"Smoking at the main entrance to the hospital"

About: Monklands District General Hospital

(as a relative),

I was visiting a sick relative at this hospital yesterday. Despite having No Smoking signs and Smoke Free Hospital Signs all around the car park. I was absolutely disgusted to see clearly sick patients in their dressing gowns sitting in their wheelchairs at the main entrance smoking away quite blatantly underneath these signs! I had to negotiate myself through a haze of smoke as some of these smokers who were clearly patients were right in front of the main automatic doors. Who allows this? Who is responsible for preventing this from happening? It is illegal and unhealthy ( for passing visitors ).

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Response from Melanie MacLean, Patient Affairs Manager, Patient Affairs, NHS Lanarkshire

picture of Melanie MacLean

Dear Ignorant smokers

Firstly can I say how sorry I am to hear about your experience when visiting your relative at Monklands Hospital.

To give you some background to NHS Lanarkshire’s no smoking policy, we introduced the policy which banned smoking on all our grounds and vehicles in 2008, and it was updated in 2014 to include e-cigarettes. The policy was implemented in an attempt to build on the good work of the national smoking ban in public places in 2006, protect people from second hand smoke, prevent young people from starting to smoke and offer specialist support for those who want to quit. A considerable effort was made, and is still being made, to inform staff, patients, visitors and the general public about our policy to help improve compliance with it.

Some of the steps we have taken to address the matter of smoking on hospital grounds include:

• Installing updated no smoking signs on all NHS Lanarkshire sites

• Rolling out a system which ensures that all patients who smoke have their smoking status assessed when they are admitted to hospital to allow these patients to be managed appropriately either for temporary abstinence or total cessation.

• Offering stop smoking support at each of our three acute sites through the NHS Lanarkshire Stop Smoking Service which offers advice and support in conjunction with free nicotine replacement therapy and varenicline from trained nurse advisors.

• Brief intervention training for our staff, providing them with the basic knowledge and skills necessary to deliver brief opportunistic advice to smokers and how to refer smokers to stop smoking support services.

• Employing a dedicated stop smoking mental health nurse specialist to provide support to mental health facilities staff and patients by offering support, advice and guidance around stopping smoking.

• Discussions with our local authority partners to identify any additional enforcement activity that can be taken forward by our environmental control staff.

• A public information campaign to make smokers aware of our policy and encourage them to smoke off our grounds.

While these steps have encouraged many smokers to respect the policy, to our frustration others don’t and persist in smoking on grounds, particularly outside hospital entrances despite the inconvenience this causes the majority of others. The policy has been difficult to enforce as, unlike the 2006 smoking ban in public places, it is not a statutory requirement by law. However, the Scottish Government has recently confirmed that it is to bring in legislation and this will help support health boards to enforce their no smoking policies.

Second hand smoke is both unpleasant and presents a health danger. To address this we also have a range of initiatives to promote the dangers and impact of second hand smoke. These include:

• Jenny & The Bear, a primary one based campaign that highlights the risks associated with children’s exposure to second hand smoke.

• Our successful tobacco prevention education pack Smoke in your Eyes which has key messages about tobacco aimed at young people.

• The ‘Big Tiny’ campaign which targets workplaces to promote the impact of second hand smoke.

• Support for the national ‘Take it Right Outside’ campaign aimed at reducing second hand smoke in the home and car.

• NHS Lanarkshire is also involved in a unique study with the University of Aberdeen and the University of Edinburgh looking into the effects of second hand smoke on children in the home and in cars.

I hope this information helps to reassure you that NHS Lanarkshire is taking the matter of second hand smoke and enforcing our smoking policy very seriously. While we are well aware that some smokers persist in smoking on our premises despite our policy, we are confident that the steps we are taking as well as the future legislative change will help us to reduce this over time.

Kind regards

Melanie MacLean

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Update posted by Ignorant smokers (a relative)

Thank you for your response. While I see that steps are being taken to discourage smoking. Why are there not staff ie security staff on hospital premises to ensure this is not happening? .. Why are ward nurses Allowing sick patients to leave the wards to smoke? .. And then there is the question of hygiene. I did notice that all around the car park and outside were these blue wheel chairs in which the smokers has been sitting .. The words .. Cross infection, cross contamination come to mind. I certainly would not like to sit in one if these chairs after it had been used and discarded by a sick smoker. Can you assure me these chairs are are thoroughly disinfected before use by next sick patient?

Response from Melanie MacLean, Patient Affairs Manager, Patient Affairs, NHS Lanarkshire

picture of Melanie MacLean

Dear Ignorant smokers,

Thany you for your reply. Whilst nursing staff cannot restrain patients or stop them from leaving the ward, if they are aware that they are leaving the ward to smoke they ensure that patients are reminded that they cannot under any circumstances do so on hospital grounds. Unfortunately the hospital has no funding for security staff to cover the front entrance. It is however the responsibility of all staff to inform patients/visitors that smoking is not permitted in any area of the hospital grounds.

As advised in my previous response, nursing staff do offer and supply nicotine therapy patches to all patients who require them and they would also arrange for the smoking cessation nurse to attend the ward and offer advice and support regarding stopping smoking.

Finally, I can reassure you that all wheelchairs are cleaned on a daily basis and any visible contamination will also be cleaned before use by portering staff.

Kind regards

Melanie MacLean

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