Delivering CQUINs on tobacco Very Brief Advice and alcohol Identification and Brief Advice
At Safe Sociable London Partnership we have been developing and delivering innovative and effective approaches to alcohol Identification and Brief Advice (IBA) and Tobacco Control. With the 2017-19 CQUINS being published in late 2016 alcohol Identification and Brief Advice (IBA) and smoking Very Brief Advice (VBA) have been identified as national CQUINS.
Given the simple nature of both IBA and VBA, and the developments in digital delivery and training approaches, with a small investment of time, effort and funding these CQUINs will be relatively easy to deliver.
The 2017-19 National CQUINS, 9a to 9e, provide for the delivery of VBA for tobacco use and IBA for alcohol use. These both include screening and the provision of brief advice to adult patients. Furthermore, the CQUIN requires a submission of data recording all patients screened and provided brief advice for both VBA and IBA.
We have developed an approach to make the delivery of these CQUINs simple and effective.
What is VBA
Very Brief Advice for smoking is a short discussion that can be had with any patient. Firstly, asking about smoking status and if the answer is ‘yes’ providing some very short advice on impacts and consequences of smoking, and signposting to further smoking cessation support if the patient is open to changing their smoking behaviour.
What is IBA
Identification and Brief Advice on alcohol use is a brief series of questions (3-10 questions) which provides an indication of the levels and potential risk or harm of the patient’s alcohol consumption volumes and patterns. This is followed by 5-10 minutes of brief advice provided in a motivational interviewing style. The brief advice includes, feedback on the patient’s drinking levels, some of the impacts of drinking, and then encourages the patient to consider ways they could change their drinking behaviour and to consider strategies and techniques to do this. IBA is always intended to be delivered with the patient’s consent and is facilitative rather than prescriptive. This can also be delivered through digital means, which can reduce the burden on staff time.
What we can do to help
We have worked in this field for many years and have significant experience in the development of processes, training and tools to help in the delivery and monitoring of IBA and VBA.
Alcohol Identification and Brief Advice
One of the key challenges experienced in delivering IBA has been ensuring consistency and quality of delivery and the recording of activity and results. We have developed an approach that addresses these key issues. We will design and deliver a framework for delivering IBA as part of the CQUIN. This will include:
- A framework for the delivery of the CQUIN – including identifying key champions, delivery points, targets and embedding the CQUIN delivery into the broader provision of support to people with alcohol misuse issues.
- A digital IBA tool and supporting materials to make IBA delivery simpler, and to ensure that data is easily collected and useable for reporting. Evidence shows that digital delivery of IBA is effective, it ensures that IBA is delivered correctly and that results are recorded. The digital tool includes AUDIT and appropriate brief advice to be provided to patients depending on their score.
- Training for staff on the effectiveness and utility of IBA, how it works and how to use the digital tools provided.
- Support for monitoring and evaluating IBA delivery, using easily accessible data captured through the digital tool.
Smoking Very Brief Advice
We will design and deliver a framework for delivery of VBA as part of the CQUIN. This will include:
- A framework for the delivery of the CQUIN – including identifying key champions, delivery points, targets and embedding the CQUIN delivery.
- A digital tool to record the number of smokers offered VBA. The digital tool provides the smoking question and followed by appropriate advice and referral for those identified as current smokers. This is bundled with the IBA digital tool to allow for delivery of both easily to patients.
- Training for staff on the effectiveness and utility of VBA, how it works and how to use the digital tools provided.
- Support for monitoring and evaluating VBA delivery, using easily accessible data captured through the digital tool.