This project set out to identify patients in general practice with a diagnosis of hepatitis B or hepatitis C with a view to encouraging appropriate investigation, management and referral of these patients. Patients were reviewed and offered further testing, immunisation and referral as clinically indicated.
The project also encouraged practices to screen high-risk patient groups for blood-borne viruses and to immunise at-risk patients against hepatitis B.
Data from the hospital service showed there was an increase in BBV screening and testing for HIV, hepatitis B and hepatitis C by 62%, 16% and 18% respectively compared to the same period 12 months previously. A total of 124 immunisations were given.
One of Scotland’s most deprived cities, Dundee has a high incidence of sexually-acquired HIV in men who have sex with men (MSM), and certain ethnic groups.
Access to records of hepatitis B and C positive patients showed that a significant number had never accessed the hepatitis service, or had done so but missed follow-up care. Practice registers of hepatitis patients were poor.
Dundee CHP already knew that screening those at risk of BBV helped uncover unknown cases of hepatitis B and C. The best way to encourage BBV patients back into service was through contact with a general practice, and that the best approach to screening at-risk patients was for GPs to proactively screen those with BBV transmission-associated risk factors.
The aim was to engage as many Dundee GP practices as possible, establish a credible BBV team to support clinical engagement and give GPs access to current clinical knowledge.
The project hoped to reconcile the BBV Managed Clinical Network (MCN) hepatitis B database with GP practice registers, and to furnish the latter with read codes to allow call/recall of patients. GPs were to be encouraged to refer patients with suspected BBV back into secondary care.
Objectives included boosting the number of at-risk patients screened by GPs, carrying out more screenings in general practices and increasing immunisation. The project also aimed to improve patient access to diagnosis, treatment and follow-on care. The model had be suitable for roll out across Tayside.
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