There is no documentation in the guidance to suggest the advice has to be face to face but to fulfil the set criteria in the book you would need to discuss the options with the patient. This could be done over the telephone and documented as a telephone consultation with evidence of what was discussed.
Many practices are struggling with the new smoking indicators, Smoking 6 and Smoking 8.
The percentage of patients with any or any combination of the following conditions: CHD, PAD, stroke or TIA, hypertension, diabetes, COPD, CKD, asthma, schizophrenia, bipolar affective disorder or other psychoses who smoke whose notes contain a record of an offer of support and treatment within the preceding 15 months
The percentage of patients aged 15 years and over who are recorded as current smokers who have a record of an offer of support and treatment within the preceding 27 months.
To fulfil both indicators:
To be included in the dominator the patient would need to be listed as a ‘current smoker’ (A latest entry of one of the smoking QOF Codes).
To achieve the criteria for this indicator (numerator) for those patients in the denominator you have to have a record of being offered support and treatment in the preceding 15 months.
The smoking codes are as follows:
Version 2 – Advice and Support CTV 3
8CAL. Smoking cessation advice Ua1Nz Smoking cessation advice
8HTK. Referral to stop-smoking clinic XaFw9 Referral to stop-smoking clinic
8HkQ. Referral to NHS stop smoking service XaQT5 Referral to NHS stop smoking service
8H7i. Referral to smoking cessation advisor XaItC Referral to smoking cessation advisor
8IEK. Smoking cessation programme declined XaIye Seen by smoking cessation advisor
9N2k. Seen by smoking cessation advisor XaW0h Practice based smoking cessation programme start
13p50 Practice based smoking cessation programme start date
date XaX5W Consent given for follow-up by smoking cessation
8IAj. Smoking cessation advice declined team
8IEM. Smoking cessation drug therapy declined XaX5X Declined consent for follow-up by smoking
9Ndf. Consent given for follow-up by smoking cessation cessation team
team XaRFh Smoking cessation advice declined
9Ndg. Declined consent for follow-up by smoking XaREz Smoking cessation programme declined
Version 2 – Pharmacotherapy “ advice and support”continued
745H%. Smoking cessation therapy XaMwY% Smoking cessation therapy
8B3f. Nicotine replacement therapy provided free XaIQn Nicotine replacement therapy provided free
8B2B. Nicotine replacement therapy XaEKU Nicotine replacement therapy
8B3Y. Over the counter nicotine replacement therapy XaFst Over the counter nicotine replacement therapy
8IEM. Smoking cessation drug therapy declined XaMlI% Smoking cessation drug therapy
du3..% NICOTINE XaXpT Issue of nicotine replacement therapy voucher
du6..% BUPROPION XaZ01 Smoking cessation drug therapy declined
du7..% NICOTINE 2 du3..% NICOTINE
du8..% VARENICLINE du6..% BUPROPION