Guidance on Smoking Cessation Services and Prescribing Responsibilities

This guidance outlines the LMC’s position on the provision of smoking cessation services and the prescribing of related medications.

Contractual Offers to Provide Smoking Cessation Services

When a practice receives an offer to provide a smoking cessation service, it is essential to:

1. Review the service specification, requirements, and responsibilities in full.
2. Decide whether to sign up to deliver the service.

If a practice chooses to sign up, it becomes contractually obligated to deliver the service in accordance with the specification, including the prescribing of medications as clinically appropriate.

Declining to Provide the Service

If a practice decides not to sign up for the service:

• The commissioner is responsible for ensuring equitable patient access by arranging for alternative providers to deliver the service.
• These alternative providers must deliver the service fully in line with the specification, including prescribing medications as clinically appropriate.

It is vital that any identified provider has access to their own prescriber to fulfil these requirements.

Responsibilities for Practices Not Providing the Service

Practices that do not sign up to deliver the service are under no contractual obligation to undertake unresourced work. This is crucial for the following reasons:

1. Clinical Indemnity:
   • Practices and their clinicians must work under a contractual agreement to ensure appropriate indemnity cover. Undertaking work without a formal contract may leave clinicians exposed to significant legal and professional risks.
2. Patient Safety:
   • The medications used in smoking cessation services carry significant risks. They require a comprehensive assessment to determine suitability before prescribing.
     • If prescribing is undertaken by another clinician or service, all associated risks remain with that prescriber.
     • Without proper assessment and oversight, these risks may increase, making it inappropriate for clinicians to take on this responsibility outside of a formal service agreement.

Key Takeaways for Practices

• Review any smoking cessation service offer carefully before deciding whether to sign up.
• Declining to deliver the service means the commissioner must provide alternative arrangements to ensure equitable patient access.
• Practices not signed up for the service are not obligated to undertake unresourced work, ensuring both indemnity and patient safety are upheld.

This guidance aims to support practices in making informed decisions and ensuring safe, effective delivery of smoking cessation services for patients.

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Updated on Thursday 9 January 2025

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