Up to 83% of the expected number of patients with chronic hepatitis C have already been diagnosed by the proactive blood-borne virus testing carried out by community drug treatment services in Leeds. Once stabilised in drug treatment services, these patients are offered further investigations with a view to referral for antiviral therapy in the locally-commissioned Community Hepatitis C Service.
This beacon service provides a diagnostic, investigation, referral and treatment service for people living with hepatitis C who have traditionally found it difficult to access treatment programmes in conventional hospital-based clinical settings. This allows for continuity of care between prisons, hospital and the community drug treatment service.
Patients were not being successfully recruited into treatment for hepatitis C from prisons or from the community drug treatment service in Leeds, despite significant numbers of diagnoses and referrals.
A community multidisciplinary team launched in January 2012, formalising the service in HMP Leeds and the Rapid Access Prescribing Service (RAPS). This allows continuity of care between prison and the community, and between primary and secondary care providers.
Opt-out blood borne virus screening for new prisoners was implemented on April 1, 2014. This could add to the burden of diagnosed hepatitis C infection, along with the challenge already posed by the 18-week referral to treatment compliance required by the current service level agreement.
The main objective was to provide a high quality, GPSI prison-based Hepatitis C treatment service for up to 24 patients (or 16 patients with three on protease inhibitors), at any one time, at HMP Leeds and HMP Wealstun.
The project also aimed to provide clinically appropriate hepatitis C positive prisoners at the two prisons with early access to treatment and support.
Other objectives included providing a hepatitis C treatment that achieves SVR (Sustained Viral Response) rates comparable with published results according to genotype, and supplying service users with information and advice regarding hepatitis C.
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