Theme: Epidemiology & Public Health Research Year: 2024
Background: To meet the World Health Organisation elimination target for Hepatitis B and C, Blood-Borne Virus (BBV) testing in settings attended by people at high risk has widely evolved. Testing is offered through a range of professionals and organisations which include substance use key workers, BBV nurse, third sector organisations and peers. An innovative approach has been developed in Wales with Biomedical Scientist and laboratory trained Point of Care Practitioners establishing a key role in the expansion of BBV testing. The team have led high intensity testing initiatives across a range of settings, demonstrating enhancement of diagnostic and treatment outcomes.
Methods: Rapid Point of Care Testing (POCT) has been used to identify Hepatitis C infections alongside Dried Blood Spot Testing (DBST) to diagnose HIV and Hepatitis B. In each initiative, key stakeholders have collaborated to design bespoke pathways for their service. Lookback exercises have been facilitated to review current clients, identifying past BBV history and enabling the correct diagnostic test to be selected. An appointment system offered efficient access to testing. Exit plans were developed with services to enhance sustainability of testing when the initiative finished. Robust result reporting mechanisms were established for clinical governance and epidemiology purposes.
Results: In 2023, a team of three laboratory trained professionals held screening events at 35 different sites across Wales. 2720 BBV tests were performed including 1092 Hepatitis C antibody POCTs, 307 rapid HCV PCR POCT and 1321 DBST. All patients diagnosed were referred to specialist teams for treatment.
Conclusion: Biomedical Scientists in clinical facing roles is a new and exciting concept. Leading high intensity BBV screening has proven to be highly efficient with the skills and expertise of the team enabling the provision of an enhanced, high-quality service. The logical, rational and methodical working practices along with adherence to quality assurance processes ensured test performance accuracy and specificity. The teams’ knowledge of quality control processes enabled early identification of errors allowing prompt corrective measures to be applied.