Smoking sheds -- similar to bus shelters - for Bradford hospital workers to have a cigarette break, are among ideas under discussion by health chiefs.

Bradford Hospitals NHS Trust aims to ensure a smoke-free and safe environment for patients, visitors and staff.

But John Dammon, trust corporate affairs director, said: "It is unrealistic to seek a total ban on smoking for staff, not least because of the risk of illicit smoking in potentially hazardous areas."

The staff smoking room at Bradford Royal Infirmary was poorly ventilated, despite air conditioning, and action was needed, said Mr Dammon.

Board members had agreed that seeing people standing around outside hospital entrances smoking gave a bad impression, but concerns about security of staff using the smoking sheds, especially at night, were raised. They were also worried about staff leaving wards and departments to go outside for a cigarette.

The board agreed there should be a total ban on visitors smoking in the hospital - but there were potential problems policing the ban.

Mr Dammon said: "It can be difficult for staff to enforce the policy when some patients and visitors refuse to comply, particularly in the context of growing numbers of reported violent acts."

Plans to provide designated smoking areas for patients, perhaps serving a cluster of wards, were welcomed by trust board members.

But flexibility was needed for patients, especially those who were terminally ill and unable to leave the ward. Immobile patients could be permitted to smoke in a "safe" area, at the ward manager's discretion.

A £22,000 grant from Bradford's Health Action Zone will train staff in the best ways of encouraging patients to give up smoking. And a patient-counselling pilot scheme in Bradford Royal Infirmary's ear, nose and throat department will bid for more HAZ cash if it proves successful.