The Committee will receive a verbal presentation from Doctor Matt Evison, Consultant at Manchester University NHS Foundation Trust on the CURE programme (a service to prescribe medication to tackle patients addiction to tobacco and offer intensive support to help them stay smoke-free during their stay at hospital and once they go home) and the lung cancer screening programme.

The Committee welcomed Dr Matt Evison, Consultant at Manchester University NHS Foundation Trust who had been invited to the meeting to discuss his involvement with the CURE programme, a service to prescribe medication to tackle patients’ addiction to tobacco and offer intensive support to help them stay smoke-free during their stay at hospital and once they go home and the lung cancer screening programme.

A Member introduced Dr Evison, informing the Committee that she had personal experience of the care and treatment provided by Dr Evison and his colleagues at the site following a referral by her own doctor to the RAPID (Rapid Access to Complex and Pulmonary Investigation Days) service.

Dr Evison described that the impact of smoking and tobacco addiction, with its associated health conditions, such as lung cancer were the biggest contributor to premature death, illness and economic inequality across the region.

Dr Evison described lung cancer as a particularly aggressive form of cancer that often presented without any symptoms to the patient, therefore detection and treatment at an early stage was very important to improve the chances of a full recovery. He then went onto describe the three initiatives that had been developed at the Wythenshawe Hospital site.

He described that the CURE programme represented a significant shift in the attitude amongst health professionals to the treatment of smoking. He said that for far too long smoking had been regarded as an individual’s behaviour and lifestyle choice. He said that now smoking and tobacco dependency was regarded as physical disease and as such needed to be treated as a chronic physical illness with the use of prescription medication. He said that when a patient was admitted to the hospital, regardless of their condition staff were trained to discuss with the patient their smoking habits and their addiction was graded based upon their consumption. He said that this was then electronically recorded and the treatment would commence immediately with the issuing of nicotine patches. He said that following a patient’s admission, staff from the CURE team would visit the patient within 48 hours to discuss the medical treatments available to them to assist with their addiction. He said that following discharge from hospital a patient would receive follow up contact and support from the CURE team and the patient’s doctor would continue to administer any medication required.

He said that there was overwhelming robust medical evidence to support this approach to treating patients who were addicted to tobacco. He said that in addition to the health benefits to the individual there were significant financial savings to be made to the wider health economy due to a reduction in the number of hospital admissions each year and the pressures on primary care as a result of smoking related illness. He said hospitals needed to invest in medication and staff to realise these long term savings. He commented that the devolution of the health budget and the transformation fund had contributed to these initiatives and these were being closely monitored nationally. 

With regard to the lung health checks pilot he said that these had been delivered in areas of the city where the levels of smoking amongst the population were very high. He said that for those citizens assessed as being at high risk of lung cancer they were offered an immediate CT scan. He said that this had resulted in 1 in 23 scans identifying lung cancer, with 80 of these being at stage 1 which meant they were treatable.

Dr Evison described how the RAPID service had been designed from a patient perspective that had brought specialist teams together in a reorganisation of care, rather than working in silos to facilitate the timely screening, diagnosis and treatment of patients. He said that with teams working collaboratively this removed system delays and improved patient diagnosis and care pathways. He said that the lessons of the RAPID programme would be learnt and reviewed with the ambition to scale up this service so that it could be delivered across the city.

In response to a comment from a Member regarding recent reports of a national shortage of radiologists he acknowledged that this was an issue and commented that the success of future schemes was reliant on qualified radiologists being able to undertake and correctly analyse scans and surgical teams able to accommodate the increased number of procedures required. He said that to successfully roll out the scheme more widely across the city this would also require partnership working between commissioners and primary care so that suitable care pathways were established.

Decisions

1. The Committee note the presentation by Dr Evison; and

2. Recommend that the Executive Member for Adults, Health and Wellbeing and the Director of Population Health and Wellbeing support this programme and the wider roll out of this service across the city.