Leena Sankla Project Director Working with BME Groups to aid Smoking Cessation

1
Leena SanklaProject DirectorWorking with
BME Groups to aid Smoking Cessation

2
Cardio Wellness - Background

• Cardio Wellness is a registered UK charity.
• Provide advice and support to deprived, hard to
  reach communities on CHD, diabetes, obesity,
  stress management, smoking and oral tobacco
  chewing.
• Experience of working with relevant BME groups
• Experience of working in the NHS and have worked
  with the PCTs on a number of different
  projects.
• Proven track record of achieving smoking
  cessation targets.
• Experience of working with BME groups including
  Polish community, asylum seekers illegal
  immigrants.

3
Cardio Wellness Project in Slough
4
It has not been smooth sailing
5
Slough Demographics

• Young and culturally diverse, with one of the
  highest BME populations outside London.
  predominately South Asian (42) and rising Polish
  population
• Deprived in comparisons to its neighbours, with
  one ward in the most deprived 25 in England
• gt25 of the adult population estimated to smoke
• Number of deaths from smoking are considerably
  higher then England, SE Region and similar Local
  Authorities

6
Project Background

• Started in November 2005 as a South Asian Pilot
  Project for smokers tobacco chewers.
• Initially funded by Pfizer consumer healthcare
  and East Berkshire PCT
• From June 2006, East Berkshire PCT commissioned
  Cardio Wellness to deliver against LPSA (ODPM)
  stretch target for smoking cessation for deprived
  hard to reach groups in Slough.

7
Project Aims

• Provide cessation services to smokers in the
  lowest socioeconomic groups.
• Engage all of sloughs BME groups with a
  multi-lingual service
• Provide more services in community based
  settings.
• Address areas of inequality
• Provide more quitters and reduce smoking
  prevalence

8
Target Performance

• Deliver 280 CO verified quitters at 4 weeks over
  the period June 2006 to March 2008.
• To date we are well on target to deliver 280
  quitters below budget and 4 months ahead of time!!

9
Service

• Clinics are held in the following venues
•  
• Pakistani Welfare Association
• Polish Church,
• Local Pub
• GP Practices
• Main Shopping Centre
• Mosques
• Hindu Temple 

These clinics are in areas of highest deprivation
and we are providing a service directly into the
heart of the community, in easily accessible and
safe locations.
10
How Do We Generate Throughput?

• Work with all of the key stakeholders as a team
  to generate as much referrals as possible.
• Work closely with GPs and practice managers to
  get them to refer and register patients.
• Identify patients on a high risk of heart
  disease, diabetes, stroke and get their GP to
  refer them.
• Hold regular Smoking cessation events to
  generate interest and get registrations.

11
How Do We Generate Throughput?

• We are very flexible and work late evenings
  weekends, variety of settings not necessarily GP
  surgeries.
• Use language as an asset -We deliver our services
  in the mother tongue of our patient, this
  includes English, Punjabi, Urdu, Hindi and
  Polish.
• Monitor/ regular debriefs with team to foresee
  possible barriers with actions to overcome these.
• Time is essence as targets are huge if any month
  is low then we identify what will increase
  activity subsequent months
• Heart of the community/ identify locally
  influential individuals to help raise our service
  profile Faith and community leaders
• Adapt the campaign during festive and religious
  periods to further strengthen the message and
  make it work harder.
• Media self generated/ national local events etc

12
Key Differences in the Approach

• All our advisors are health professionals and
  include doctors, nurses specialist advisors.
• We deliver our services in the mother tongue of
  our patient, this includes English, Punjabi,
  Urdu, Hindi and Polish.
• Interacted with target audience at grass root
  level through community events and organisations,
  and places of worship
• Quote from a locally influential GP in the Slough
  Observer It definitely helps running the clinics
  in different languages because the patients can
  express themselves more freely and we can
  communicate the dangers of smoking more freely

13
Key Differences in the Approach Continued.

• Aim to be culturally sensitive, remember the
  issues and barriers for change.
• Highlighted the health risks e.g Heart Disease
  Diabetes. South Asians can relate to this as they
  are very likely to have or a family member with
  these problems.
• Take a holistic view and included weight
  management, healthy eating and physical activity.
• Remind them which products contain tobacco in
  a number of cases patients are unaware of the
  contents.

14
Our Approach

• High emphasis on the the five Rs for smoker
  motivation.
• Relevance Personalise the reasons to quit
• Risks Heart Disease, Diabetes
• Rewards Improved health, example to children
• RoadblocksWithdrawn symptoms, fear of failure
• RepetitionMost smokers make several attempts to
  quit, before achieving long term abstinence

15
Positives

• For the Smoker
• Direct supply of FREE NRT without need for
  prescription charges identified as a major
  advantage in working with deprived communities.
• More community based services available
• Multi-lingual services available
• Improved choice of service

16
Positives

• For the PCT
• LPSA has been an excellent way to fund extra
  cessatio work from an external source.
• Contract allowed for a large say in how and where
  the services are provided.
• PCT was able to uitilse additional skills of
  Cardio Wellness
• Improve equity of cessation services
• More quitters towards LDP target
• Reward grant for PCT

17
Positives

• For Cardio Wellness
• Utilised experience and knowledge of the Smoking
  Cessation service
• Utilised PC contacts such as local shopping
  centre, pub etc
• Use of NHS logo and name
• Guaranteed source of funding for three years of
  work

18
Take Away Messages

• These Hard to Reach Groups can be reached by us
  trying harder and modifying the standard
  approach and being culturally sensitive
• Must be flexible to work weekends late
  evenings.
• Motivate staff, give them the importance and
  confidence of the work they are delivering.
• Remember the Patient is Number 1.
• Work on all the elements which take you towards
  the target and beyond.

19
Cardio Wellness is working closely with BBC and
ITV and has produced a series of health related
programmes covering heart disease, smoking, oral
cancer, tobacco chewing.
20
Cardio Wellness ITV Health Watch Series on
Smoking and Tobacco ChewingOral CancerShown
on ITV
21
(No Transcript)
22
For further details please contact Leena
Sankla, Project Director Leena.Sankla_at_Cardio-Well
ness.com 0118 9310 361 / 07941898810 www.Cardio-
Wellness.com