By Nigel Praities
Exclusive: Costs at NHS stop smoking services are soaring amid growing questions over whether they are offering value for money, Pulse can reveal.
Spending by primary care organisations on their stop-smoking services has leapt by almost a third in just the last two years, while quit rates have barely risen.
The figures, obtained from 36 primary care organisations across the UK, come as some GPs warned they are being placed under pressure to refer to stop smoking services, rather than treating patients in general practice.
The average cost of a PCO’s NHS stop smoking services rose from £469,474 in 2007/08 to £608,873 in 2009/10 – a jump of 30%.
But over the same period, the number of four-week quitters has risen by only 8%, from 2,378 in 2009/10 to 2,199 in 2007/08, with the average cost per quitter rising by 20%, from £213 to £256.
There is also huge variation in the efficiency of local services, with the cost per quitter in 2008/09 only £62 per quitter at NHS Gloucester, but £1,225 in Shetland.
Smoking cessation experts said the rising cost reflected an overreliance on specialist services, at the expense of GP services.
Dr Kevin Gruffydd-Jones, a GP in Box, Wiltshire and a member of the Primary Care Respiratory Society, said: ‘General practice is an ideal place for smoking cessation to be carried out, but my impression is that resources are placed with specialised services – sometimes distant from the patient’s home. These might more suitably spent on training and incentivising in-house practice services.’
The figures also come despite rising use of smoking cessation drugs in primary care. However in some areas GPs are being forced to send patients to their local pharmacy to get smoking cessation drugs.
Dr Colin Brown, a GP in Paisley, said he was frustrated by the move: ‘The implication is that GP prescribing of NRT is less cost-effective than supply by community pharmacists.’
Dr Alex Bobak, a GP in Wandsworth, south London and a smoking cessation adviser at his PCT, said GP services were highly cost-effective, because they could combine smoking advice with a series of other activities.
‘We have a service in our practice where the healthcare assistants do most of the work and are doing lots of other things as well – recording for QOF, data capture and so on.’
The average cost of a PCO’s NHS stop-smoking services has risen 30% in just two years The average cost of a PCO’s NHS stop-smoking services has risen 30% in just two years