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#1 Posted : 07 April 2006 08:47:00(UTC)
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Posted By Mike Grey Due to the tragic events at Hornchurch will NHS Trusts who operate a "site free" policy be urgently reviewing such policies. Many of these policies put employees and vulnerable patients at risk and it appears that many Trusts have not considered the issues on a risk based approach. Any comments, particularly from NHS employees and HR personnel.
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#2 Posted : 07 April 2006 09:06:00(UTC)
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Posted By Paul Leadbetter Mike I must have missed something; what are the tragic events to which you refer? Paul
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#3 Posted : 07 April 2006 09:22:00(UTC)
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Posted By Ron Young I believe that Mike is referring to yesterday's tragic fatal stabbing of a nurse as she took a smoking break away from hospital grounds, as required by the smoking policy at that particular NHS trust.
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#4 Posted : 07 April 2006 09:25:00(UTC)
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Posted By Paul Leadbetter Thanks, Ron I've found the story now; very sad. Paul
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#5 Posted : 07 April 2006 09:34:00(UTC)
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Posted By J Knight Mike, In Scotland now, and in England and Wwales from next year, there will be little option but to enforce smoke free policies. And looking at a risk-based approach; how many people have been stabbed while taking five for a smoke? What is the estimated death rate from passive and active smoking in the UK? (Yes, I know this is contentious, but risk is always based on estimates). In my view its no contest, and allowing smoking indoors or on the premises isn't an appropriate response to security issues. Nobody should get stabbed on work time, whether nipping out for a quick smoke or just getting a breath of fresh air, though having said that this could well be one of those cases where the employer may have been able to do nothing to prevent it. Myabe she was even frolicking? John
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#6 Posted : 07 April 2006 10:04:00(UTC)
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Posted By J Knight To whoever I inadvertently offended; 'on a frolic of one's own' is a legal phrase used to describe a situation where an employee is acting so far outside their expected work role as to be no longer accorded a duty of care by their employer. My comment was meant in this sense, and was not intended to trivailise murder. In Scotland, from the weekend before last, and in England & Wales from next year smoking on the premises will become very much more constrained anyway. And taking a risk based view, the number of people murderd on smoking breaks is very much lower than the number of people killed every year by the effects of tobacco. This event is about security, not about smoking, John
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#7 Posted : 07 April 2006 10:28:00(UTC)
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Posted By Mike Grey Just a few points to make about the implementation of policies within the NHS and the difficulties posed. It is understood that smoking in enclosed spaces and around entrances should not be tollerated and causes offence and risk to non smokers. The Government white paper advised NHS Trusts to prohibit smoking in enclosed public areas and strive for site free smoking policies. Many Trusts have extensive grounds with the opportunity to provide areas for smokers including; Relatives attending ICU and A&E Relatives in reciept of distressing news Patients with high drug/alcohol dependancies Patients with mental health issues It must be realised that these policies apply to patients, visitors, contractors and employees with the possibility of patients requested to leave site for a smoke, there are not enough nursing staff to escort those patients. This is a 24 hour operation and not just a 9-5 issue. When i talk about risk i look at balancing the risk to others by those smoking in open spaces and the vulnerabilty of patients and staff whilst smoking off site, not easy and a subject which can be debated for many hours.
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#8 Posted : 07 April 2006 10:57:00(UTC)
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Posted By J Knight Hi Mike, We have similar issues, albeit on a smaller scale, as we have Hospices and Nursing Homes, also 24 hour operations, in extensive grounds and some in very remote and secluded areas. However you need to read the guidance published by the NHS on the operation of the new law in Scotland (http://www.clearingtheairscotland.com/faqs/pdf/Smoke%20Free%20Scotland.pdf), this will give you a picture of how things will probably pan out here. There are, for example, restrictions on the kind of smoking shelter we are allowed to provide, and there is no doubt at all that the intent of the Scottish law is to reduce smoking in general in Scotland, not simply to remove it from enclosed workplaces. It goes much further than the white paper, and is law. People nipping out for a fag may be at risk, but so are people walking to their cars, people inspecting drains, people delivering samples and so on. Security is the issue here, and I agree thatb its a very difficult area. Personal safety training and risk assessments can help; I'm sure that Suzy Lamplugh would help, and there are other organisations workign in this area. We have just been contacted by an organisation called Human Applications who have done work with Marie Cure Cancer Care on these types of things, John John
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#9 Posted : 07 April 2006 11:12:00(UTC)
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Posted By Mike Grey John Do you insist your patients/service users leave the grounds for a cigarette or do you use your discretion based on the risk to those persons. Mike
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#10 Posted : 07 April 2006 11:24:00(UTC)
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Posted By J Knight Mike, Patients/Service Users are allowed to smoke in Hospices and Nursing Homes in the new Scottish dispensation, provided that the room meets certain requirements. Visitors and Staff cannot smoke indoors at all; we don't make them leave the grounds, but smoking 'shelters' in Scotland can only be enclosed on 2 sides (or have sides which are more than 50% open if you wnat four sides). One of our Hospices in England already bans smoking indoors for everybody, but that is possible because Hospice stays nowadays are relatively short, and are usually for assessment purposes. One of the changes we have had to make in Scotland is that Service Users are no longer allowed to smoke in their rooms; we have allowed this in certain circumstances in the past when people have been too ill or disabled to leave their beds. The Scottish guidance effectively prohibits this, and it will be interesting to see how things pan out in England. I know that some NHS Trusts forbid smoking anywhere on the premises; so do some Local Government and commercial unertakings. We have been asked by some of our Retail Managers to make a similar stipulation for Charity Shops, but so far have avoided doing this; however this is less meaningful because many of our shops have no grounds at all, so people have to leave the premises to smoke anyway, John
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#11 Posted : 07 April 2006 11:36:00(UTC)
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Posted By atm A tragedy but can the NHS be held responsible for the law and order on our streets?
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#12 Posted : 07 April 2006 12:37:00(UTC)
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Posted By jackw. Hi, We allow visitors and staff to smoke in residential units so long as they use designated smoking rooms, with proper ventilation etc. If you read it carefully you will find that the new smoking law in scotland does not in fact prohibit this. The guidance notes accompanying the law considers this to be bad practice. but not following guidance notes to the exact degree does NOT mean you are breaching the actual regulations.. ok maybe not acting in the spirit.. so why.. we feel it is much safer for staff on night shift not to leave the building..it also eliminates the security risk of having a door open whilst staff go out side for a "fag"
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