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What do clients think What do clients think about NHS stop about NHS stop
smoking services? A smoking services? A client satisfaction client satisfaction
surveysurvey
Fiona Dobbie, Rosemary Hiscock, Fiona Dobbie, Rosemary Hiscock, Linda Bauld Linda Bauld
Outline Outline
Background to the survey Sample, analysis and caveats around interpretationFindings:
Overall level of satisfaction Making initial contact Appointment time and venue Service received Medication
Conclusions/ points for discussion
Background to the Background to the surveysurvey
Designed in 2008 as part of the Department of Health’s monitoring and evaluation guidance for SSS
Survey purpose is to assess levels of satisfaction with the SSS
Survey is self-complete and there is no requirement for SSS to actively use it
Was included as part of larger study (ELONS) looking at longer term outcomes for clients who use NHS SSS
Included as an incentive to encourage services to become recruitment sites for ELONS
Research team did not plan to administer the CSS
Background to the Background to the surveysurvey
All clients who agreed to take part in ELONS (n=3075) were sent a CSS (regardless of their quit attempt outcome)
Two reminder mailings and prize draw to encourage response
1006 questionnaires were received and the final dataset had 996 cases = 33% response rate
Questionnaires were entered into excel and then transferred to SPSS for analysis
Analysis – 3 phasesAnalysis – 3 phases
1)1) Descriptive frequencies for each Descriptive frequencies for each satisfaction variablesatisfaction variable
2)2) Crosstabs with ELONS study Crosstabs with ELONS study information:information:
1)1) Quitters compared with non quittersQuitters compared with non quitters
2)2) Behavioural support types compared Behavioural support types compared
3)3) Free text comments added to Free text comments added to augment findings augment findings
CSS sample CSS sample characteristics characteristics
Recruited to ELONS
Responded to client
satisfaction survey
N % N %Total 3069 100 996 100 Smoking status CO validated quit 1350 44 711 71.5Not CO validated quit 1719 56 285 28.5 Self-report quit 1737 56.5 831 83.5Not self-report quit 1332 43.5 165 16.5 Gender Male 1355 44 558 56Female 1714 56 438 44 Age groups 16-44 1766 57.5 413 41.545-85 1303 42.5 583 58.5
Key findingsKey findings
Overall levels of Overall levels of satisfaction satisfaction
87% satisfied or very satisfied87% satisfied or very satisfied 96% would recommend SSS96% would recommend SSS 96% would return to the SSS if 96% would return to the SSS if
neededneeded 86% believed they would be 86% believed they would be
welcomed backwelcomed back
Subgroup differencesSubgroup differences Quitters more likely toQuitters more likely to
Be satisfied/very satisfied Be satisfied/very satisfied (88% vs 84% (88% vs 84% p=.001)p=.001)
Believe they would return (96% vs 89% Believe they would return (96% vs 89% p<.001)p<.001)
Believe they would be welcomed backBelieve they would be welcomed back
(88% vs 79% p<.001)(88% vs 79% p<.001) Belief they would be welcomed back Belief they would be welcomed back
differed significantly by behavioural differed significantly by behavioural support (p=.011)support (p=.011) Open groups were more likely to say they Open groups were more likely to say they
would be welcomed back (92%) than other would be welcomed back (92%) than other (pharmacy, closed group, unclassified) (80%)(pharmacy, closed group, unclassified) (80%)
I would have struggled to stop smoking without the help of the service. I would definitely recommend anyone wishing to stop smoking to use this service.
I hope to never use the service again
but would not hesitate to if the requirement came about.
Making initial contact 94% agreed it was easy to contact 94% agreed it was easy to contact
SSSSSS 88% given an appointment date88% given an appointment date 93% said the length of time they had 93% said the length of time they had
to wait was acceptableto wait was acceptable 60% waited 0-5 days60% waited 0-5 days 30% waited 6-10 days30% waited 6-10 days 10% waited >10 days10% waited >10 days
31% had motivating contact from SSS 31% had motivating contact from SSS before appointmentbefore appointment
Appointment time and venue
95% said the time was convenient95% said the time was convenient 97% said the place was convenient97% said the place was convenient 42% able to choose group or 1 to 1 42% able to choose group or 1 to 1
(11% unsure)(11% unsure) 16% said there was no child care 16% said there was no child care
support support
Appointment time and venue
Free text comments also very positive Free text comments also very positive but some suggestions for improvement:but some suggestions for improvement:
flexible appointment times There are no evening appointments at my
local clinic, which makes things difficult for those who work full time
a wider choice of behavioural support I would have preferred individual
appointments to group therapy
Appointment time and venue
a longer treatment period I feel that instead of having to attend for just
4 weeks it should be rolled out to at least 8. From past experience I feel 4 weeks is too quick
more telephone contact to maintain morale Maybe a text or phone call between
appointment time. i.e. 2 weeks is a long time to leave someone without encouragement.
Service received % responding
positively %Support from staff 89
Advice and support helpful
90
Written information helpful
81
CO reading helpful 86 Note
7% reported that they did not receive written information 6% reported that they did not have their CO taken every visit
Which subgroups were more likely to think staff were
supportive? Varied by whether quit (p<.001)Varied by whether quit (p<.001) 91% quitters 91% quitters 85% non quitters85% non quitters
Varied by behavioural support Varied by behavioural support P=.014P=.014
Open group 94%Open group 94% Drop in 92%Drop in 92% One to one specialist 86%One to one specialist 86% GP practice 86%GP practice 86% Other 85%Other 85%
Advisors– free text comments
Client/advisor rapport and advisor Client/advisor rapport and advisor continuity importantcontinuity important [Name of advisor] was the best person for the
job, she was dead easy to talk to about anything but the woman who took over from her made me feel really unsettled in a telephone consultation therefore never went back!!!
It would be helpful to see the same person every week. Sometimes I saw different people and had to keep introducing myself and explaining how long I'd given up etc.
Medication
Source of medication GP prescription 50Chemist (bought myself) 3Chemist (with a voucher) 14Chemist (with service letter or prescription)
18
Stop smoking service 20
9494% thought medication information % thought medication information was helpfulwas helpful 96% quitters & 89% non quitters 96% quitters & 89% non quitters
(p<.001) (p<.001)
92% thought it was easy to access92% thought it was easy to access
Medication – free text Medication – free text commentscomments
lack of information on the side-effects of medication
Side effects of champix need to be highlighted - include info on all possible side effects.
Medication – free text Medication – free text commentscomments
difficulty obtaining medication It would be better if stop smoking staff
could give out medication as I had to make three trips with letters, prescriptions etc. to finally get medication 5 days later.
Chemist don’t carry enough stock! Most weeks I have to wait for some. Normally next day + costs of travel again.
Conclusions Conclusions
Consistent pattern pointing to a very Consistent pattern pointing to a very positive experiencepositive experience
Examples of good practice beyond DH Examples of good practice beyond DH requirementsrequirements
Free text highlighted the importance of Free text highlighted the importance of client/advisor rapport client/advisor rapport
Quitters more likely to report higher Quitters more likely to report higher levels of satisfaction than non –quitterslevels of satisfaction than non –quitters
CSS not widely or consistently used by CSS not widely or consistently used by SSS SSS
Acknowledgements Acknowledgements Study Team Stop Smoking Service
recruitment sites
Linda BauldLeonie BrosePaul AveyardTim ColemanFiona DobbieCarol Anne GreenanRosemary HiscockMaureen KennedyJo Leonardi-BeeAndy McEwenHayden McRobbieSusan MurrayRichard PurvesLion ShahabSarah Simm
BristolCounty Durham and DarlingtonHull and East RidingLeicestershire County and RutlandOldham NorthamptonshireNorth East and North LincolnshireRotherhamSouth East Essex
Acknowledgements Acknowledgements Funders: This project was funded by the National Institute Funders: This project was funded by the National Institute
for Health Research Health Technology Assessment (NIHR for Health Research Health Technology Assessment (NIHR HTA) Programme (project number 09/161/101) and will be HTA) Programme (project number 09/161/101) and will be published in full in Health Technology Assessment.published in full in Health Technology Assessment.
The views and opinions expressed therein are those of the The views and opinions expressed therein are those of the authors and do not necessarily reflect those of the HTA authors and do not necessarily reflect those of the HTA programme, NIHR, NHS or the Department of Health.programme, NIHR, NHS or the Department of Health.
UK Centre for Tobacco and Alcohol Studies, North51, UK Centre for Tobacco and Alcohol Studies, North51, National Centre for Smoking Cessation and Training, NHS National Centre for Smoking Cessation and Training, NHS Stop Smoking Services, PCRN/CLRNStop Smoking Services, PCRN/CLRN
For further information contact: Fiona DobbieFor further information contact: Fiona Dobbie, ELONS , ELONS Project Manager, School of Management, University of Project Manager, School of Management, University of Stirling, Stirling FK9 4LA, Tel: 01786 467369, Email -Stirling, Stirling FK9 4LA, Tel: 01786 467369, Email [email protected]@stir.ac.uk
Recruited to ELONS
Responded to client satisfaction
survey
N % N %Total 3069 100.0 996 100.0 Location Site 1 273 8.9 94 9.4Site 2 741 24.1 245 24.6Site 3 95 3.1 18 1.8Site 4 396 12.9 136 13.7Site 5 74 2.4 23 2.3Site 6 690 22.5 245 24.6Site 7 146 4.8 43 4.3Site 8 555 18.1 159 16.0Site 9 99 3.2 33 3.3 Behavioural support type Closed group 102 3.3 32 3.2Open group 550 17.9 207 20.8Drop in 887 28.9 255 25.6One to one specialist 1,131 36.9 389 39.1GP practice 270 8.8 79 7.9Pharmacy 97 3.2 25 2.5Other or unclear 32 1.0 9 0.9
