Improving access to NRT
Michelle Battlemuch, Stop Smoking Service Team Leader, Nottingham City PCT, UK

Abstract
In 2005 Nottingham City PCT Stop Smoking Service began to use a Patient Group Direction (PGD) to supply NRT. This enabled registered health professionals to supply NRT. Prior to that the supply had been through a Voucher scheme if exempt from prescription charges and GP if not exempt. The PGD was a significant service improvement but was limited in that only professionally registered team members could use it. It seemed unsatisfactory that shop workers could sell products that specialist advisors could only supply if they were also a registered health professional.
In 2007 the service commenced the development of the General Sales List Protocol (GSL). At that time 4 out of the 6 NRT products had GSL licenses (Now 5 out of 6 have). This protocol allowed non-registered team members to supply NRT. 

The process to get to the implementation of the GSL in Jan 2008 involved:

(1) reviewing all SPC’s for NRT products and categorising the special precaution groups (a small number sill recommend medical initiation for some special precaution groups this varies from company to company);

(2) the document;

(3) reporting to the DPH;

(4) resenting the document and rational to the medicine management and clinical governance teams;

(5) developing client information leaflets for special precaution groups;

(6) developing a health assessment tool to identify special precaution groups (when supply is made to Special precaution group the GP is always informed of the supply);

(7) liaising with pharmaceutical companies; writing supporting policy; and

(8) training staff. The GSL was introduced in January 2008. A number of SSS have requested the document and we feel the presentation of the process and rational would be of national benefit.