Smokefree pregnancy pathway

This form is for pregnant women and people who access the smokefree pregnancy pathway at Cambridge University Hospitals NHS Foundation Trust (CUH).

The smokefree pregnancy pathway

The smokefree pregnancy pathway has been designed to provide you with support to quit smoking during your pregnancy, to prevent relapse and to have a smoke-free home once baby is born. It will be tailored to work with you and will include behavioural support, nicotine replacement therapy, with a personalised plan to prevent relapse.

• The pathway will offer you regular support and contact for the whole pregnancy and for 12 weeks following the birth of your baby.
• There will also be a contact visit planned for one year after your quit date.
• The support will involve a mixture of face-to-face appointments at your choice of location, with telephone and online virtual appointments at the discretion of the service providers.
• Our smokefree advisors are experts in supporting a smokefree pregnancy and home; however, they are not medically trained. If you have any questions or concerns about your pregnancy, please speak to your midwife or GP or contact your local maternity department to speak to a healthcare professional.

Evaluating the smokefree pregnancy pathway

To ensure the smokefree pregnancy is effective we are required to collate and report information regarding its implementation. We will ask to collect your information which will be securely uploaded to NHS Digital. If you do not wish your information to be collected, stored or reported you are still eligible to access support via the smokefree pregnancy pathway.

Your information may also be used to:

• ensure that the service and information / support you receive is right for you
• ensure that the right people are involved in the delivering of the smokefree service at the right time to maximise your chances of quitting smoking
• check and report on how effective CUH has been in providing services to you
• communicate directly with you about appointments and what services are available
• check and report on the effectiveness of the pathway
• review the care given to make sure it is of the highest possible standard and amend the pathway where necessary to reduce inequalities in healthcare
• investigate complaints, legal claims, or serious incidents
• make sure services are planned in order to meet people’s needs in the future

Storing and protection of personal details

To support delivery of the smokefree pregnancy pathway, we may share your information for health purposes with other organisations such as NHS England, your local authority and the Cambridgeshire and Peterborough Integrated Care Board (ICB).

• We maintain secure systems to protect your personal information.
• We will update your information or preferences promptly when you ask us to.
• We will not hold your personal information for longer than is necessary. The amount of time data is kept before being disposed of will vary depending on why it was collected, how it is used, and will be held in line with any applicable UK laws.
• We follow strict procedures when storing or handling information that you have given us.
• All staff who are using information also undertake regular training to comply with policies and procedures around data protection, information security, confidentiality, and the safe handling of information.

Consent

In order to collect, store and report your information, we need your consent to do so. You may withdraw your consent at any time and with no negative consequence or impact on care. To withdraw your consent please write to:

Treating Tobacco Dependency team
The Rosie Hospital, Robinson Way, Cambridge, CB2 0SW

or speak to your smokefree advisor, who can action your request.

If you do not wish your information to be collected, stored or reported you are still eligible to access support via the smokefree pregnancy pathway.

Consent form

I, . . . . . . . . . . . . . . . . . . . . . . . . . . . ., give consent to the Treating Tobacco Dependency Team at Cambridge University Hospitals NHS Foundation Trust to collate, store and report my information as required for the smokefree pregnancy pathway.

I confirm that I have read and understood the above information and I understand that I can change my mind at any point and should contact the healthcare professional in charge of my care to record any such changes to my preferences.

Signed: . . . . . . . . . . . . . . . . . . . . . . . . . . . . Date: . . . . . . . . . . . . . . . . .