Theme: Models of Care Year: 2022
Background:
National Health Service England (NHSE) plans to eliminate Hepatitis C (HCV) by 2025. With a
reported HCV prevalence of about 6% in male prisons, and about 12% in female prisons, secure
environments are an essential component of this elimination plan. Yorkshire is a region in England
with a general population of about 3.7M. PPG is the provider of healthcare to 9 prisons in Yorkshire,
with approximately 6,000 residents, many of whom are current, or previous, substance users.
Description of model of care/intervention:
To support NHSE in the elimination of HCV, a partnership between Gilead Sciences, Practice Plus
Group (PPG) and the Hepatitis C Trust (HCT) was formed in 2019. This partnership works with prison
and hospital teams to optimise test and treat pathways for new prison admissions. In addition,
whole prison HCV Intensive Test and Treat events (HITT programmes) were run in targeted prisons
to ensure testing of residents who were incarcerated before these optimisations were implemented.
Effectiveness:
HCV screening, within 7 days of prison entry, increased from 27% in May 2019 to 93% in January
2022. This increase was achieved despite COVID-19 restrictions remaining in place since March 2020
across all English prisons. In addition, HITT programmes were used to test residents who were
missed at prison entry. The overall result is that 8/9 prisons have achieved micro-elimination status,
as defined by: ≥95% of prison residents tested within the previous 12 months, ≥90% of RNA positive
patients treated or initiated on treatment and presence of a robust system to review ongoing testing
and treatment performance to ensure these targets are maintained.
Conclusion and next steps:
Micro-elimination of HCV will now need to be maintained in these prisons by ensuring the uptake of
HCV testing remains >95%. Plans are in place to micro-eliminate the final prison – which is a highsecurity prison presenting unique challenges to HCV micro-elimination.
Disclosure of Interest Statement:
Gilead funds, and plays an active role in the design and execution of, the activities with Practice Plus
Group and the Hepatitis C Trust, as part of the NHS England HCV Elimination Program.