title: Developing the public health role of a front line clinical service: integrating stop smoking advice into routine podiatry services.
abstract: BACKGROUND
  Although smoking is a major public health problem, many clinicians do not routinely provide evidence-based health improvement advice to smokers to help them to quit.
  
  
  METHODS
  Plan, Do, Study, Act (PDSA) cycle methodology was used to design and implement a service development so that health improvement advice for smokers featured in all podiatry consultations provided by a Primary Care Trust in North East England. IT systems were developed to record the number and proportion of patients for whom smoking status was assessed, and the number and proportion of smokers who were given advice to quit and referred for specialist support. A questionnaire to staff explored their perceptions of the development on their clinics and consultations.
  
  
  RESULTS
  During a 6-month period, smoking status was recorded for all 8831 (100%) patients attending podiatry clinics; 83% of smokers were given brief advice to quit; 7% of smokers were given help to access specialist stop smoking support services. Improvements were introduced within existing budgets and did not prolong clinics.
  
  
  CONCLUSIONS
  It is straightforward and inexpensive to develop clinical services so that public health guidance is routinely implemented. More widespread implementation of similar service developments could lead to national improvements in public health.
authors.affiliation: Department of Public Health, Gateshead Primary Care Trust, Team View, 5th Avenue Business Park, Team Valley Trading Estate, Gateshead NE11 0NB, UK. Jackie.gray@ghpct.nhs.uk
authors.forename: Jackie
authors.initials: J
authors.lastname: Gray
authors.forename: Gary
authors.initials: G
authors.lastname: Eden
authors.forename: Maria
authors.initials: M
authors.lastname: Williams
mesh_terms: D006801:Humans; D010353:Patient Education as Topic; D010819:Physician's Role; D011032:Podiatry / Q000191:economics / Q000379:methods*; D015980:Public Health Practice; D016540:Smoking Cessation / Q000191:economics / Q000379:methods*