Statistics on NHS Stop Smoking Services in England - April 2020 to December 2020

NHS Stop Smoking Services were first set up in 1999/2000 with the aim of reducing health inequalities and improving health among local populations.

Services were rolled out across England from 2000/2001 and provide free, tailored support to all smokers wishing to stop, offering a combination of recommended stop smoking pharmacotherapies and behavioural support.

The NHS Stop Smoking Services Quarterly Return is used to monitor the delivery of NHS Stop Smoking Services, and NHS Digital are responsible for collecting and publishing data submitted by local authorities (LAs). 

This data quality statement aims to provide users with an evidence based assessment of quality of the statistical output included in this publication. 

It reports against those of the nine European Statistical System (ESS) quality dimensions and principles¹ appropriate to this output. In doing so, this meets NHS Digital’s obligation to comply with the UK Statistics Authority (UKSA) Code of Practice for Statistics², and the following principles in particular:

• Trustworthiness pillar, principle 6 (Data governance) which states “Organisations should look after people’s information securely and manage data in ways that are consistent with relevant legislation and serve the public good.”
• Quality pillar, principle 3 (Assured Quality) which states “Producers of statistics and data should explain clearly how they assure themselves that statistics and data are accurate, reliable, coherent and timely.”
• Value pillar, principle 1 (Relevance to Users) which states “Users of statistics and data should be at the centre of statistical production; their needs should be understood, their views sought and acted upon, and their use of statistics supported.”
• Value pillar, principle 2 (Accessibility) which states “Statistics and data should be equally available to all, not given to some people before others. They should be published at a sufficient level of detail and remain publicly available.”

¹ The original quality dimensions are: relevance, accuracy and reliability, timeliness and punctuality, accessibility and clarity, and coherence and comparability; these are set out in Eurostat Statistical Law. However more recent quality guidance from Eurostat includes some additional quality principles on: output quality trade-offs, user needs and perceptions, performance cost and respondent burden, and confidentiality, transparency and security.
² UKSA Code of Practice for Statistics

This dimension covers the degree to which the statistical product meets user needs in both coverage and content.

Data are collected and reported on a quarterly basis. Data submitted in quarters 1 to 3 is provisional but all data submitted in quarter 4 is final for that financial year.

For each LA aggregated quarterly data are collected for the following:

1. Number of people setting a quit date
2. Number of successful quitters (self-reported)³
3. Number of successful quitters (self-reported) where non-smoking status confirmed by CO validation⁴
4. Number of unsuccessful quitters (self-reported).
5. Number not known/lost to follow up.

Additional information is collected on each quitter including demographic data (e.g. gender, age, ethnic category and socio-economic group) and treatment data (e.g. pharmacotherapy, intervention setting and intervention type).

Collecting this information:

• Enables monitoring of performance and identification of best practice.
• Helps LAs identify which treatment settings, pharmacotherapies and intervention types are consistently getting the best results.
• Helps inform the person making the stop smoking attempt which settings are available to them in that area and the relative success rate of these.
• Assists regions in monitoring the performance of their LAs more effectively.

³ A treated smoker who reports not smoking for at least days 15–28 of a quit attempt and is followed up 28 days from their quit date (-3 or +14 days). (Russell Standard).
⁴ A treated smoker who reports not smoking for at least days 15–28 of a quit attempt and whose CO reading is assessed 28 days from their quit date (-3 or +14 days) and is less than 10 ppm.

This dimension covers the degree to which the statistical product meets user needs in both coverage and content.

Validation of NHS Stop Smoking Service Data
NHS Digital is responsible for the collection and validation of the data received from LAs. The validation process can be found in the technical appendices accompanying this publication. Responses from LAs to queries raised following the validation process can be found in Table 5.3b.

Treatment of Missing Data
National and regional totals from 2016/17 onwards have not been adjusted to estimate for those LAs who did not provide any data or only provided data for some quarters. Therefore, these totals are underestimates and not directly comparable with previous years. Table 5.3a provides further information on which LAs have not provided data.

Estimated data has been used to calculate national and regional totals in the Q4 reports for 2013/14, 2014/15 and 2015/16 when only Bradford LA did not provide data during this period. Since then several more LAs have stopped providing data and some of these had changed provision such as concentrating on pregnant women making estimation more complex and less accurate.

Timeliness refers to the time gap between publication and the reference period. Punctuality refers to the gap between planned and actual publication dates.

LAs usually submit data to NHS Digital within 10 weeks of the end of the monitoring period for Quarters 1, 2 and 3 and have 11 weeks to return the Quarter 4 data. However, this collection was deprioritised in March 2020 as part of the response to the covid-19 pandemic, allowing submitters to concentrate on higher priority programmes of work. The data for Quarter 1 2020/21 has been submitted within 3 months of the end of the reporting period, and this publication is being released within 5 months of the end of the reporting period.

Coherence is the degree to which data which have been derived from different sources or methods but refer to the same topic are similar. Comparability is the degree to which data can be compared over time and domain.

There are no known alternative sources of data on which to compare these results.

Comparable data on the number of people setting a quit date and successful quitters, by age, gender, ethnicity and among pregnant women, has been collected and published since the introduction of NHS Stop Smoking Services in 1999/2000. NHS Digital has published these data since 2005; earlier reports are available from the Department of Health and Social Care.

National and regional totals from 2016/17 onwards have not been adjusted to estimate for those LAs who did not provide any data or only provided data for some quarters. Therefore, these totals are underestimates and not directly comparable with previous years.

From 2014/15 amendments were made to data requirements on the monitoring return for pharmacotherapy treatment received (part 1F); Intervention setting (part 1H) and financial information on smoking cessation services (part 2A) and this will affect comparisons over time and means these data will not be comparable with previous years.

Financial data may not be returned by LAs on a comparable basis and therefore caution should be exercised when making local level comparisons.

Data on Stop Smoking Services in Scotland can be found at:
https://www.isdscotland.org/Health-Topics/Public-Health/Smoking-Cessation/
Data on Stop Smoking Services in Wales can be found at:
https://statswales.gov.wales/Catalogue/Health-and-Social-Care/NHS-Performance/smoking-cessation-services

Accessibility is the ease with which users are able to access the data, also reflecting the format in which the data are available and the availability of supporting information. Clarity refers to the quality and sufficiency of the metadata, illustrations and accompanying advice.

This report is published on the NHS Digital website and is available free of charge with accompanying tables (in Excel (.xls) and Comma Separated Values (.csv) format).

This dimension describes the extent to which different aspects of quality are balanced against each other.

People making multiple quit attempts will be counted multiple times. This is a necessary trade-off due to the absence of NHS number in the collection.

This dimension covers the processes for finding out about users and uses and their views on the statistical products.

This report was also part of a wider consultation on all NHS Digital publications in 2016. There were proposals for changes to this report in sections A10 and C3.

In response to user feedback gathered from this consultation the collection has continued on a quarterly basis, and this report has now been reformatted with extensive written content being replaced by headline results and associated graphics. These presentation techniques are in line with other reports already being produced by NHS Digital which have received positive feedback from users.

Changes to the monitoring collection form have already taken place as a result of feedback from LAs, as detailed in the Comparability and Coherence section.

NHS Digital is keen to gain a better understanding of the users of this publication and of their needs; feedback is welcome and may be sent in an email to [email protected] with “Stop Smoking Services” as the subject heading. Information on the Users and Uses of the report are included in the appendices that accompany the main report.

This dimension describes the effectiveness, efficiency and economy of the statistical output.

The cost incurred by data providers to collect and submit Stop Smoking Services data was assessed in 2016 and was estimated to be £143,000.

NHS Digital costs incurred in the collection and publication of the data were estimated at the same time to be around £22,000.

The procedures and policy used to ensure sound confidentiality, security and transparent practices.

This publication is subject to an NHS Digital risk assessment prior to issue. Data have not been supressed as these data are non-disclosive. The only suppression is applied for accuracy purposes. Specifically, the quit rates5 are suppressed if the denominator is between 1 and 20 as agreed at NHS Digital’s Disclosure Control Panel on 22 September 2015.