with home visits fortnightly but was known not to engage with service

5. Quit Attempt HIP supported client to set quit date – 1 st April - in line with agreed reduction protocol agreed by consultant Dual products selected – Nicotine Patch 21mg & Strips Client reported in first week: –slept through first 2 nights using NRT –delighted at how much easier it had been to stop –pleased with change in sleep pattern –Only using Patch 21mg HIP and CPN shared weekly support to client through initial 12 weeks of quit. Client achieved 4 and 12 week quit and CPN confirmed remains currently non-smoking February 2016.

6. Strengths & Challenges Establishment of local Smokefree Mental Health pathway and referral process Increased knowledge between services Increased referral rate to service Shared care approach beneficial for clients Low staff awareness of local SFS Mental Health pathway Lack of staff understanding of SFS support model New staff training ? Self-referral remains main referral route to SFS

7. Thank You Cathy Williamson Health Improvement Practitioner East Dunbartonshire HSCP Tel: 0141 355 2327 or 07766 085900 Email : cathy.williamson@ggc.scot.nhs.uk