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Chiswick health centre rolling groups using CBT language
Darush Attar-Zadeh, Chiswick Health Centre, London

Abstract
1) Description of the Project:

Every Tuesday & Thursday a drop in clinic takes place to help people stop smoking.
Darush Attar-Zadeh (Pharmacist Lead/Mentor& Trainer) with support from his colleagues at the Ealing & Hounslow (E&H) stop smoking service tend to run a unique ¡¥ROLLING GROUP¡¦ session.

Clients are referred from the E&H stop smoking service, GPs in the health centre, reception staff (mainly from the biggest practice ¡V Dr Hirst & Partners), and my colleagues in Campbell¡¦s Chemist opposite the surgery. The whole system is extremely smooth and provides seamless care PCT ¡V HEALTH CENTRE ¡V ADVISOR - CHEMIST.

A typical NHS 6 week session entails the following information (see attached sheet), the difference mainly here in the rolling group is that a session 1 (info session) is covered on every session with motivational support. The sessions tend to vary a lot as we cover topics that are raised by the group.

The Chiswick Health Centre receptionists advertise the free service extensively and have added laminate posters highlighting the times of the sessions.

2) Why was it undertaken?

To help clients stop smoking in an innovative way using the NHS evidence based model, Cognitive Behavioural Therapy, Group support and backed up by medication (provided on site via the chemist)

3) In what way does it break new ground?

Rolling groups are a mixture of a drop in clinic and a group; I developed the program approximately 3 years ago in an attempt to integrate clients at different stages of their quit attempt. The beauty of it is there are clients who have quit for 4 months who still attend the clinic and instill confidence in those that are just starting out. In addition a key frustration for clients in other settings is that they can¡¦t get the on going support (after the typical 6 sessions ¡V no payment). With the rolling group it is there for them for however long they need that assistance.

Not all Pharmacists can provide this service unless they are at least level 3 trained (most are level 2 ¡V see clients on a 1 to 1), but there is a huge opportunity for us as a profession to sell our services. This system also saves Pharmacy time (as clients are seen in a group ¡V over 1 and a half hours) and saves NHS resources too!

4) In what way has it improved patient care?

• It allows clients to bounce ideas of one another
• As the lead for the service they are not just limited to the conventional NHS level 3 support; CBT is also indicated.
• Medication is provided without the wait
• It is free for however long they want the service!
• Quit rates have been very good

5) What has been done to measure patient outcomes and to develop the initiative?

We have a database at the E&H stop smoking service and have noticed the 4 week quit rates are on par with the national average. It is difficult to assess but would assume with the number of clients that I am seeing after 4 months that the 52 week quit rate is higher as they are getting on going support.

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Biography
Darush Attar-Zadeh BPharm, MRPharmS, D.Hyp (Dist), PDCHyp, MBSCH Darush has specialized in the field of smoking cessation for the last ten years and has an array of techniques to help people stop. As well as achieving a practitioner status in clinical hypnotherapy he has an honours degree in pharmacy. Both courses were studied at the university of London (Imperial & Kings). Darush is a Pharmacist Director of medicenres, and one of his main roles is to help large corporate businesses go smoke free. He also advises and trains many NHS primary care trusts (pcts) on providing evidence based smoking cessation advice (he has trained many GPs, dentists, nurses & pharmacists). Over 80% of the staff at the hospital he works in have stopped smoking, and the local NHS pct he advises have reached the government target for the last 3 years!Darush understands the complexities of stopping smoking and spends a lot of his time helping clients to understand the importance of positive beneficial suggestions and self talk in a healthy rational manner. Darush enjoys raising money for charities such as QUIT & the British Heart Foundation and has run the London Marathon on 3 occasions.

Aarun Taylor B Sc hons , M Sc IntPC - Ealing and Hounslow Stop Smoking Service Manager - Aarun joined the NHS in 2000 after 10 years working as a property/estate management professional. Having worked as a project co-ordinator at St Mary¡¦s Hospital and Health Promotion Manager, he joined the Ealing and Hounslow Stop Smoking Service in 2003. He has been the Service Manager since 2005. He has been the main lead person on the Stop Smoking Service achieving targets for both PCTs since 2003. He has applied his project management expertise, partnership working, smoking cessation knowledge and skills to help the service meet targets and achieve very good quitter success rates of 70%+. The Ealing and Hounslow Stop Smoking Service runs a diverse range of services including drop-in and group clinics, a community.

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