Quit smoking services - Quit4You

Summary

A request was made for detailed statistics, budget figures, and policy documents regarding the Isle of Man's Quit4You smoking cessation service from 2011 onwards. The authority responded by sending all requested information, including 37 pages of documents covering service data and carbon monoxide safety procedures.

Key Facts

• The Department of Health and Social Care confirmed that all information requested was sent.
• The response included 37 pages across 4 documents.
• The request covered data from October 2011 broken down by financial year.
• The response contained specific procedures for handling high carbon monoxide readings in clients.
• Information on carbon monoxide poisoning symptoms and causes was provided as part of the service documentation.

Data Disclosed

• 2019-10-07
• 2019-10-28
• 11 October 2011
• 37 pages
• 4 documents
• November 2016
• 685894
• 650040
• 647303

Original Request

From 11 October 2011, broken down by financial year, please supply the following information: Question 1: How many people signed up for quit for you smoking service? Question 2: How many people completed the full quit for you course or treatment? Question 3: The allocated budget for quit for you? Question 4: How many staff are employed in Quit4You and at what total cost? Question 5: List all pharmacotherapies and licensed nicotine replacement therapies on your formulary that is prescribed. Question 6: Are all people who volunteer for quit for you given pharmacotherapies and nicotine replacement therapies free of charge? Question 7: The total cost of giving smokers free pharmacotherapies and nicotine replacement therapies? Question 8: Copies of all quit for you posters/leaflets. Question 9: Copies of quit for you policies. Question 10: From your own data how many people on the island smoke? All of the above requests are by financial year, e.g. FY 2011 ' 2012, less for copies of policies, posters etc.

Data Tables (32)

Full Response Text

November 2016

CO High readings procedures

If a client attends with particularly high CO reading: (this may be a reading unusual for that client- e.g. not smoking or not many cigarettes but reading 50 or above)

Some things to ask include:  Check if they are smoking anything that may produce high CO readings (e.g. cannabis, cigars, sheesha/hookah pipes etc)
 If they are only smoking cigarettes- ask if they were bought from different source other than shop etc e.g. duty free, other country, mate/pub/car boot (could be counterfeit)  Are there other people living in the same home? - consider potential risk to these people. Can their CO reading be tested? Also ask about pets. o More vulnerable groups include- babies and young children, pregnant women, people with chronic heart disease and respiratory problems
o Pets are often the first to show signs of carbon monoxide poisoning. The smaller an animal or a person is, the faster they'll be affected.  Do they have wood/coal burner, gas fire, central heating/boiler etc?
 Has boiler been serviced/checked recently? (Heating appliances including gas, oil, coal or wood need to be checked regularly as fumes from these appliances can also contain large amount of carbon monoxide gas)  Where do they work? Could they have been exposed to high levels of CO at work (e.g mechanics etc?)  Is the client experiencing symptoms (see overleaf)?  If there are concerns they have faulty heating appliances at home or in the workplace: call Environmental Health 685894  If serious concerns, contact A & E for advice 650040 – advise client to attend  Check-in with client again later that day or next day (phone to check OK)  The fire department strongly recommend fitting a carbon monoxide detector in any property where there is a solid fuel burning stove/fireplace, or gas boiler or appliances present. Available from DIY or hardware stores.  Community Fire safety also offer free fire safety checks in the home 647303 Department of Health and Social Care

Rheynn Slaynt as Kiarail y Theay

November 2016 INFORMATION ABOUT CO POISONING After carbon monoxide is breathed in, it enters your bloodstream and mixes with haemoglobin (the part of red blood cells that carry oxygen around your body), to form carboxyhaemoglobin. When this happens, the blood is no longer able to carry oxygen, and this lack of oxygen causes the body’s cells and tissue to fail and die. (Blood also becomes thicker and increases risks of clots).

Symptoms of carbon monoxide poisoning The symptoms of carbon monoxide poisoning aren't always obvious, particularly during low-level exposure. A tension-type headache is the most common symptom of mild carbon monoxide poisoning. Other symptoms include: • dizziness • nausea (feeling sick) and vomiting • tiredness and confusion • stomach pain • shortness of breath and difficulty breathing The symptoms of exposure to low levels of carbon monoxide can be similar to those of food poisoning and flu. But unlike flu, carbon monoxide poisoning doesn't cause a high temperature (fever). The symptoms can gradually get worse with prolonged exposure to carbon monoxide, leading to a delay in diagnosis. Your symptoms may be less severe when you're away from the source of the carbon monoxide. If so, investigate the possibility of a carbon monoxide leak, and ask a suitably qualified professional to check any appliances you think may be faulty and leaking gas.

What causes carbon monoxide to leak? Carbon monoxide is produced when fuels such as gas, oil, coal and wood don't burn fully. Burning charcoal, running cars and the smoke from cigarettes also produce carbon monoxide gas. Gas, oil, coal and wood are sources of fuel used in many household appliances, including:  boilers  gas fires  central heating systems  water heaters  cookers  open fires Incorrectly installed, poorly maintained or poorly ventilated household appliances – such as cookers, heaters and central heating boilers – are the most common causes of accidental exposure to carbon monoxide. The risk of exposure to carbon monoxide from portable devices may also be higher in caravans, boats and mobile homes.

Other possible causes of carbon monoxide poisoning include:  blocked flues and chimneys
 burning fuel in an enclosed or unventilated space – e.g. running a car engine, petrol- powered generator or barbecue inside a garage, or a faulty boiler in an enclosed kitchen  faulty or blocked car exhausts
 paint fumes – some cleaning fluids and paint removers contain methylene chloride (dichloromethane), which can cause carbon monoxide poisoning if breathed in  smoking shisha pipes indoors – shisha pipes burn charcoal and tobacco, which can lead to a build-up of carbon monoxide in enclosed or unventilated rooms

Reference: NHS CHOICES www.nhs.uk/conditions/Carbon-monoxide-poisoning/Pages/Introduction.aspx#symptoms

1

DEPARTMENT OF HEALTH AND SOCIAL CARE

PUBLIC HEALTH

RETENTION OF RECORDS POLICY

CONTENTS

SECTION

PAGE NO.

1. Introduction .................................................................... 2
2. Definition ........................................................................ 3
3. Records Storage .............................................................. 3
4. Paper records ................................................................. 4
5. Non-paper records .......................................................... 4
6. Record Disposal ............................................................. 4
7. Record Destruction ........................................................ 5
8. Retaining records beyond their retention period ................ 6
9. Transferring records to the Public Record Office................ 6
10. Implementation, monitoring, review ................................. 6
11. Legislation ...................................................................... 7
12. Record Retention Schedule .............................................. 9

2

1. Introduction

This Policy provides information and advice about record retention, transfer and destruction. It applies to ALL records held by Public Health regardless of the media on which they are held. It does not apply to central staff records or payroll that will be retained and managed by Human Resources and Finance Directorates respectively.

Records are a valuable resource because of the information they contain. High- quality information underpins the delivery of high-quality evidence-based healthcare, and many other key service deliverables. Information has most value when it is accurate, up to date and accessible when it is needed. An effective records management service ensures that information is properly managed and is available whenever and wherever there is a justified need for that information, and in whatever media it is required. Information may be needed: -

a)
to support patient care and continuity of care;
b)
to support day-to-day business which underpins the delivery of care;
c)
to support evidence-based clinical practice;
d)
to support sound administrative and managerial decision making, as part of the knowledge base for National Health and Care services;
e)
to meet legal requirements, including requests under subject access provisions of the Data Protection Act or the Freedom of Information Act;
f)
to assist clinical and other types of audits;
g)
to support improvements in clinical effectiveness through research and also to support archival functions by taking account of the historical importance of material and the needs of future research;
h)
to support patient choice and control over treatment and services designed around patients.

The Data Protection Act 2002 requires that personal data be processed for a specific purpose or purposes and the 5th Principle of the Act states that data shall not be kept for longer than is necessary. The Data Protection Act however does not specify how long information should be retained for. The Code of Practice on Access to Government Information 1996 and the Freedom of Information Act 2015 allows for the disclosure of information around public services, how they are run, how much they cost, who is in charge and what complaints and redress procedures are available. Also what services are being provided, what targets are set, what standards of service are expected and the results achieved. We must ensure that records regarding our services are retained for a relevant time and are accessible.

Where the Division has records created by others (that are not service user specific) for example minutes of meetings attended consideration must be given to early destruction with a note that would indicate where the master copy is held.

1. Definition

A retention, storage and disposal schedule (“Retention Schedule”) is a timetable for the planned review of all records to determine their ultimate fate, which is either:

 Permanent retention for records having long term value for the Department or nationally, or  Secure destruction of records which the Department is not obliged to keep for legislative or business reasons. 3

This schedule lists record types with brief descriptions and their minimum required retention period. Note that retention periods apply to both paper and electronic records. At the end of their retention period, a sample of records from a series should be reviewed before destruction to confirm that they are no longer required.

1. Record Storage

The Retention Schedule identifies those records likely to have permanent research and historical value.

Some records may have a long-term research value outside the Department that created them (e.g. both administrative and clinical records from a number of different hospitals have been used to study the 1918 influenza epidemic). The Information Governance team will liaise with the Public Records Office to determine the current and potential research uses of records.

The following factors must be considered when storing health records:

 Compliance with health and safety regulations.

 Security

 Types of record to be stored

 Size and quantities

 Usage and frequency of retrieval

 Suitability, space efficiency and cost

 Retention periods

1. Paper Records

It is important that libraries are well managed to ensure space is efficiently utilised and the width of aisles and general layout of storage areas conform to fire, health and safety regulations. In addition all records must be stored off the floor to provide some protection from flood, dampness and dust.

It is important that where other health records are stored, e.g. offices etc, these need to be stored effectively, conform to fire and health and safety precautions. In addition, all records must be stored off the floor to provide some protection from flood, dampness and dust.

1. Non-paper Records

Non-paper storage includes electronic and microfilm formats.

Electronic and microfilm formats are used to capture and store images of otherwise bulky or deteriorating archival material. However managers must be aware of issues around storing records particularly in microfilm format where there may be a reduction 4

in the clarity of records printed.

Medical photographs are regarded as Public Records and under the provisions of the Data Protection Act 2002 on registration and restriction of disclosure, relate to photographs of identifiable individuals as well as to other personal records.

1. Record Disposal

When records identified for disposal are destroyed, a register of these records needs to be kept. When records have reached the end of their retention period the Information Governance Team should be contacted to assist with the secure disposal of the records or transfer to the Public Record Office.

In the case of electronic records please note that a record is not deleted if it is merely sent to the ‘recycle bin’. It must also be deleted from this folder to be considered fully deleted. This is important in terms of the Freedom of Information Act 2015.

There are some records that do not have to be kept at all and staff may routinely destroy such “unimportant” information in the course of their duties. For example:

 Compliment Slips  Catalogues and magazines  Telephone slips where the information has been transferred to a file note.  Trivial e-mail or notes not related to the core business of Public Health  Out of date distribution lists  Early drafts of documents not shared with colleagues  Some duplicated or superseded material

Records which do not contain personal or sensitive material may be disposed of in the normal manner i.e. shredding or confidential wheelie bin or other recycling facilities where possible. Contractors employed to shred confidential information/records will be asked to produce written certificates as proof of destruction.

1. Record Destruction

The Information Governance Manager will be responsible for advising on local policy for the retention, archiving or disposal of Public Health records. The destruction of records is an irreversible act and must be clearly documented.

A decision for destruction of records must be made by the Director of Public Health upon the recommendation of the relevant manager who has knowledge of the relevant business area to which the records relate, in conjunction with the Information Governance Manager. Destruction of records must not take place without recorded agreement from the Information Governance Manager and completion of a Certificate of Records Destruction.

Records not selected for archival preservation and which have reached the end of their administrative life will be destroyed.

If a record due for destruction is known to be the subject of a request for information or potential legal action the records must not be destroyed. The minimum retention periods should be calculated from the end of the calendar year following the last entry in the health records. 5

Guidance must be sought from the responsible manager or the Information Governance Manager if there are any queries around destruction or transfer of a record.

1. Retaining records or information beyond the retention period

In the majority of cases records will be disposed of when they reach their retention period. However, when assessing whether records or information is required to be retained for a longer period than that identified within the Retention Schedule, consideration should be given to the holding of information for longer than necessary which incurs extra storage costs and leaves the De

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