In response to the COVID-19 pandemic, NHS APA member Avon & Wiltshire Mental Health Partnership NHS Trust (AWP) have joined forces with a number of other local service providers across Dorset to form an innovative cross-provider partnership that is enabling the Dorset HCV Elimination Project plan to continue.
The partners include: Bournemouth, Christchurch and Poole Council (BCP) Drug and Alcohol Commissioning Team (DACT), The Pan Dorset Blood Borne Virus Service (BBV), Homeless Health Services, Hep C Trust Peer Support Lead – Wessex, Hep C U Later Programme Coordinator, and St Mungo’s rough sleeper team.
Chronic Liver Disease is the 5th biggest killer in the UK, and is the only major cause of death which is continuing to rise. It is estimated that in the UK 0.5% of the population are infected with Hepatitis C, with 214,000 individuals being affected. Hepatitis C related end-stage liver disease is continuing to rise and a significant number of individuals remain undiagnosed and untreated.
Three years ago, the UK made an important promise - alongside 193 other countries it pledged to help eliminate Hepatitis C (HCV) by 2030. In January 2018, NHS England announced it was going further and would aim to eliminate it by 2025, making the UK the first country to do so.
This drive for elimination has come with the advent of new direct-acting antiviral treatments which offer 95% cure rates (viral eradication). This is typically administered via a 8-12 week course of daily tablets with minimal side effects.
“Hepatitis C related end-stage liver disease is continuing to rise and a significant number of individuals remain undiagnosed and untreated”.
In light of the Covid 19 outbreak, the Dorset HCV Elimination Project plan has been revised. After securing additional funding through a Hepatitis C Elimination bid, mass screening events had been planned to take place across Dorset over the next 12 months. However, due to the pandemic, such events are unlikely to be sanctioned for some time due to the need for social distancing. Subsequently, with guidance from NHS England (NHSE) and through liaison with *partners an alternative approach has been agreed.
This is an excellent collaborative team effort which will be delivered by all the partners. Care will be brought to those most affected through targeted cohort “test and treat” clinics at suitable locations across the county, including hotels, hostels and supported housing provision where many of the patients are currently living.
Bournemouth, Christchurch and Poole Council had an unprecedented response to Covid 19, which saw 325 individuals who were previously homeless (including rough sleepers), being temporarily housed in Poole and Bournemouth. A similar approach has also been taken by Dorset Council in Weymouth. These individuals, who we have been trying to engage with and treat for Hepatitis C for many years, are now more stable and keen to be treated. This is a massive elimination opportunity that we need to maximise.
“This is an excellent collaborative team effort which will be delivered by all the partners. Care will be brought to those most affected through targeted cohort “test and treat” clinics at suitable locations across the county”.
To date, three clinics have been delivered, they have proved to be a great success and were very well received by those coming forward for testing. In the first week, 33 individuals were tested, 10 of which will start on curative Hepatitis C treatment in the next 2-3 weeks if test results show that they have an ongoing chronic infection that warrants treatment.
This is a fantastic example of collaborative work, and a successful and innovative response to the many challenges that the Covid-19 pandemic has brought, in order to secure the best possible outcomes for service users.
*Partners: Bournemouth, Christchurch and Poole Council (BCP) Drug and Alcohol Commissioning Team (DACT), Avon & Wiltshire Mental Health Partnership NHS Trust (AWP) and the Pan Dorset Blood Borne Virus Service (BBV) Homeless Health Services, Hep C Trust Peer Support Lead – Wessex, Hep C U Later Programme Coordinator, and St Mungo’s rough sleeper team.