Patients who are seen in their own homes by staff from the East and North Hertfordshire Teaching NHS Trust – which includes Mount Vernon Cancer Centre in Northwood – may now be asked not to smoke in the room where they will be treated for at least an hour before the visit.
Those who refuse may be asked to attend a “suitable smoke-free venue” for their treatment or care instead.
Meanwhile, Trust staff have been told they must not be seen smoking while in uniform or representing the Trust – even if they are not on Trust premises.
These new rules are part of the Trust’s updated smoke-free policy, which now bans smoking in the grounds of all four of its hospitals:
- Lister Hospital, Stevenage
- Hertford County Hospital, Hertford
- Mount Vernon Cancer Centre, Northwood
- New QEII Hospital, Welwyn Garden City
However, vaping is still allowed in some designated areas, to support those who want to quit smoking.
The updated measures aim to protect staff from second-hand smoke and promote the Trust’s role as a health-promoting organisation.
Trust medical director Justin Daniels called smoking “the biggest single cause of health inequality in the UK”. He also stressed the need to protect staff – especially those with respiratory conditions such as asthma – from second-hand smoke.
He explained that staff would ultimately decide whether to carry out home visits in smoky environments, but that care for unwell patients would always take priority.
“There are currently few occasions when staff from the Trust would need to visit a patient’s home,” he said.
And he made clear that “the Trust would never not treat a critically ill patient, because their house was smoky.”
He told the Local Democracy Reporting Service: “Where we have a member of staff with asthma, they can become significantly unwell by going into a really smoky home.
I think there is a balance. Clearly people have a right to do what they choose when at home – but staff have a right to be protected from second-hand smoke.
“We’re trying to get the balance right. If the patient is really unwell we have got to put the patient first. But for a routine review and the patient is relatively well, we don’t think staff should be exposed to that – and should have the right to say could we come back another day or could we see you somewhere else. It about getting the balance right. We would never not see an unwell patient – but we also need to protect staff as well.”
As part of the new policy, hospital staff can now only smoke during official breaks – and only if they are at least 10 metres away from the site boundary.
They are also required to change out of uniform before smoking to reduce the impact of smoke on their clothes when providing patient care. At the very least, they should wear a coat or similar item to cover their uniform, so they are not identified as Trust staff and to keep their uniforms clean and free of smoke odour.
The policy also applies to staff representing the Trust offsite: “Staff are not permitted to smoke, or have smoking materials, visible at any time in public when representing the Trust and when attending meetings on behalf of the Trust, whenever and wherever these are held,” the policy states.
The Trust highlights smoking as the leading preventable cause of death and disability in the UK, and says more than half of smokers die earlier because of their smoking. The smoke-free rules are meant to promote a healthy environment for patients, staff, and visitors.
While the Board considered a full ban including e-cigarettes, the agreed policy still permits vaping in designated areas, recognising its potential to support people in quitting smoking.
“It is a future aspiration of the Trust to move to being a completely smoke-free site including the use of e-cigarettes in line with anticipated future legislation,” says the policy.
“The Trust does not encourage the use of e-cigarettes but acknowledges their potential to help people quit smoking. The use of e-cigarettes will therefore be permitted on the site in designated areas only but will be evaluated as part of the next policy review.”
The Trust estimates there are around 99,415 adult smokers in the county. In line with the policy, patients, staff and visitors who smoke will be encouraged to stop and offered a referral to the Hertfordshire Stop Smoking Service.
Mr Daniels acknowledged that giving up smoking is difficult and that support is available.
He told the LDRS he did not want to downplay the challenges faced by long-term smokers and reiterated that help is on offer.
Deborah is a Local Democracy Reporter covering news across Hertfordshire, with a strong focus on councils, local government and public policy. Her reporting includes county council decisions, council tax, spending pressures, legal and regulatory issues, healthcare stories including junior doctors, and community projects affecting local residents.
