Smokers face care warning (From Oxford Mail)

Smokers face care warning

6:30am Thursday 28th June 2007 in

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Patients treated at home will be ordered to visit their health centre for care if they refuse to stop smoking in front of community health staff.

Although tobacco will be banned in the workplace from Sunday, the law will not be eligible for workers visiting other people's homes.

As a result, district nurses, midwives and health visitors have been told they will be able to stop seeing patients who ignore requests for them to stub out their cigarettes when they call round.

Instead, smokers will have to go to a GP surgery for treatment - where the smoking ban will be in operation.

There are 400 district nurses working in communities across Oxfordshire, who last year made 272,000 visits to patients.

Another 160 county health visitors visited 65,790 adults and 146,335 children in 2006.

A spokesman for Oxfordshire Primary Care Trust, which oversees community health services, said: "Most practitioners have a good relationship with their patients, so this isn't going to start being an issue.

"It's up to the practitioner whether they want to go into a home or not, and we've told them to use their own judgement. For example, they wouldn't ask someone to stop smoking if they'd recently been bereaved.

"But there is a letter that can be sent to a patient who doesn't want to stop smoking when one of our staff is around, which requests them to stop smoking or go to their health centre for treatment."

District nurse Nina Billen, who works in East Oxford and sees about seven or eight patients a day, said it was unlikely that she, or her colleagues, would need to use the letter to force people to stop smoking in their presence.

She said: "Patients don't smoke very often while I'm in their home, but there are some people who do try and light up while I'm there. I just say, 'Could you put that out please', and they're quite happy to do that.

"We do chronic disease checks on patients every nine months and ask them, if they do smoke, whether they'd like to give up. If they do, we can put them in touch with someone who can help."

Neighbouring PCTs have drawn up similar policies. Berkshire West PCT has told staff to make their own judgements, without compromising patient safety or welfare.

A spokesman said: "Staff have the full support of the trust to make decisions about services in these circumstances.

"Each case should be judged on individual circumstances and staff should discuss these issues with their manager."

Oxfordshire Social Services has also put plans in place to protect its 500 home support workers, who carry out non-medical tasks in about 1,000 people's homes across the county.

But care will not be cancelled if patients refuse to stop smoking.