Defiance: UK Hospitals Page 1

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England, Scotland, Wales, Ireland THE Royal Liverpool Hospital last night admitted its blanket ban on smoking on its grounds is not working.

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Smokers threaten hospital staff
Extra security has been drafted in at Alder Hey Children’s Hospital in Liverpool to combat abusive smokers who are flouting new rules.
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July 5, 2007
The entire hospital grounds are no smoking since the national 1 July ban.

Staff say they are being subjected to aggressive abuse when they ask people to stub out their cigarettes.
They say smoking near entrances and by open windows is causing smoke to drift inside and that they are particularly worried about the cancer wards.
Reminder cards have been printed by the special no-smoking task force to hand to smokers explaining the rules but staff say they are having little effect.
Marcia Mercia, the hospital’s acting chief nurse, says the staff feel threatened.
“Verbal abuse and aggression that has been displayed by members of the public is making it very difficult.
Security patrols
“They are causing lots of problems by refusing to abide by the no-smoking rules.
“They are smoking underneath wards where the smoke is drifting in.
“Our main concern is our oncology units where we nurse our cancer patients.
“People are smoking underneath the windows and it is causing us concern, especially for the children.”
The hospital said that although they have employed extra security to patrol the site and remind families and other members of the public of the rules, they have also been subject to abuse and have had little effect.
Ms Mercia added: “We are not disallowing people to smoke, we just need them to move off-site.
“We need them to think of the children’s health, their health and that of the staff here at the hospital.”

Rampton patient fights smoking ban at high security hospital
? Cigarettes ‘important’ to many offenders
? Lawyers argue that policy breaches human rights
Clare Dyer, legal editor
May 28, 2007
Patients at Rampton high security psychiatric hospital, which houses some of the country’s most dangerous criminals, are challenging a smoking ban in a test case which claims the refusal to permit cigarettes in the hospital’s buildings or grounds violates their human rights.
The case, due for hearing in September, is being brought by Terrence Grimwood, a patient who has been given legal aid to contest the no-smoking policy, imposed at the end of March.
His lawyers argue that the ban by Nottinghamshire Healthcare NHS Trust, which manages the hospital, breaches article 6 of the European convention on human rights, which guarantees respect for private and family life.
They say the hospital is the patients’ home and to stop them smoking there when they are not free to go elsewhere constitutes a disproportionate interference with their right to do what they want in their own home as long as it poses no harm to anyone else.
The average stay at Rampton is seven or eight years, and some patients will spend the rest of their lives there, making it effectively their home, Mr Grimwood’s legal team argues.
Rampton, in Retford, Nottinghamshire, is one of three top security hospitals which house mentally disordered offenders who have been convicted of the most serious crimes, and the only one of the three so far to impose a no-smoking rule.
Apart from those convicted of serious crimes, its 380 inmates include patients with schizophrenia and psychopathic disorder who have been sectioned under the Mental Health Act and are considered to pose a risk to others, although they may not have committed a crime.
The no-smoking policy at Rampton precedes a smoking ban in public places due to come into force throughout England on July 1.
Mr Grimwood is also challenging the legality of regulations made under the act, saying they discriminate against detained psychiatric patients.
The new legislation allows the health secretary to set aside designated rooms for smoking in care homes, hospices and prisons. But there is only a temporary, year-long exemption for mental health units, which expires in July 2008.
Around 70% of psychiatric patients smoke, as do 80% of prisoners.
The head of the prison service, Phil Wheatley, warned ministers in 2005 that banning smoking in prisons would cause disorder and an increase in assaults on staff.
Mr Grimwood’s counsel, Paul Bowen, told a high court judge at a preliminary hearing last week that for many at Rampton, smoking was “the most important thing in their otherwise desperate lives”.
Marcus Brown of Cartwright King, Mr Grimwood’s solicitors, said: “The issue with the case is not really to do with the right to smoke.
“It’s about the issue that, in the case of Mr Grimwood and many others in Rampton and similar places, it’s their home. And they ought to have the right to do what they choose to do even if that might not be good for them on one view of the evidence.
“The case is being run on behalf of one patient as a test case, but we have instructions from a large number of other patients who are affected by it. We’re certainly aware of other firms who have clients in a similar position.”
The smoking ban remains in force until the hearing in September.


Doctor’s smoking jibe wins mother ?44,000 payout
by ARTHUR MARTIN
21st December 2006
A mother who was criticised by a doctor for nipping out for a cigarette moments before her caesarean operation has won more than ?44,000 for her ‘hurt feelings’.
The heavy smoker claimed that she developed severe post-natal depression after the anaesthetist told her off.
The patient, known only as Mrs G, delayed the operation by leaving the ward in the private clinic to get her nicotine fix.
The anaesthetist, referred to as Dr A, claimed her coughing made it difficult to give her an epidural before surgery.
After the birth he told her: ‘You’ve seen your daughter born, if you give up smoking you might see her get married too.’
The patient, who is in her 20s, complained that the doctor had harassed her and was awarded ?44,500 for ‘pain and psychological distress’. Her legal fees were also paid for.
She also claimed that the doctor failed to provide proper pre-anaesthetic care but experts ruled it was appropriate.
The compensation claim is just one example listed by the Medical Protection Society in its quarterly casebook to help educate medical staff.


Smoking ban
10th December 2006
SMOKING is now banned throughout the Princess Alexandra Hospital site, Harlow.
Patients, staff and visitors are being told to stub it out on hospital premises after health chiefs closed the designated indoor smoking areas and banned smoking from all outdoor areas on its grounds.
The ban follows a three-month countdown, during which a 30ft banner declaring “PAHT is Proud to be Smoke Free from December 2006” was hung from the hospital entrance and leaflets were handed to patients and visitors.
Human resources director Alan Farmer wrote to all staff telling them about the new policy and information about the ban was provided in staff newsletters and internal briefings.
Security staff will enforce the ban, which will cover all areas of the hospital grounds except allocated rooms in residential accommodation.
Trust medical director Dr Sandra Dimmock is one of many consultants supporting the ban.
She said: “So many of the patients I see in surgery are suffering serious illness as a direct result of smoking. I think it’s only right that the hospital is taking this stance now.”
Mr Farmer said: “As an NHS Trust, Princess Alexandra Hospital should be promoting good health practice, and that means not endorsing smoking in any form.
“There are so many proven healthcare problems associated with smoking and increasingly that includes passive smoking.
“We appreciate that some members of staff and long-term patients are going to find it difficult to go without. That’s why we’re giving staff the chance make use of the smoking cessation services provided by the primary care trust.
“The response we’ve had today has been generally very positive.
“It seems that most people understand what we’re doing and support it.”
A smoke-free zone was introduced at the St Margaret’s Hospital, Epping, and Ongar War Memorial Hos-pital sites by the then Epping Forest Primary Care in March.


Patients defy smoking ban
They still light up outside hospital
By Megan Featherstone
01 November 2006
PATIENTS and visitors are continuing to smoke one month after cigarettes were banned at Calderdale Royal Hospital.
Staff, patients, visitors and contractors have been told to stub it out in all hospital buildings and grounds from October 1.
But the Courier can report that patients and visitors are still smoking outside the main entrance – and are determined to continue.
Patient Lisa Clegg said smokers were not causing anyone any harm.
“Our smoking is nothing to do with anyone else,” she said.
“It keeps your stress levels down. How can you stop when you’re in hospital?”
Brenda Barker, of Halifax, who is being treated for stomach problems, said: “The ban won’t work.
“They haven’t worked at other hospitals in Bradford, Leeds or Doncaster and they can’t stop us here either. I’m not quitting for anyone.”
Paul Noble, 48, of Illing-worth, Halifax, who is in a wheelchair and has had a lump removed from a nerve on his spine, said: “If we go out on to the road we would be putting ourselves at risk.” Terry Frankland, of Tod-morden, regularly visits his son who is a patient and said he had not been asked to stop smoking.
New signs have been put up to remind people of the policy – part of a Government initiative to ensure all NHS trusts are smoke-free by the end of the year.
Perspex shelters previously used by smokers have been taken down.
Hospital bosses hoped it would be the end for the controversial sight of pat-ients in dressing gowns having a smoke outside the front door.
Patients have also claimed that some staff are still smoking but said they went to Dryclough Lane.
Pauline Pilcher, Calder-dale branch secretary for Unison, said employees of the trust had, on the whole, accepted the smoke-free policy.
She said: “I had far more complaints before this ban from staff members having to run the gauntlet of smokers when entering the premises on a daily basis.”
Staff also complained they had to keep windows shut to prevent smoke drifting in.
But she added: “Policing this Government policy was never intended to fall on any specific staff group or for them to become involved in confrontation and the debate on human rights of individuals.”
A spokesman for the trust said: “We realise there is still not 100 per cent compliance with our new smoke-free policy.
“But there has been a marked reduction in smoking on our sites, which is to everyone’s health benefit. However, it is still early days for this policy and this initial period was designed to give us time to address any issues that arise ahead of full implementation on January 1 when every hospital in the country is due to be smoke-free. It is everybody’s res-ponsibility to support the policy and all staff are encouraged to remind people of the policy.
“The situation is being monitored.”
The ban, approved unanimously by Calderdale and Huddersfield NHS Trust, also includes Huddersfield Royal Infirmary and all surrounding hospital land.


Hospital may start ‘no-smoking patrols’ to enforce its ban
November 1 2006
HEALTH chiefs at Lynn’s Queen Elizabeth Hospital are considering taking action against patients, staff and visitors who continue to flout its no-smoking ban.
Patients continue to “blatantly ignore” no smoking signs and staff asking them to stub out their cigarettes are often met with abuse and point blank refusal.
Staff banned from smoking on site since September 1 have also started puffing away on nearby Springwood Estate – sparking complaints from residents about rats.
Anxious residents have bombarded the hospital with calls about smokers congregating outside their homes, and say food being dropped under trees separating the QEH from the estate is attracting rodents. It has also been revealed that despite the ban, the hospital still pays ?1,500 a year to clear up cigarette ends.
The situation has prompted the hospital to look into steps it can take, including regular patrols by “stop smoking” advisers, and disciplinary action against staff. It is also urging hardened smokers to “stub it out – and put your health first”.
Amanda Lyes, hospital director of human resources and facilities, said: “It is bizarre when we’re trying our best to treat people inside the hospital for cancer, respiratory and heart problems associated with smoking, and yet just outside smokers are puffing away regardless.
“It is extremely disappointing that so many people blatantly refuse to acknowledge the ban.”
She also urged staff to consider the neighbours when going off site during unpaid lunch breaks, and reminded them they are not permitted to leave the site during paid breaks.
Staff who assist patients leave the building for a smoking break are being warned they too risk disciplinary action.
UNISON representative Ron Glazebrook said: “If staff ignore the restrictions, they leave themselves open to disciplinary action.

Hospital total smoking ban starts
1 October 2006
A complete ban on smoking at the biggest hospital in the South West has come into force.
The trust which runs Derriford Hospital in Plymouth had aimed to make the whole site smoke-free by September 2007.
But the trust board decided in May to introduce a ban across the site from 1 October this year.
Derriford is the latest trust to make its entire site smoke-free. The Royal Devon and Exeter Hospital brought in a ban on Thursday.
Hospital staff are also being encouraged to kick the habit and are being given information on smoking advice centres and details of quitting groups.
Another of Plymouth Hospital Trust’s sites, the Royal Eye Infirmary banned smoking completely in February.
Signs are being placed in prominent sites around the outside of Derriford Hospital and existing smoking shelters moved outside the ring road.

Smoking Ban Is Unpopular With Mental Healthcare Staff, UK
20th September 2006
Government proposals to extend next year’s smoking ban to mental healthcare settings are likely to face stiff opposition from NHS staff.
A survey in the UK has asked 2574 NHS clinicians about their attitudes to health care settings as smoke-free environments. The results showed clear differences between general healthcare staff in comparison to staff in mental health settings.
While only 1 in 10 general healthcare staff disagreed with a smoking ban in their wards or clinics, as many as 1 in 3 psychiatric staff were against such a ban in their setting.
In consultation on the recent Health Act (2006), the government has proposed that only those premises that provide long-term accommodation will be exempt from the smoke free legislation.
Many staff worry that introducing a smoking ban in mental health units is unfair and will cause confrontation between patients and staff.
Previous research, however, has consistently shown that this is not the case and that no-smoking policies in mental health settings rarely result in significant disruption.

NHS CUTS HALT CIGS CRUSADE
Sept. 17, 2006
A CAMPAIGN to help NHS nurses quit smoking has been scrapped by the Health Department because of budget cuts.
Under the Choosing Health drive, nurses who smoked were to be targeted with nicotine replacement therapy, anti-smoking support and a phone helpline.
The idea was to make them role models for patients who wanted to quit. But the Royal College of Nursing revealed the project has now been put on hold because the Department of Health has withdrawn its funding.
A spokesman said: “It’s very disappointing when the Health Department fails to fulfil its commitment. It’s the gap between rhetoric and reality that is so frustrating.”

Hospital smoking ban row: Council steps in
17 September 2006
Pamela Mcgown
CARLISLE councillors are calling for a meeting with hospital bosses over their controversial new smoking ban.
Residents of nearby Clift Street say smokers are congregating in the alley between their homes and the Cumberland Infirmary.
This includes patients, visitors and even staff, who can no longer smoke outside the hospital entrance or anywhere else on the premises.
But city councillor Jim Tootle, who represents the Castle ward, said residents were angry that smokers are spilling onto their street.
He has also had complaints about the amount of cigarette butts and litter discarded in the lane.
Now he and fellow Castle ward councillors are demanding action.
Mr Tootle told the News & Star that neighbours have already had to fight to stop their road being used as a hospital car park.
“Residents of Clift Street have had to put up with a lot. We’ve managed to get parking restricted to an hour, now this happens,” he said.
“There has been no staggered entry into this ban. For some reason the hospital do not seem to want to negotiate – they just do things.
“We now need to know what they intend to do about this problem.
“They can’t just push it onto the street.”
The Liberal Democrat councillor added that litter is not the only problem.
“They people don’t want groups of people hanging around on street corners, especially on dark nights.
“You don’t know who they are or whether they are just smoking,” he added.
The controversial smoking ban was introduced by the North Cumbria Acute Hospitals NHS Trust on September 1 this year. It affects both the Cumberland Infirmary and West Cumberland Hospital in Whitehaven.
The new rules were introduced ahead of government legislation, which will see all NHS buildings and grounds becoming smoke-free by the end of the year.
The north Cumbrian trust wanted to lead the way and set an example to the public. It has also banned all of its staff from smoking, on or off the premises, while in NHS uniform.
Since the News & Star highlighted the problem on Clift Street, the city council has cleared the alleyway to the hospital of litter.
The hospital has also been reminded that dropping cigarette ends on Clift Street could result in litter fines.
Carlisle City Council spokesperson said: “We’ve been in touch with the hospital to remind them that new legislation gives the city council power to issue fines, of a minimum of ?50, to people who litter the streets.
“We will be keeping a close eye on the areas around the hospital and we’re intending to put up some signage emphasising that fines could be incurred.”
This follows the introduction of legislation which gives the city council power to issue on-the-spot fines of up to ?75 for littering.
However, Mr Tootle and his fellow councillors still want to meet with the hospital trust to discuss the long-term impact of the smoking ban.
He is also trying to determine exactly where the hospital boundary ends, as the trust owns some properties and land on Clift Street.

Doctors urge total hospital smoking ban
8th September 2006
DOCTORS today called for a smoking ban on all hospital grounds.
The British Medical Association said patients should not have to walk through clouds of smoke when they arrive at and leave hospital.
Wales’s smoking ban is due to take effect next summer, although ministers have said they hope to enforce it in April, before May’s Assembly elections.
The Assembly Government, which is drawing up rules on where the ban will apply, said it would consider the BMA’s proposal.
Welsh Secretary of the BMA Dr Richard Lewis said: “BMA Cymru Wales has campaigned long and hard for the banning of smoking in enclosed public places – and this should include all hospital grounds.
“Hospitals are places where people go to be cured of illnesses – not to increase their chances of getting another one by having to fight their way through clouds of cigarette smoke.
“The Welsh Assembly Government has already made great strides by backing smoke-free legislation but must not lose this opportunity to make hospital grounds smoke-free.”

Hospital backs BMA call for smoking ban
08 September 2006


Hospital bans smoking in vehicles
2 September 2006
Smokers visiting a hospital are to be banned from lighting up – even if they stay in their cars.
The habit is already outlawed inside Bath’s Royal United Hospital but from 1 November the ban will include the grounds.
The rules will extend to car parks, meaning people will not even be allowed to smoke in cars.
Health chiefs said the decision was made in response to national policy and was in line with other NHS trusts.

Hospitals fail to cut out smoking
28th August 2006
By Sally Henfield
PLANS to ban puffing on cigarettes in East Lancashire hospitals have gone up in smoke after staff failed to attend training sessions to implement the new policy.
And patients and visitors have been openly flouting the anti-smoking ban and lighting up inside the buildings and grounds run by the East Lancashire Hospitals Trust, a report says.
The ban was implemented in December last year, one year ahead of governmental requirements.
A report presented to Burnley, Pendle and Rossendale Primary Care Trust by its stop smoking’ service reveals it has been hard to get the message across to patients because staff are not attending training sessions that help them deal with the issue, including coping with angry reactions from people asked not to smoke.
Sessions at Burnley General Hospital even had to be cancelled because turn out was so low.
Ann Smith, specialist smoking cessation nurse adviser, said: “There has been a major problem with the enforcement of the policy. Many staff are reluctant to confront patients and visitors who smoke in the grounds. Hopefully the number of patients smoking will reduce when more nurses are trained.”
She continued: “During my three days a week at the hospital I see many patients smoking in the grounds at Burnley General Hospital.
“Compliance with the policy is very poor. I speak to many of the smokers and find that they either have no information about the policy or are blatantly ignoring it.”
Mrs Smith requested tobacco control nurses on each ward who will monitor the situation and provide training for other nurses. This was implemented this month.
Lynne Barton, of East Lancashire Hospitals NHS Trust, said that the Trust knew it would take some time for the new rules to be followed.
She added: “Recently we have had some problems with patients and visitors smoking in our hospital grounds.
“For the welfare of other patients, clearly we need to ensure that this does not continue.
“To this end, we are currently reviewing the implementation of our policy and the signage around our hospitals to ensure that everyone is clear about the measures in place and their own responsibilities.
“One of the key areas that we will be focusing on is the training offered to staff to help them provide information and support to patients on the policy.”
Read

Total smoking ban for hospital

August 26 2006

Designated smoking rooms for patients and staff will close and smoking in the hospital grounds will be outlawed, as the final stage of the ban comes into effect.

It means long-term patients who have to stay on the hospital site at all times will now have nowhere to smoke, and staff will have to leave during breaks if they want a cigarette.

The first stage of the ban was rolled out last April when smokers were forbidden from lighting up within a five-yard radius of all hospital entrances.

No smoking signs were put up outside, but a hospital spokesman said many visitors have “blatantly ignored” them and continued to smoke.

Then in January this year, the ban was extended across the hospital except for the three designated smoking rooms and within the grounds.

From next Friday, visitors caught smoking inside the buildings or anywhere within the grounds will be asked to stop and staff could face disciplinary action.

When the ban was first proposed in February last year, it sparked concern from nurses who feared it would create a fire risk and lead to more pressure on staff who smoke to de-stress.

This week a spokesman said the hospital will be offering staff and patients specialist help if they want to use the ban as an opportunity to quit smoking.

The spokesman said: “We are relying on goodwill of visitors. People are generally very sensible and we believe they will understand we are doing this with the best of intentions.”


Hospital smoking ban is failing

Nov 19 2005
EXCLUSIVE by Sam Lister Daily Post Staff

THE Royal Liverpool Hospital last night admitted its blanket ban on smoking on its grounds is not working.

Groups of patients are still huddling outside the doors of the hospital to smoke cigarettes and refusing to obey the highly-publicised new rule.

The hospital was one of the first large organisations in Merseyside to announce an outright ban on March 9 this year, signalling its backing for Smoke Free Liverpool’s plan to outlaw smoking in all places of work.

Yesterday’s news raises serious questions about the enforceability of such a law as people continue to flout the rules.

Many staff say they have been verbally abused when they have asked people to stub out cigarettes or move away.

A hospital spokesman said patients and staff are angry that they still have to pass through the groups of smokers as they walk into the hospital for their treatment sessions.

Patient Margaret Shields last night appealed to the smokers to stop ignoring the ban.

The 53-year-old former swimming instructor, who has one daughter, had a double mastectomy after being diagnosed with breast cancer, and has now been diagnosed with a secondary cancer in her spine.

She said: “The staff at the Royal are doing everything they can to keep me alive, but every time I go I have to run the gauntlet of smokers to get in there.

“It’s not just one or two. It’s groups of 20 stood by the door and I have to breathe in their smoke.

“I have cancer, I don’t want the risk of passive smoking.

“The staff at the Royal do really try to stop them, but I have seen them just get a mouthful of abuse.

“I have asked people to move away myself, but the response has been the same.

“I understand it is not easy to give up, but there are a lot of patients in my position who have to go through the same as me and it’s very upsetting.”

The Royal Liverpool and Broadgreen Hospital NHS Trust became the first in the country to ban staff and patients from smoking.

The hospital closed all smoking rooms and removed outdoor shelters.

Sensors have also been installed at doors and entrances which play an audio no smoking message when triggered by smoke.

The hospital is also offering support helping smokers to quit, including patches and cessation courses.

But it admits that it is powerless to stop patients intent on smoking.

A spokesman said: “It is totally unacceptable that patients who have suffered like this lady have to walk through big groups of smokers.

“There is a hard core of smokers that, whatever we did, would say it is their right to smoke.

“We cannot push it too hard or people will put their barriers up.

“The difficulty is that it is not a prison – we cannot stop people smoking. “But, for every one person that gives a member of staff abuse when asked to move away, there are two who apologise and put their cigarettes out.

“We just have to keep plugging at it and getting the numbers of people doing it as low as possible.”

Smokefree Liverpool wants to see a ban at public buildings throughout the city

THE Royal Liverpool Hospital is one of many public buildings to ban smoking as part of the city’s smoke-free agenda.

The city council is keen to make Liverpool smoke-free and many public buildings such as the Royal Liver Building and private attractions such as The Beatles Story have declared their own ban.

Last November, Liverpool introduced a Local Government Bill to the House of Lords which is due to go before a Parliamentary Committee early next year, and could become law before the city is European Capital of Culture in 2008.

The Bill would ban smoking in all restaurants, pubs, shops, offices and other workplaces to protect employees from being exposed to cigarette smoke.

The city council say the legislation is important for health and safety reasons and would be similar to laws already in force in Ireland and New York.

The legislation is being promoted by Smokefree Liverpool, a partnership which includes health groups, the city council, Liverpool Chamber of Commerce, the North West TUC and the Roy Castle Lung Cancer Foundation.

Under the Bill any individual or business in breach the new law will face fines of up to ?5,000.

The rest of Merseyside is following Liverpool’s lead with a similar bill to ban smoking in the workplace to be handed to Westminster by the end of this month.

If successful the legislation will cover Wirral, Knowsley and St Helens, but a move to back the bid in Sefton narrowly failed to get the votes it needed.

The British Medical Association, the Royal College of Nursing and the Joint Consultants Committee announced their support for

the smoke free bills after research in the BMJ said secondhand smoke killed at least 30 people every day in the UK.

Last month, the Government revealed its own legislation which will ban smoking in the workplace but will still allow it in bars which do not serve food, and in private members’ clubs..

Campaigners claim the move will cause more inequality and will affect the poorest areas most.

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