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Independents' Day

GPs under pressure to hit smoking referral targets

GPs will be told to increase the number of referrals to smoking cessation services in an attempt to meet new Government targets.

Smoking cessation guidance sent to primary care trusts last week said GPs must be able to generate 10 referrals or self-referrals per 100 smokers a year to meet the targets.

The Government has told PCTs it wants to see 800,000 smokers successfully quitting at the four-week stage by 2006 ­ the equivalent of 900 smokers a year for the average PCT.

The guidance said just 50 per cent of patients attending smoking cessation services actually set a quit date.

This meant 10 per cent of smokers would need to be referred or advised to use the service by GPs, of whom about 5 per cent would attend and 2 per cent would stop smoking for four weeks.

Professor Robert West, co-author of the guidance and professor of psychology at St George's Hospital Medical School in London, said GP referrals were a 'crucial source of clients'.

He said around 2 per cent of smokers currently attended services in any year.

Professor West said about five smokers per GP requested a prescription for nicotine replacement therapy or Zyban (bupropion) every month.

He added: 'If just a third of these patients were to attend treatment services this would produce a throughput of 2,000 smokers per average PCT per year ­ sufficient to meet the target of 900 four-week successes per year.'

Smoking cessation features as part of the quality and outcomes framework in the new contract.

GPs can earn 74 points

for recording smoking status and offering cessation advice in six clinical areas ­ coronary heart disease, diabetes, stroke, hypertension, asthma and COPD.

Dr Tim Coleman, senior lecturer in general practice at the University of Nottingham, said the evidence for prescribing NRT and Zyban to certain groups of patients such as pregnant women and adolescents, was 'patchy' and if in doubt, GPs should follow the NICE guidance.

How useful do you find your local smoking cessation service?

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