Are Kirklees Council’s level 2 community smoking cessation services as good as the old specialist stop smoking service?

When Smoking cessation was a specialist service offered in the Kirklees area, Chrissie Parker successfully stopped smoking, with the help of Nurse Deborah at her local GP Surgery.

Here she reports on the reduced help that’s available to people who want to stop smoking, now that there is NO specialist stop smoking service in Kirklees. Instead the Council has contracts with a lot of so-called level 2 providers of stop smoking services – these are GPs, a few pharmacies and some community providers, such as Locala.

If you have experience of this GP/Pharmacy stop smoking service, please let us know how it’s worked for you. Before Kirklees Council changes it yet again by putting it into the new Integrated Wellness Servicewhich expects “communities and individuals to find their own solutions to the challenges they face.”

Chrissie writes,

“My stop smoking appointments to start with were every 2 weeks. Having tried Nicotine Replacement Therapy(NRT), Zyban and Champix with no real success, I decided I would try to quit with a Vape, even though this was not recommended as there hadn’t been sufficient research. But they were still happy to support me and check general health, weight and blood pressure at appointments.

“Deborah, the stop smoking nurse, was very supportive, pat on the back and congratulations when goals were reached, and when there was a slip off the wagon great support to get you back on track.

3 months face to face support

“I was supported for around 3 months and felt fantastic and proud to have quit. It’s not just a habit and a bad one, it’s also an addiction. That’s what many people don’t realise. The Vape helped with the habit, and reduction of the nicotine for me was the best option with the best result. We won’t go in to the reason I went back to this dreadful weed.

“But Kirklees Council has removed funding and discontinued what I feel is a great support mechanism which was successful. I would not have stopped without that support from Deborah.

Level 2 stop smoking services only allow for up to 6weeks face to face support

“Now there is no specialist stop smoking service in Kirklees, but there are a lot of so-called level 2 providers of stop smoking services.

“Kirklees Council say that this means practitioners such as practice nurses, GPs and support staff in pharmacies are trained to level 2 intermediate advisor, which allows for face to face support for up to 6 weeks.

I decided to have a scout round to see what the new stop smoking services offer

“I called at several independent Chemists, 3 or 4 had no idea of any kind of smoking cessation service, even after checking with the pharmacist. Others gave me a post card “Want to Stop Smoking?” The card had no phone number, but links to 2 web sites:
www.nhs.uk/smokefree
www.kirklees.gov.uk/smokingcessation

“Having checked the Kirklees Council smoking cessation web page, there was a list of Kirklees community smoking cessation service providers: most GP Surgeries in the area, and a few chemists.

“According to the Kirklees Council webpage , GP Surgeries that provide stop smoking services must have a GP in-house intermediate level 2 advisor that is trained and registered with Kirklees Public Health.

“The Kirklees Council website says that the intermediate level 2 advisor

‘will carry out stop smoking support for patients registered with a Kirklees practice according to the Community Smoking Cessation contract for Kirklees.’

Self Management Pathway for smoking cessation

“What the GPs level 2 smoking support amounts to is not clear from the Kirklees Self Management Pathways webpage for smoking cessation.

“But it a lot of it appears to be all about Self Care – online advice and leaflets.

Pharmacy’s stop smoking service

“Huddersfield Pharmacy, Market Street does offer the level 2 stop smoking service. It seems to be the only chemist in the town that does.

“I spoke with a member of staff to ask what was involved with the smoking cessation service they offered, did they check your weight and blood pressure, and were there 2 weekly or monthly chats with the staff member offering the service, she was quite vague, but the appointment was with the pharmacist to discuss options that would suit you best.

“Of course they did sell Nicotine replacement therapies (NRT). I asked about Champix and was that available.

“They said that as Champix is a prescription-only medication, if they felt Champix was your best option they then referred you to your GP.

“If your GP agreed they would fill the prescription for you (if I remember correctly then you went back every 2 weeks for your repeat prescription, as they only give Champix 2 weeks at a time).”

Stop smoking support is to become part of Kirklees Integrated Wellness Service

Kirklees Council says it is now,

“reviewing provision in relation to our emerging integrated Wellness Service, which will also include some smoking cessation provision.”

According to information in current job ads, the newly established Kirklees Integrated Wellness Service is

“developing new ways of working upstream to support communities and individuals to find their own solutions to the challenges they face”.

Sounds ominously like: sort yourself out because there’s no public funding to help you.

The Kirklees Integrated Wellness Service is:

“an integrated Health Improvement approach for adults; to help people build their capacity to maintain good health and be independent.  
We want to bring together organisations, people and services to develop a shared approach, using a ‘strengths based’ mind-set that acknowledges, builds upon and unlocks the strengths, skills and capacities of people to live healthy lives utilising the assets within the local community.”

An interesting article in the Journal of Community Practice concludes that asset based community development (ABCD),

“is a capitulation to neoliberal values of individualization and privatization…several practitioners are using ABCD to privatize
public issues such as inequality and justify dramatic cuts to the
…welfare state.”

And this blogpost, What’s the Matter with Asset-Based Community Development?, points out,

“A key target of ABCD is the welfare state which is constructed as bureaucratic, hierarchical and anti-democratic because, ABCD supporters argue, it breeds a culture of dependency in poor communities. In contrast, ABCD is presented as an inclusive and democratic process of empowering citizens by ‘ignoring the empty half of the glass’ of poverty and inequality (McKnight 2010: 72)… These arguments reveal a deep scepticism and distrust of the social welfare state and its ability to function for the benefit of society. Anti-statist views are not new in community development. However, to understand what ABCD is and the types of ideas and values it promotes, it is vitally important to place it in its particular historical context—namely, the rolling back of the social welfare state in 1980s America.”

Dr. Akwugo Emejulu, Senior Lecturer at the Moray House School of Education, University of Edinburgh.

We’ve been warned!

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