Development of a ten-year
tobacco control strategy using
outcome-focussed planning
within NHS Ayrshire and Arran
Elaine Young
Senior Manager
Public Health
What I am going to
talk about….
• Why strategies are important
• What relevance strategies have to
practitioners
• How we approached writing our strategy
• Lessons learned from writing our strategy
Why
strategies
are
important
Why strategies
are important
“A journey of a thousand miles begins with a
single step”
Lao Tzu
Why strategies
are important
“By not acting, we are
killing people”.
Nicola Roxon, Minister for Health
in Australia, who championed plain
packaging
What relevance strategies
have to practitioners
• Variety of posters and presentations here
today from Ayrshire and Arran, but why
are we working on these areas?
– Prison – using Varenicline
– Hospital – respiratory opt out project
– Hospital into community – follow up
– Veterinary practices – second hand smoke
What relevance strategies
have to practitioners
…because
- they are part of
our strategy
- practitioners’
objectives flow
from this strategy
- we can clearly
show budgetary
spending
How we approached
writing our strategy
• Our director had a vision….
How we approached
writing our strategy
• ….about using outcome focussed planning
i.e. looking at
– long term, intermediate and short
term outcomes for tobacco control
– how these connect to the national outcomes
– the local actions required to meet these
outcomes along with appropriate performance
measures
How we approached
writing our strategy
• Step 1: We formed a Tobacco Leadership
group with members from Public Health
and Policy, Planning and Performance
Department
• Step 2: We developed a project plan and
Volume 2 – fact file describing
epidemiology, current services, local
issues “where are we now in relation to
tobacco control”
How we approached
writing our strategy
• Step 3: We held an initial stakeholder
event:
How we approached
writing our strategy
Outcomes triangle
Logic models
EXAMPLE
Tobacco – all sectors
Improved mental wellbeing
Reduced inequalities in healthy life expectancy
Reduced inequalities in CHD and cancers
High level
outcomes
Intermediate
outcomes
Multiple results chains
Behaviour
Reduced adult smoking rates
Reduced uptake of smoking by young people
Environments
Reduced exposure to second
-hand smoke
Reduced availability of tobacco to under 18s
Short-term
outcomes
Increased quit
rate
Increased quit
rate
Reduced
frequency of
smoking
Compliance with
laws
Compliance with
laws
Reach
Adult smokers
Hard to reach
smokers
Young irregular
smokers
Under 18s
General public
Outputs
Smoking
cessation
services
Outreach SC
services
Outreach
services for YP
Tobacco retail
sales
Smoke free public
places
Activities
NRT + Brief
advice
NRT + Brief
advice +
support
Brief advice
Enforcement of
laws on underage
sales
Enforcement of
smoking ban
NHS
Voluntary
orgs
School
LAs:
School
health teams
(joint
delivery)
Local
authorities
Local
authorities
Inputs
How we approached
writing our strategy
• We discussed how we might wish to
change these national logic models to
reflect our local situation
• We then spent some time in workshops
collating activities/actions which we
thought would result in these locally
agreed short term outcomes
How we approached
writing our strategy
• Step 4: Brought together a multidisciplinary strategy development task and
finish group who used the information from
the stakeholder event to develop our draft
strategy and action plan over a period of 3
meetings
How we approached
writing our strategy
• Step 5: We engaged widely with
community planning partners and the
public on our draft strategy and action
plans and amended the documents
accordingly
How we approached
writing our strategy
• Step 6: We took the draft strategy and
action plan through our management
structures to the NHS Board requesting
that it was endorsed for a period of formal
consultation
Digital Story: My smoke free family
How we approached
writing our strategy
• Step 7: We consulted on the draft strategy
and action plans in a more targeted way,
using focus groups etc
• Step 8: We took the consultation report
and amended strategy back to the NHS
Board in Feb 12 and it was endorsed for
implementation
How we approached
writing our strategy
• Next steps:
– Multi-agency Tobacco Strategy
Implementation Group
– Actions and monitoring via covalent –
performance management system
– Working with North, South and East CHPs
– Leadership group continues, working with
Health Scotland
How we approached
writing our strategy
• Next steps:
– Poster at Public Health Conference
– Presentation at national Smoking Cessation
Conference
– Benchmarking against National Strategy and
altering our action plan if required
Lessons learned from
writing our strategy
• It takes longer than you think
• The tendency is to be over ambitious
• Engagement and consultation are vital to
producing a document which is owned by
partners and the public
• The process has been useful in raising the
profile of smoking and smoking related issues
• We have created a template for the development
of other strategies
Contact details
elaine.young@nhs.net
01292 885914