Quality standard
Quality statement 6: Healthcare settings: smokefree grounds
Quality statement 6: Healthcare settings: smokefree grounds
Quality statement
Healthcare settings do not allow smoking anywhere in their grounds and remove any areas previously designated for smoking.
Rationale
Healthcare services have a duty of care to protect the health of people who use or work in their services and to promote healthy behaviour among these groups. Healthcare settings set an example to the wider community and ensure that 'no smoking' is the norm. Many healthcare services already have a smokefree policy in place, which includes smokefree grounds. However, some still facilitate smoking in their grounds by providing outdoor smoking areas, such as smoking shelters or designated smoking points.
Quality measures
The following measures can be used to assess the quality of care or service provision specified in the statement. They are examples of how the statement can be measured, and can be adapted and used flexibly.
Structure
Evidence of arrangements within healthcare settings to operate smokefree grounds and remove any areas previously designated for smoking.
Data source: Local data collection.
Process
a) Proportion of healthcare settings that do not allow smoking anywhere in their grounds.
Numerator – the number in the denominator that do not allow smoking anywhere in their grounds.
Denominator – the number of healthcare settings in the specified geographic area.
Data source: Local data collection.
b) Proportion of healthcare settings with no designated smoking areas.
Numerator – the number in the denominator with no designated smoking areas.
Denominator – the number of healthcare settings in the specified geographic area.
Data source: Local data collection.
What the quality statement means for different audiences
Directors and senior managers of healthcare settings or their representatives ensure that smoking is not allowed anywhere in the grounds of healthcare settings. They ensure that the smokefree policy applies to anyone using the premises for any purpose at any time. They should also remove any areas in the grounds previously designated for smoking.
Commissioners ensure that their contracts with healthcare services include smokefree grounds and removal of any existing areas designated for smoking in the grounds.
People who work in healthcare services (including contractors and volunteers) are not allowed to smoke anywhere in the grounds of their healthcare setting. The setting does not have any areas set aside for smoking.
Patients and visitors of healthcare settings are not allowed to smoke anywhere in the grounds of the healthcare setting.
Source guidance
Tobacco: preventing uptake, promoting quitting and treating dependence. NICE guideline NG209 (2021, updated 2023), recommendations 1.21.1 and 1.21.2
Definitions of terms used in this quality statement
Healthcare settings
All publicly funded community, primary, secondary and tertiary healthcare facilities, including buildings, grounds and vehicles. [Adapted from NICE's guideline on tobacco, recommendation 1.21.1 and terms used in this guideline; secondary care]
Equality and diversity considerations
People who are unable to leave the healthcare setting because of disability, vulnerability or detention under the Mental Health Act will have to abstain from smoking, unlike other people who can leave the grounds to smoke if they wish. Additional support should be provided for people unable to leave the healthcare setting.