Theme: Models of Care Year: 2024
Background: NHS England (NHSE) seek to achieve elimination of Hepatitis C (HCV) ahead of the WHO target of 2030. It is important that there are effective testing and treatment pathways for those accessing drug treatment services (DTS). The HCV DTS Provider Forum was established by Gilead Sciences under the NHSE HCV Elimination Program bringing together 5 third sector providers of DTS in England, 14 NHS Trusts and The Hepatitis C Trust to encourage collaboration and innovation.
Description of model of care/intervention: The HCV DTS Forum reached consensus on criteria for achieving micro-elimination within a DTS. These criteria have been collaboratively established through extensive review. It is important to note that there are caveats around the criteria, which are not intended to be a definitive definition of elimination, but aspirational targets to drive elimination efforts.
Agreed Criteria:
•100% of clients offered BBV screening.
•100% of those with a history of injecting have been tested ever
•90% of current & previous injectors (at risk) have a test date within the last 12 months
•90% of HCV+ patients commencing DAA treatment (or 90% of service users with a positive HCV polymerase chain reaction (PCR status) having successfully completed treatment or cleared naturally)
Effectiveness: Development of agreed micro-elimination criteria has supported HCV elimination efforts within DTS in England. Provider Forum DTS members have delivered over 200,000 HCV tests since September 2019 with over 10,0000 individuals starting treatment. There have been 41 micro-eliminations across forum member DTS.
Conclusion and next steps: Providing specific testing and treatment targets supports HCV elimination efforts. DTS staff find specific targets motivational, and declarations of micro eliminations have spurred services to increase effort. It is recognised that there may be at-risk individuals that are excluded from these criteria so we intend to re-evaluate the criteria to include a wider population.