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Journal of Public Health Advance Access originally published online on May 11, 2007
Journal of Public Health 2007 29(2):118-122; doi:10.1093/pubmed/fdm011
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© The Author 2007, Published by Oxford University Press on behalf of Faculty of Public Health. All rights reserved

Developing the public health role of a front line clinical service: integrating stop smoking advice into routine podiatry services{dagger}



Jackie Gray, Consultant in Public Health Medicine1,

Gary Eden, Head of Podiatry Services1

Maria Williams, Head of Service2
1 Department of Public Health, Gateshead Primary Care Trust, Team View 5th Avenue Business Park, Team Valley Trading Estate, Gateshead NE11 0NB, UK
2 Gateshead and South Tyne Stop Smoking Service, Clarendon House, Windmill Way, Hebburn, Tyne & Wear, NE31 1AT, UK

Address correspondence to Dr Jackie Gray, E-mail: Jackie.gray{at}ghpct.nhs.uk


  Abstract

Background Although smoking is a major public health problem, many clinicians do not routinely provide evidence-based health improvement advice to smokers to help them to quit.

Methods Plan, Do, Study, Act (PDSA) cycle methodology was used to design and implement a service development so that health improvement advice for smokers featured in all podiatry consultations provided by a Primary Care Trust in North East England. IT systems were developed to record the number and proportion of patients for whom smoking status was assessed, and the number and proportion of smokers who were given advice to quit and referred for specialist support. A questionnaire to staff explored their perceptions of the development on their clinics and consultations.

Results During a 6-month period, smoking status was recorded for all 8831 (100%) patients attending podiatry clinics; 83% of smokers were given brief advice to quit; 7% of smokers were given help to access specialist stop smoking support services. Improvements were introduced within existing budgets and did not prolong clinics.

Conclusions It is straightforward and inexpensive to develop clinical services so that public health guidance is routinely implemented. More widespread implementation of similar service developments could lead to national improvements in public health.

{dagger} This project was planned, conducted and reported by Jackie Gray, Gary Eden, and Maria Williams. Clare Beard, Guy Blackburn and Pat Elms were also involved in the early planning and conducting stages, but were not involved in reporting the project. All staff in the Department of Podiatric Medicine were instrumental in delivering the service improvement.


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