public health – Page 18 – The NEN

England’s smokers urged to swap cigarettes for vapes in world first scheme

Pregnant women will also be offered financial incentives to help them quit as part of a sweeping package of measures to cut smoking rates in England

One million smokers will be encouraged to swap cigarettes for vapes under a pioneering new “swap to stop” scheme designed to improve the health of the nation and cut smoking rates.

As part of the world-first national scheme, almost one in five of all smokers in England will be provided with a vape starter kit alongside behavioural support to help them quit the habit as part of a series of new measures to help the government meet its ambition of being smokefree by 2030 – reducing smoking rates to 5% or less. Local authorities will be invited to take part in the scheme later this year and will design a scheme which suits its needs, including deciding which populations to prioritise.

In a speech today, Health Minister Neil O’Brien will also announce that following the success of local schemes, pregnant women will be offered financial incentives to help them stop smoking. This will involve offering vouchers, alongside behavioural support, to all pregnant women who smoke by the end of next year.

The government will also consult on introducing mandatory cigarette pack inserts with positive messages and information to help people to quit smoking.

Additionally, there will be a crackdown on illicit vape sales as part of measures to stop children and non-smokers take up the habit – which is growing in popularity among young people.

Health Minister Neil O’Brien will say: “Up to two out of three lifelong smokers will die from smoking. Cigarettes are the only product on sale which will kill you if used correctly.

“We will offer a million smokers new help to quit. We will be funding a new national ‘swap to stop’ scheme – the first of its kind in the world. We will work with councils and others to offer a million smokers across England a free vaping starter kit.”

The new policies will deliver the UK Government’s three aims to help more adults quit smoking, stop children and non-smokers from taking up vaping, and using vaping as a tool for established adult smokers to quit.

For those who quit, the risk of heart attack is halved after one year of quitting, ultimately halving the likelihood of ending up in a hospital bed or worse.

Supporting more women to have a smokefree pregnancy will reduce the number of babies born underweight or underdeveloped with health problems requiring neonatal and ongoing care. It will also reduce the risk of miscarriage and stillbirth.

Cutting smoking rates reduces the number of smoking-related illnesses needing to be treated, in turn reducing the pressure on the NHS, helping to deliver on our priority to cut NHS waiting lists.

NHS figures for 2021 showed that 9% of 11- to 15-year-old children used e-cigarettes, up from 6% in 2018.

In recognition of the sharp increase, Minister O’Brien will launch a Call for Evidence on youth vaping to identify opportunities to reduce the number of children accessing and using vape products – and explore where government can go further.

Working with enforcement agencies and learning from the government’s work with Trading Standards on illicit tobacco, £3 million of new funding will also be provided to create a specialised ‘illicit vapes enforcement squad’ to enforce the rules on vaping and tackle illicit vapes and underage sales.

As part of the measures, HMRC and Border Force will also be publishing an updated strategy this year to tackle illicit tobacco. It will lay out strategically how we continue to target, catch and punish those involved in the illicit tobacco market.

Smoking prevalence in England in 2021 was 13% – the lowest on record thanks to measures such as doubling duty on cigarettes since 2010 and continued funding to local stop smoking services

In 2021-22, £68 million of public health grant funded was spent on stop smoking services by local authorities and nearly 100,000 people quit with the support of a stop smoking service.

In addition, £35 million has been committed to the NHS this year so that all smokers admitted to hospital will be offered NHS-funded tobacco treatment services.

However, 5.4 million people in England smoke tobacco which remains the single biggest cause of preventable illness and death. Up to two out of three lifelong smokers will die from smoking and recent data shows one in four deaths from all cancers were estimated to be from smoking.

Last year an independent smoking review led by Javed Khan proposed a range of measures to help people stub out the addiction, which has informed the measures set out today.

UK Government crackdown on illegal sale of vapes

‘Bold new measures’ to combat rising levels of youth vaping to be announced this week

A new ‘illicit vapes enforcement squad’ – backed by £3 million of government funding – to be formed to enforce rules on vaping and tackle illegal sales of vapes to under-18s
Call for Evidence also launched to identify opportunities to stop children vaping

The UK Government is expected to unveil tough new measures to combat the illegal sale of vapes to under-18s as part of its plans to reduce smoking and tackle youth vaping in England.

In his speech at Policy Exchange on Tuesday 11 April, Health Minister Neil O’Brien is expected to announce a new ‘illicit vapes enforcement squad’ – backed by £3 million of government funding – to enforce the rules on vaping and tackle illicit vapes and underage sales.

Working across the country, the enforcement squad led by Trading Standards will share knowledge and intelligence across regional networks and local authorities.

It will undertake specific projects such as test purchasing in convenience stores and vape shops. It will also produce guidance to help build regulatory compliance, and will have the power to remove illegal products from shops and at our borders.

The minister is also expected to announce the launch of a Call for Evidence to identify opportunities to reduce the number of children accessing and using vapes, while ensuring they remain available as a quit aid for adult smokers.

It will explore topical issues such as the marketing and promotion of vapes and the environmental impact of disposable products.

Health Minister Neil O’Brien said: “Smoking kills, so our priority is to prevent people smoking, and support them to quit. We remain committed to our ambition to be smokefree by 2030.

“However, while vaping is a preferable alternative to smoking for adults, we are concerned about the rise in youth vaping, particularly the increasing use of disposable vaping products.

“The new illicit vapes enforcement squad will work across the country and clamp down on those businesses who sell vapes to children – which is illegal – and get them hooked on nicotine. Our Call for Evidence will also allow us to get a firm understanding of the steps we can take to reduce the number of children accessing and using vapes.”

Smoking prevalence in England in 2021 was 13.0%, the lowest on record, thanks to measures such as doubling duty on cigarettes since 2010 and continued funding to local stop smoking services. In 2021-22, £68 million of funding from the public health grant was spent on stop smoking services by local authorities, and nearly 100,000 people quit with the support of a stop smoking service.

In addition, £35 million was committed to the NHS last year so that all smokers admitted to hospital will be offered NHS-funded tobacco treatment services.

Children aged 6 months to 4 years in a clinical risk group to be offered a Covid vaccine

The Joint Committee on Vaccination and Immunisation (JCVI) has advised that clinically vulnerable children aged 6 months to 4 years should be offered a coronavirus (COVID-19) vaccine.

Although young children are generally at low risk of developing severe illness from COVID-19, infants and young children who have underlying medical conditions are over 7 times more likely to be admitted to paediatric intensive care units.

Over one million children aged 6 months to 4 years in the US have received at least one dose of the Pfizer-BioNTech COVID-19 vaccine since June 2022. Data from the US showed the most common side effects reported were similar to those seen with other vaccines given in this age group, such as irritability or crying, sleepiness, and fever.

In the UK, the Medicines and Healthcare products Regulatory Agency (MHRA) first authorised use of the Pfizer-BioNTech vaccine for children aged 6 months to 4 years on 6 December 2022.

Following that authorisation, the JCVI has advised that children aged 6 months to 4 years who are in a clinical risk group should be offered the vaccine. The JCVI does not currently advise COVID-19 vaccination of children aged 6 months to 4 years who are not in a clinical risk group.

Eligible children should be offered 2 doses of the vaccine, with an interval of 8 to 12 weeks between the first and second doses.

NHS England has confirmed it will begin offering vaccinations to those eligible in England from mid-June. Parents should wait to be contacted before coming forward.

Professor Wei Shen Lim, Chair of the JCVI’s COVID-19 Committee, said: “For the vast majority of infants and children, COVID-19 causes only mild symptoms, or sometimes no symptoms.

“However, for a small group of children with pre-existing health conditions it can lead to more serious illness and, for them, vaccination is the best way to increase their protection.”

Dr Mary Ramsay, Head of Immunisation at the UK Health Security Agency (UKHSA), said: “COVID-19 is still in circulation, with thousands of new cases reported every week.

“The extra protection offered by the vaccine could be important for young children in clinical risk groups, who are at greater risk of severe illness. The virus is not going away so I would encourage all parents to bring their child forward if they are eligible. Parents should wait to be contacted by their local health professionals.”

Health and Social Care Secretary Steve Barclay said: “Children are at very low risk of harm from Covid. However, there are a very small number of children with health conditions which make them particularly vulnerable, and for those children we want to give parents the choice as to whether they wish to vaccinate their at risk child or not.

“I have accepted advice from the Joint Committee on Vaccination and Immunisation on vaccinating children aged from 6 months to 4 years who are in a clinical risk group. It is a parental decision, and this advice is simply to enable parents of children with medical conditions to choose if they wish to have the protection.”

Scotland is expected to follow suit.

Humzah Yousaf announces another £1 million to tackle health inequalities

First Minister Humzah Yousaf has announced additional support for general practices in most deprived areas. People living in some of Scotland’s most deprived communities will benefit from an additional £1 million of funding to help tackle health inequalities.

The Inclusion Health Action in General Practice programme provides targeted funding for support to patients whose social circumstances have a negative impact on their health.

The funding is allocated directly to practices which are in the NHS Greater Glasgow and Clyde Health Board area and feature on the list of 100 most deprived practices in Scotland.

First Minister Humza Yousaf made the announcement as he visited the New Gorbals Health Centre in Glasgow.

The First Minister said: “General practice is at the heart of our communities and is uniquely placed to deliver the care and support needed by patients who experience health inequalities.

“Of the one hundred poorest practices in the whole of Scotland, shockingly 81 currently sit within the Greater Glasgow and Clyde Health Board area – a statistic I am determined to change.

“This additional funding of £1 million will build on the foundations of previous funding. At a time when the cost of living crisis is widening health inequalities, this is an important step that supports our commitments to prevention and early intervention with patients at highest risk of poor health.”

Lorna Kelly, Chair of the Primary Care Health Inequalities Development Group said: “The NHS needs to be at its best where it is needed the most, or health inequalities will continue to worsen.

“This additional resource to general practices serving the most deprived communities in Scotland is therefore very welcome.”

COVID-19 spring booster programme gets underway today

At-risk groups offered additional dose

Residents in care homes for older adults are receiving their spring COVID-19 booster from today (Monday) as the latest stage of the national vaccination programme gets underway.

Following recent advice from the Joint Committee on Vaccination and Immunisation (JCVI), a spring booster dose will also be offered to those aged 75 and over from 11 April and individuals aged five and over with a weakened immune system from 24 April. These groups will either receive appointment details through their preferred means of contact or will be sent details of how to book.

Health Secretary Humza Yousaf said: “We know that people in high-priority groups are at higher risk of serious illness from COVID-19 so I welcome the start of the spring rollout which will offer an additional dose to those who are most vulnerable, boosting their protection.

“Prioritising those most at risk has been our approach from the outset and vaccination has been our most effective tool against COVID-19. However, the degree of protection offered does fade over time, which is why booster vaccination is needed.

“I continue to encourage everyone to receive the doses they are eligible for as and when they become available.”

Spring coronavirus (COVID-19) booster | NHS inform

Minimum Unit Pricing ‘reducing alcohol deaths’

Report estimates the policy has saved hundreds of lives

Today, Public Health Scotland (PHS) and The Lancet publish new evidence showing the impact of alcohol minimum unit pricing (MUP) on deaths and hospital admissions attributable to alcohol consumption. The report has been welcomed by the Scottish Government.

Carried out in collaboration with the University of Glasgow, the study evaluated the impact of MUP on alcohol health harms, over the first two-and-half years of the policy.

The study estimated a 13.4% reduction in deaths, and a 4.1% reduction in hospital admissions, wholly attributable to alcohol consumption following the implementation of MUP. The study also found that MUP reduced deaths and hospital admissions where alcohol consumption may be one of a range of causative factors. The findings cover the period from MUP implementation up to the end of 2020.

This latest report builds on previous work that estimated alcohol sales reduced by 3% in the three years following the implementation of MUP.

Dr Grant Wyper, Public Health Intelligence Adviser at PHS, said: “Our study estimates that, following more than two and a half years of implementation, around 150 deaths, and around 400 hospital admissions, wholly attributable to alcohol consumption, were averted each year due to MUP.

“The greatest reductions were seen for chronic alcohol health harms, in particular alcoholic liver disease, which were slightly offset with less certain evidence of increases in acute alcohol health harms.

“The findings highlight that the largest reductions were found for males, and for those living in the 40% most deprived areas, groups which are known to experience disproportionally high levels of alcohol health harms in Scotland.

“We know that those living in the most socioeconomically deprived areas in Scotland experience alcohol-specific death rates more than five times higher compared to those living in the least deprived areas.

“The results published today are therefore very encouraging in addressing this inequality, and the overall scale of preventable harm which affects far too many people.”

Prof Daniel Mackay, Professor of Public Health Informatics at the School of Health and Wellbeing, University of Glasgow, said: “The methods we’ve used in this study allow us to be confident that the reduction in alcohol health harms we’ve shown is due to the introduction of MUP, rather than some other factor.

“This was important as the COVID-19 pandemic occurred towards the end of our study period and may have had an impact on alcohol-related health harms that was unrelated to MUP. Our main findings for the whole study period were consistent with findings from an additional analysis that focused on the pre-pandemic period only.

“In fact, we tested our main finding across a range of different scenarios and found the results to be largely consistent with our main finding, strengthening our conclusion that MUP has been effective at reducing the harm to health caused by alcohol.”

Prof Jim Lewsey, Professor of Medical Statistics also at the School of Health and Wellbeing, University of Glasgow, added: “Our approach compared what happened to alcohol health harms in Scotland with its neighbouring country, England, where MUP was not introduced.

“The methods we have used and the consistency of our findings with what was anticipated before MUP was introduced, allow us to be confident that the reduction in alcohol health harms is because of the MUP intervention.”

The MUP Evaluation Portfolio comprises of a number of research studies that are being undertaken to assess the impact of MUP across a range of outcomes, all of which have now been concluded. A report bringing together all the evaluation findings will be published in June 2023.

Research which estimates 156 deaths were averted each year following the implementation of Minimum Unit Pricing (MUP) has been welcomed by the Public Health Minister Maree Todd.

A Public Health Scotland and University of Glasgow study indicates a 13.4% reduction in deaths, and a 4.1% reduction in hospital admissions wholly attributable to alcohol consumption in the first two and a half years after MUP was introduced in May 2018. The report also concludes the policy had reduced deaths and hospital admissions where alcohol consumption may have been a factor.

Researchers say they are confident there is a link between the introduction of MUP and the reduction in alcohol health harms. They also noted there had been significant reductions in deaths in areas of deprivation, suggesting MUP has helped reduce inequalities in alcohol-attributable deaths in Scotland.

Ms Todd said: “I am very pleased with these findings which point to more than 150 lives a year being saved and 411 fewer hospital admissions, further underlining the value of our world-leading Minimum Unit Pricing policy which has helped reduce alcohol sales to their lowest on record.

“We’re determined to do all we can to reduce alcohol-related harm which is one of the most pressing public health challenges that we face in Scotland.

“Minimum Unit Pricing continues to achieve its aim – cutting overall sales, particularly cheap high-strength alcohol, which is often drunk by people drinking at harmful levels.

“It’s also encouraging to see that the research has highlighted that the policy is having an effect in Scotland’s most deprived areas – which experience higher death rates and levels of harms from problem alcohol.”

The study – published by PHS and the Lancet – focused on the first two-and-half years of the policy. It follows a previous report which estimated that alcohol sales had dropped by 3% after MUP. A report bringing together all the evaluation findings on MUP will be published in June this year.

PHS report – ‘Evaluating the impact of alcohol minimum unit pricing (MUP) on alcohol-attributable deaths and hospital admissions in Scotland’.

evaluating-the-impact-of-alcohol-minimum-unit-pricing-mup-on-alcohol-attributable-deaths-and-hospital-admissions-in-scotland-briefing-paper Download

Campaigners call on Scottish Government to develop national strategy to prevent child sexual abuse

Stop It Now! Scotland and NSPCC Scotland are calling on the Scottish Government to develop a national strategy to tackle child sexual abuse that focuses on prevention to make the country a safer place to grow up.

The two charities hosted an event in partnership with the Scottish Parliament this week (Wednesday, March 15) with leading experts in the field.

They discussed the devastating harms and long-lasting impact that sexual abuse can have on victims, that punishment alone will not eradicate this problem and what we can do to prevent children being abused in the first place. They also talked about the next steps we need to take to guarantee Scotland is the safest country for children to grow up.

They are urging the Scottish Government to develop a comprehensive and coordinated national approachto prevent child sexual abuse, which involves health, police, education, community safety, children’s services, social services, housing and the wider community. The child protection charities say it is vital that everyone understands what child sexual abuse is and knows how they can be part of preventing it.

A review of UK data revealed that 15 per cent of females and 5 per cent of males will experience some form of sexual abuse before the age of 16.

This means at least 80,000 children in Scotland will have been affected by this issue before they leave high school. Although this is thought to be an under-representation of the scale of the problem and the actual number of children who have experienced sexual abuse in Scotland is not known.

The charities say that to understand the numbers of children in Scotland affected and the scale of the suffering it is crucial that a prevalence survey is conducted.

Professor Elizabeth Letourneau, Director of the Moore Centre for the Prevention of Child Sexual Abuse, School of Public Health, John Hopkins University, said: “Child sexual abuse affects about one in nine children – 12 per cent of all children – globally. Victims are at risk of immediate harms, such as fear, injury, and pregnancy, and a broad array of serious health problems can emerge and last across the lifespan.

“Only one in five cases of child sexual abuse are ever reported to the authorities. This means that we miss at least 80 per cent of cases, so punishment will never be enough if we are to effectively address this public health problem.

“I believe our failure to focus on prevention stems from a general misgiving that child sexual abuse really is not preventable. That people who are at risk of perpetrating abuse are monsters and their behaviour cannot be predicted or prevented, and they will only respond to punishment.

“But we know this is not true. We already have good evidence that we can effectively prevent child sexual abuse perpetration.”

Pat Branigan, Assistant Director of NSPCC’s Together for Childhood, said: “One of the most important messages from today is that child sexual abuse is preventable and not inevitable.

“The ultimate goal is to develop a framework, based on evidence of what we know already works, which can be used to support agencies and organisations to work together and prevent child sexual abuse in communities.

“We need to create strong local partnerships between social care, schools, health, voluntary groups, the police and communities that focus on preventing people from offending, and empower and educate children and adults to recognise the signs of abuse and how they can report their concerns.

“Ultimately it will not be governments, experts or professionals who eradicate child sexual abuse, it will be individuals, families and communities.”

Stuart Allardyce, Director, Lucy Faithfull Foundation / Stop It Now! Scotland, said: “Last year we helped 7,000 people across the UK through our Helpline. Not all were adults worried about their own sexual thoughts, feelings and behaviour, but around half of them were.

“We also had adults who were worried about another adult, or because they had found evidence their partner has been seeking out child sexual abuse material online.

“We believe that if you build prevention initiatives, people will come – professionals, protective adults, but also those who worried about the risk that they may present to children. We can no longer say that people won’t use self-help prevention resources, because the evidence is that they can and do and that prevention works.”

Childlight, based at the University of Edinburgh, also launched the first comprehensive global data repository this week, which will look at all forms of child sexual exploitation and abuse (CSEA), with the aim of being able to show the scale and nature of this abuse.

Children and young people can contact Childline for free, confidential support and advice 24 hours a day online at www.childline.org.uk or on the phone on 0800 1111

Anyone with concerns about a child’s wellbeing can contact the NSPCC Helpline on help@nspcc.org.uk. The NSPCC practitioners provide free and confidential help and advice and can take appropriate steps to help keep children safe. If a child is in immediate danger, please call 999.

The NSPCC also has advice and resources for parents, carers on how to have simple, age appropriate conversations with children to help prevent sexual abuse through their Talk PANTS campaign. This helps children understand that their body belongs to them and to recognise when something is not okay and how to tell someone.

NHS Lothian releases results of research into transmission of COVID-19 from hospitals into care homes

Scientists in NHS Lothian have helped to develop national infection controls after studying COVID-19 transmission between hospitals and care homes.

The teams found that 99 per cent of patients discharged from hospital into care homes during the first wave of the pandemic did not introduce COVID-19 into care homes.

The study, conducted with the University of Edinburgh, focused on patients in Lothian discharged from hospital into 130 care homes from 1st March 2020 to 31st May 2020.

Of the 787 discharges in this time, the researchers found that the majority – a total of 776 – did not introduce COVID-19 into care homes as a result of their hospital stay.

Forty-one of the discharged patients had a positive COVID-19 test within two weeks of leaving hospital and genome sequencing was used to identify if these cases could be linked.

The study found that 30 patients likely contracted this in the care home or from the community.

The results of 10 patients were inconclusive and one patient was confirmed to have contracted COVID-19 during their stay in hospital.

Very sadly, this patient later passed away and a number of residents in their care home subsequently contracted COVID-19.

Dona Milne, Director of Public Health and Health Policy, NHS Lothian, said: “This study has shown that 99 per cent of hospital discharges didn’t introduce COVID-19 cases into Lothian care homes during the first wave of the pandemic.

“However, we’re able to say with certainty that one care home outbreak in this time originated from us. We are deeply saddened by this, and our heartfelt apologies and condolences are with the families and loved ones of those affected.

“We began testing symptomatic care home residents very early in the pandemic, so it’s been really important for us to use this information to find out what we can learn about how the virus was contracted and spread and how this linked to our hospitals.”

Before the nation went into its first lockdown when testing wasn’t widely available, NHS Lothian built capacity into its labs specifically to PCR test those who were symptomatic in hospitals and care homes.

Because of this early testing of symptomatic patients, in-depth data was available to the research team to enable them to genome sequence the transmission of the virus as part of the study.

Dr Kate Templeton, Head of Molecular Diagnostics for NHS Lothian who led the study, said: “Testing was a priority for us from the beginning and we were the first health board in Scotland to build capacity in our labs specifically for care home residents.

“This early testing has enabled us to genome sequence the virus and track where this was acquired and how this spread, leading to the creation of an outbreak methodology which has informed best practice at both Scotland and UK-level.

“This methodology not only has applications to COVID-19 but other viruses too and has been vital in learning lessons around infection control. It also clearly shows that the protection of the most vulnerable in society needs to involve not just health authorities but the community too.”

You can read the study in full here.

Next First Minister must halt exodus from NHS dentistry

The British Dental Association has warned the future of NHS dentistry in Scotland is in doubt, and action here must be high on the agenda for the next First Minister.

A devastating new survey of dentists across Scotland reveals:

An exodus is in motion. 59% of dentists say they have reduced the amount of NHS work they undertake since lockdown – by an average of over a fifth.This movement is going unseen in official data, which counts heads, not commitment, and gives the same weight to a dentist doing a single NHS check-up a year as an NHS full timer.
Over 4 in 5 (83%) now say they will reduce – or further reduce – their NHS commitment in the year ahead. Over a third (34%) say they will change career or seek early retirement.
Just 1 in 5 (21%) say their practices have returned to pre-COVID capacity. 61% cite recruitment problems as an issue, over two thirds (67%) cite treating patients with higher needs requiring more clinical time.
A sustainable model must be in place come October. 90% cite financial uncertainty as having a high impact on their morale.

Health Secretary Humza Yousaf recently stressed NHS staffing was “at a historically high level”, with ‘record’ numbers of dental staff in hospitals alongside medics and allied health professionals. However, NHS Education for Scotland data indicates an 8% drop in high street NHS dentists delivering care since lockdown, a fall from 3,038 in March 2020 to 2,791 in September 2022.

The BDA stress even this fall understates the full scale of losses in light of this new survey evidence. The Scottish Government has never attempted to make a ‘Whole Time Equivalent’ estimate of the NHS dental workforce. Most dentists combine NHS and private work, and the BDA warn that without these estimates movement to the private sector is going undetected, and workforce planning is effectively impossible.

NHS dental care free at the point of use remains a central Scottish Government policy. BDA Scotland has long warned that any return to the service’s ‘business as usual’ model – low margin and high volume – will put practices under huge financial pressure and will likely lead to closures or movement to the private sector, with many practices left delivering some NHS care at a loss.

The SNP leadership election has seen key deadlines to reform this broken system move. The profession had anticipated the Scottish Government would reveal changes to the payment model on 1 April, that would be rolled out from October.

The BDA stress a sustainable model must be in place come October, when the current bridging payments that uplifted NHS fees finally lapse, exposing many NHS practices to unsustainable costs.

David McColl, Chair of the British Dental Association’s Scottish Dental Practice Committee, said: “Behind hollow boasts on record workforce numbers is a service that is hollowing out.

“The majority of dentists have pared down their NHS work, and many more are set to follow. It’s an exodus that’s going untracked by government but is the inevitable result of working to a broken system.

“NHS dentistry’s survival requires rapid action, with meaningful reform and sustainable funding.

“The steps taken in the next First Minister’s First Hundred Days will determine whether this service will have a future.”

Online poll of General Dental Practitioners in Scotland, Fieldwork February 2023, 526 respondents:

What changes in your working life do you anticipate in the next 12 months? % Net Likely n

I will reduce my personal NHS commitment 83% 439

I will change career/seek early retirement 43% 178

Approximately what proportion of your income was NHS based prior to March 2020?

% n

100% (exclusively NHS) 4% 23

90-99% (NHS) 43% 227

80-89% (NHS) 23% 122

70-79% (NHS) 13% 69

60-69% (NHS) 4% 22

50-59% (NHS) 4% 22

40-49% (NHS) 2% 11

30-39% (NHS) 1% 3

20-29% (NHS) 2% 12

10-19% (NHS) 1% 4

1-9% (NHS) 2% 9

0% (exclusively private) 0% 2

Approximately what proportion of your income was NHS based now?

% n

100% (exclusively NHS) 2% 8

90-99% (NHS) 25% 134

80-89% (NHS) 19% 98

70-79% (NHS) 14% 71

60-69% (NHS) 9% 48

50-59% (NHS) 11% 60

40-49% (NHS) 6% 32

30-39% (NHS) 4% 20

20-29% (NHS) 4% 20

10-19% (NHS) 3% 16

1-9% (NHS) 3% 16

0% (exclusively private) 1% 3

309 respondents reported a fall in NHS work between March 2020 and February 2023 – with an average drop of 22%.

Please estimate your practice’s current overall capacity compared to pre-COVID levels.

100% (my practice is at full capacity) 21% 111

90-99% 17% 91

80-89% 22% 116

70-79% 19% 102

60-69% 10% 54

50-59% 4% 21

40-49% 0% 2

30-39% 0% 2

20-29% 1% 4

10-19% 0% 2

1-9% 0% 2

0% (my practice is not operating) 0% 0

Don’t know 4% 19

What factors would you say are constraining your practice from operating at pre-COVID capacity (select any that apply)

% n

Recruitment and retention problems for dentists 61% 304

Patient cancellations/Did Not Attends 44% 220

Ongoing Infection Prevention and Control restrictions 18% 93

Staff sickness 43% 213

Higher needs patients requiring more clinical time 67% 336

For each of the statements below please rate the impact each currently has on your morale working as a dentist

Net High impact % n

Inability to provide pre-COVID levels of care 61% 321

Financial uncertainty 90% 472

Patient Anger/Abuse 67% 352

ASH Scotland urges more cessation support following dramatic drop in quit attempts

Health charity urges Scottish Government to increase cessation support for Scotland’s 730,000 smokers

ASH Scotland is urging the Scottish Government to boost specialist cessation services for the estimated 730,000 Scots who smoke, after it emerged that quit smoking attempts have dropped by more than a third compared to the year before the COVID-19 pandemic started.

The latest annual NHS Stop Smoking Services Scotland report (April 2021 to March 2022) published by Public Health Scotland today (Tuesday 21 February 2023) reveals there were 31,359 quit smoking attempts, around 17,000 fewer than the 48,749 in 2019/20.

With smoking continuing to cause 100,000 hospitalisations and 9,000 deaths in Scotland each year, and the 2034 target for the country to be tobacco-free on track to be missed by an estimated 16 years, ASH Scotland says it is vitally important that the Scottish Government and health boards consider the promotion and expansion of the country’s smoking cessation services as top priorities.

Sheila Duffy, Chief Executive of the health charity ASH Scotland, said: “It is alarming that these latest figures show stop smoking attempts with NHS support have fallen for the 10th consecutive year and by almost 75% since the peak of 121,385 attempts in 2011/12.

“At a time when the health service is under considerable pressure and smoking continues to be the biggest preventable cause of illness and death, swift action is required by the Scottish Government and health boards to ensure NHS Quit Your Way services are promoted and better resourced to reach more of the two-thirds of Scots who smoke and want to quit.

“Quit Your Way services, which provide specialist person-centred smoking cessation support, must be boosted as a matter of urgency to continue their critical role helping people who have the highest smoking rates, such as those living in our most deprived communities, and experiencing mental health problems, to leave tobacco behind.”

ASH Scotland research suggests that smoking prevalence for people experiencing mental health problems in Scotland’s poorest communities is between 40 to 50 per cent, comparable to the country’s general population smoking rates of the mid-1970s.

People aiming to give up smoking can call Quit Your Way’s free helpline on 0800 84 84 84 or create a quit plan at www.QuitYourWay.scot.

Public Health Scotland’s 2021/22 Annual Stop Smoking publication can be found at https://beta.isdscotland.org/find-publications-and-data/lifestyle-and-behaviours/smoking

ASH Scotland’s Closing the Inequality Gap: Smoking and Mental Health report, published in 2022, can be downloaded at www.ashscotland.org.uk/mentalhealth