NHS Fife acknowledges and agrees with the importance of regular and timely review of policy/procedure statements and aims to review policies within the timescales set out.
New policies/procedures will be subject to a review date of no more than 1 year from the date of first issue.
Reviewed policies/procedures will have a review date set that is relevant to the content (advised by the author) but will be no longer than 3 years.
If a policy/procedure is past its review date then the content will remain extant until such time as the policy/procedure review is complete and the new version published, or there are national policy or legislative changes.
1.1 NHS Fife recognises its duty to comply with the Smoking, Health and Social Care (Scotland) Act 2005 which bans smoking in “wholly or substantially enclosed” public places. In addition, NHS Fife recognises its duty to comply with the Health and Safety at Work Act 1974 Section 2 which informs us that we have a legal obligation to maintain a working environment for all employees that is, so far as is reasonably practicable, safe and without risks to health. This policy sets out NHS Fife’s approach to smoking within its premises and grounds, for both patients and staff and the smoking cessation support available.
1.2 Smoking remains one of the biggest single preventable causes of ill health and early death in our community and causes the premature death of 13,000 people in Scotland every year.
1.3 NHS Fife, as an exemplar employer, also has a responsibility to set a good example in health promotion and to work towards national targets set to reduce smoking and the incidence of diseases caused by tobacco smoke. NHS Fife, as a health promoting organisation, also has a responsibility to promote healthy living and non-smoking as the norm.
This policy outlines that smoking will not be allowed within any NHS Fife premises, around entrances or buildings, within NHS Fife grounds, within any official NHS Fife vehicles, or whilst official NHS Fife vehicles are being used on NHS business.
This includes the use of e-cigarettes.
1.4 The only exceptions to this policy, in line with the Smoking, Health and Social Care (Scotland) Act 2005 are detailed in Appendix 1, (including Learning Disabilities) and are summarised as follows:
- Designated rooms / areas for psychiatric inpatients within residential psychiatric units / hospitals. These rooms/areas are for the use of patients only i.e. not staff or visitors and must have adequate ventilation (i.e. do not ventilate into any other part of the no-smoking premises and are clearly marked as rooms in which smoking is permitted).
- Adult hospices. These rooms must comply with the same criteria as designated rooms / areas for psychiatric inpatients.
2.1 This policy applies to:
- all NHS Fife staff;
- all patients, including out-patients, day-patients, in-patients and long-stay patients;
- all other people, including visitors, contractors, students, voluntary staff and anyone whose work, study or personal circumstances brings them into NHS Fife premises.
3.1 Managers are responsible for making sure that:
- Staff are made aware of and supported with the implementation of the policy with regards to colleagues, visitors, patients, contractors and other non-NHS staff;
- Employees who express a desire to stop smoking are supported;
- Any breaches to the policy are handled in a considered and thoughtful manner;
- No smoking notices are displayed within areas of responsibility;
- Application of the policy is monitored in their own areas of control.
3.2 All NHS Fife Staff are responsible for making sure that they:
- Support the implementation of the policy with regards to colleagues, visitors, patients, volunteers, contractors and other non-NHS staff;
- Report breaches of the policy, i.e. smoking in the building, by completing an incident form;
- Raise breaches of the policy with their line manager;
- Do not smoke at any time whilst they are on duty. Staff on-call are not permitted to smoke when required to attend work as a result of a call out, or if using on-call accommodation within NHS Fife premises;
- Do not smoke in any official NHS Fife vehicles at any time, or during official journeys on NHS business;
- Comply with other organisations smoking policies when working at, or visiting other sites.
4. OPERATIONAL SYSTEM
4.1 This policy is designed to:
- Protect and improve the health of the population of Fife by providing a smoke-free environment for all, while offering support to those who smoke and would like to stop;
- Prevent patients, visitors and staff from being exposed to tobacco smoke against their will;
- Promote healthy living and non-smoking as the norm. The smoking cessation service offers a range of support and advice to anyone wishing to stop smoking and this is promoted across NHS Fife and information and contact details are attached as Appendix 2.
- Support health improvement by promoting change in attitudes towards smoking and promote an environment whereby people are discouraged from starting to smoke
4.2 Apart from specific exceptions for patients, (see Appendix 1), smoking is not permitted at any time for staff, patients, visitors, volunteers, contractors or the general public:
- within NHS Fife premises or residences;
- in the vicinity of entrances to NHS Fife buildings,
- within its grounds;
- in any official NHS Fife vehicle, while on health service grounds, or whilst being used for NHS business.
4.3 In areas subject to the Smoking, Health and Social Care (Scotland) Act 2005 legislation-compliant signage will be displayed in order to make staff, patients and visitors aware that they must comply with the law. In areas not subject to the Smoking, Health and Social Care (Scotland) Act 2005 appropriate signage will be displayed in order to highlight NHS Fife’s smoking policy.
4.4 NHS Fife will support public health awareness campaigns in relation to smoking and will support and encourage employees and patients who wish to give up by offering smoking cessation classes and providing information about locality smoking cessation classes. Further information on smoking cessation services in NHS Fife are detailed in Appendix 2.
4.5 NHS Fife will ask patients, their carers or relatives not to smoke when NHS Fife staff visit them at home during the course of their duties and ideally for an hour before the scheduled time of any visit. This will also be detailed in appointment letters.
4.6 A risk assessment should be undertaken before home/off site visiting in the case of staff who have a pre-existing condition such as asthma, chronic obstructive pulmonary disease (COPD) or cardiovascular disease made worse by exposure to tobacco smoke, or who face additional risks, for example because of being pregnant. Support is available from the Occupational Health and Safety Advisory Service, (OHSAS), should this be required.
4.7 Staff should include an assessment of each patient’s smoking status on admission and take account of the possible need to deal with nicotine withdrawal symptoms in developing care plans. NHS Fife will endeavour to offer appropriate advice and support on how to stop smoking to those patients who wish to quit (see Appendices 3 and 4).
4.8 Staff should endeavour to dissuade patients who wish to leave NHS premises and grounds to smoke from doing so. Those patients who still decide to leave NHS premises and grounds to smoke must be advised by staff that they do this at their own risk and this should be recorded in patient notes.
4.9 This Smoking Policy is part of each staff member's employment documentation and prospective staff must be informed of the Policy at recruitment stage. The Policy will be confirmed to successful candidates along with their contract of employment.
5. RISK MANAGEMENT
5.1 NHS Fife is responsible for:
- maintaining a safe and healthy working environment;
- protecting the health of patients and staff, and not subjecting them to hazardous environments and materials; and
- ensuring that staff understand their responsibilities to take reasonable care of the health and safety of others.
5.2 NHS Fife has a duty to comply with the Smoking, Health and Social Care (Scotland) Act 2005 which prohibits smoking in enclosed public places. Failure to comply with this legislation could expose NHS Fife to the risk of prosecution should smoking take place in those NHS premises subject to this legislation.
5.3 Failure to implement this policy would place NHS Fife at risk of claims from employees relating to occupationally acquired smoking-related conditions. This would lead to loss of reputation as an exemplar employer and as a health promoting organisation, and possible financial consequences should any action be successful.
5.4 NHS Fife recognises that most people who smoke will adhere to this policy. Where an employee finds someone who is smoking in NHS Fife premises they should inform them of the policy and ask them to extinguish their smoking material. Employees are expected to use their initiative and professional judgement in such situations and are not expected to enforce the policy other than bringing the policy to the awareness of the person who is smoking, unless they feel that by doing so, they may be putting themselves at undue risk.
6. RELATED DOCUMENTS
- Scottish Executive. The Prohibition of Smoking in Certain Premises (Scotland) Regulations 2006
- Scottish Executive: Smoke-free Scotland – Guidance on Smoking Policies for NHS, Local Authorities and Care Providers 2005
- Scottish Executive: Improving Health in Scotland – The Challenge 2003
- ASH Scotland. Re-audit of Tobacco Policies in the NHS in Scotland. Executive Summary. Edinburgh: ASH Scotland, 2005.
- Scottish Executive: The Smoking Health & Social Care (Scotland) Act 2005
- Health & Safety at Work Act 1974