We showed the stop smoking service worked, cost less than most, and where more referrals could come from
Client and setting
Public health commissioners in a metropolitan borough, for an open-access stop smoking service taking around 300 referrals a quarter.
The challenge
Commissioners needed to know whether the service was worth continued investment. Referrals were rising, but more than half came from one hospital trust. National comparisons rest on a smoking prevalence estimate the team believed was too low locally. There was nothing on what users made of the service, what it cost per quit, or which referral routes were going unused.
What we did
Analysed three years of service data, around 4,000 referrals, by source, quarter, quit date and four-week outcome, keeping self-referral, general practice, pharmacy, hospital, maternity and mental health routes separate.
Compared activity, quit rates and the age profile of users against London and England figures, and worked out cost per quit alongside every other borough in the area.
Ran an anonymous survey of recent users recruited by text, around 90 responses, covering satisfaction, waiting times and problems getting NRT, and looked at the answers by sex, ethnicity and working status.
Held a group interview with the delivery team and checked smoking status data held by the substance misuse service, to see whether referrals were being lost between services.
The outcome
About 56% of users who set a quit date had quit at four weeks, in line with London and England, at roughly £560 per quit against a London average nearer £630. Almost 80% rated the support good or excellent. Commissioners could make the case for reinvestment, and knew that self-referral, pharmacy and general practice together accounted for only about a third of referrals.
Timescale and team
Eight weeks of analysis and fieldwork within a wider needs assessment. An accredited specialist with two public health analysts.
