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ELIMINATING HEPATITIS C: A MOVE TOWARDS PLACE-BASED HEALTH DELIVERY IN THE UK
Stuart Smith, Head of Drug & Alcohol Services, The Hepatitis C Trust, 28 July, 2017

In the UK, we’ve been talking for some time now about place-based ‘systems of care’. These are born out of collaboration with other NHS organisations and services to address challenges and improve the health of the populations we serve. At The Hepatitis C Trust, we’ve been making this happen by collaborating with patients and trusted organisations to offer the best possible care in and around hospitals for those at risk and diagnosed with hepatitis C.

Achieving the national ambition to eliminate hepatitis C as a public health threat by 2030 requires a local focus on the issues we still face. In a meeting hosted by AbbVie to mark World Hepatitis Day, local authorities in London have agreed priority actions with third and public sector organisations. For us, the opportunity to be at the table helps us agree the approach we take in a specific area and affect changes in the way health services are commissioned.

One innovative model of care shared at today’s meeting is a peer support scheme run by King’s College Hospital NHS Foundation Trust, in partnership with The Hepatitis C Trust. The scheme has just launched in the London Borough of Lambeth, which has the highest estimated prevalence of hepatitis C in London. Nearly 2,500 people are thought to be living with the virus in the borough, with an estimated 1,800 either untreated or undiagnosed.(1)

The scheme sends trained peer-educators, with lived experience of hepatitis C, out into the community to reach hundreds of people who remain undiagnosed or who are without support. Many of the people we’re trying to reach are already accessing drug and alcohol addiction services in their area. By partnering with these service providers, we can inform people about their risk of hepatitis C, how to prevent infection, and the effective new treatments that are available. Once this connection is made, the peer-educator can provide ongoing support to get tested, diagnosed, and treated with a hospital consultant – without having to rely on a GP appointment for a referral. This model has proven successful in counties across South West England, where our first pilot was able to increase the number of people being tested by 141 percent.(2)

To get to where we are today has required the backing and support of national bodies and policy-makers, and fundamental changes to the role of commissioning in the NHS. Only by starting from the ground up, in targeted areas, with the right people who can enable this kind of change, can peer support schemes work. We’re now doing this across ten sites in the UK, including a new peer support scheme about to launch in Newcastle. It’s a way of working that we hope will help us achieve our over-arching goal: to shut down because we are no longer needed. In other words, because hepatitis C has been eliminated in the UK.

(1) Public Health England, Hepatitis C: guidance, data and analysis. Hepatitis C: commissioning template for estimating disease prevalence, March 2014. Available at https://www.gov.uk/government/publications/hepatitis-c-commissioning-template-for-estimating-disease-prevalence Accessed July 2017

(1) Evaluation of the South West Hepatitis C Partnership Pilot. Available at http://www.hcvaction.org.uk/sites/default/files/resources/Hepatitis%20C%20Partnership%20Evaluation_1.pdf Accessed July 2017