Sheffield stop smoking team, left to right: Margaret Stockwell, Arlene Tingle, Jane Grice, Helen Baston, Maria Barranco Wadlow, Kath Delaney and Maggie Hanson.
In June 2010, the National Institute for Health and Care Excellence published its guideline on Quitting smoking in pregnancy and following childbirth. Implementation of this guideline requires that women are offered a carbon monoxide (CO) breath test at their first maternity booking appointment with the midwife and at each subsequent antenatal contact.
However, due to the limited number of CO monitors available, practice at the time was to offer women a CO test only when they attend the hospital for their scan appointment. Further CO monitoring was confined to those women who took up the offer of referral to a specialist stop smoking advisor. More CO monitors were purchased and CO training was developed and provided to all community midwives and members of the maternity team.
Both individual and team winners fully deserve their awards, Gill Bent for her inspirational youth work and the Sheffield Stop Smoking Midwife Service for achieving excellence with a notoriously difficult patient group.
The NICE guidance also stated that all pregnant smokers should be referred to a stop smoking service, whereas previously, only those who really wanted to stop smoking were referred. With a birth rate of over 7000 it was feared that the service would be overwhelmed with a lot of time spent seeing women who did not want to quit.
A method of triaging those who wanted to stop smoking immediately was therefore needed. Member so the local multi-agency Stop Smoking in Pregnancy Forum worked together to create an innovative pathway and tool to use with women when discussing their smoking status and readiness to quit. They also developed a bespoke referral form that flagged women who were in the cycle of change.
Women who wish to stop smoking can speak with a midwife advisor the same day and if a family member also wishes to quit they are supported at the same time.
The team has created a range of resources used by all members of staff when caring for smokers. For example, they have developed an evidence-based range of responses to the challenging comments that women make when asked about their smoking behaviour.
The team’s dedication and effort is reflected in the outcomes they achieve: 230 pregnant smoker quits in 2011-2012, compared with 184 in 2010-2011, and 125 in 2009-2010. The team’s nominator, Helen Baston, a consultant midwife in Sheffield, says that this fantastic outcome is testament to the hard work of this exceptional team who are motivated, enthusiastic and passionate about the care they provide.
‘The team have worked with energy and motivation to progress the service forward with ever increasing challenges,’ she says. ‘They have remained focused on women-centred care and health promotion and their work is highly valued within the directorate. They are enthusiastic and committed to providing a high quality service across the city, working flexibly and reliably in challenging circumstances. It is testament to the non-judgemental, multi-disciplinary working and commitment of the team that the women of Sheffield are supported to stop smoking throughout their pregnancy.’
The triage system and tools developed by the team have already been shared with other trusts and the team is happy to share them further.