This project comprised a model of care and pathway for hepatitis C blood-borne virus (BBV) within drug services in Bournemouth. The project introduced dry blood spot testing to be offered by drug workers within drug treatment services. Follow-up and coordination is provided by staff within the local services and, where appropriate, there is ongoing direct nurse to nurse referral into secondary care for assessment and treatment.
Prior to the service model being introduced just 68% of previous or current drug injectors in Bournemouth accessed drug rehabilitation services for hepatitis C. This has risen to 90% since the programme was introduced.
In 2010/2011 Bournemouth had the highest rate of drug injectors in the South West of England, with an estimated 1,921 opiate and/or crack users, 897 of them injecting.
Bournemouth Drug and Alcohol Team (DAAT) described the provision of testing for Blood Bourne Virus (BBV) as ‘patchy’. Bournemouth was also missing national testing targets. BBV testing at this time was undertaken by the BBV team through venous blood samples. They then followed up those diagnosed with hepatitis C (HCV). This was not considered cost effective.
A new service model and pathway, Dry Blood Spot Testing (DBST), was introduced in June 2011. Drug workers now offer BBV DBST, with the BBV team following up HCV-diagnosed service users, who then follow the local referral pathway.
The main objectives of the DBST initiative were threefold. Firstly, to increase the number of previous or current injectors accessing drug rehabilitation services being tested for HCV, by means of offering a test better suited to those with poor venous access. Secondly, to make better use of the BBV team’s time and resources. And finally, to introduce a clear pathway for nurse to nurse referral to secondary care for clients with chronic hepatitis C in need of assessment and treatment.
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