Theme: Models of Care Year: 2021
Background: To achieve the goal of eradicating Hepatitis C by 2030 (WHO 2016), a novel approach to testing, treating and curing Hepatitis C was needed. The main objective of ‘The Big Blue Bus’, was to shorten the pathway between testing and treating Hepatitis C by providing innovative ways of getting hard to reach groups into treatment. We describe a nurse led clinic located in a mobile bus in the centre of Birmingham with a drop-in clinic for at risk groups such as rough sleepers and people who inject drugs (PWID), who are often not accessing health services. By using a dried blood spot test (DBST) on the first contact, we organise and bring medication to the clinic for the 2nd appointment, negating the need for hospital visits. Description of model of care: • Weekly health bus in the centre of Birmingham, equipped as a stand-alone mobile clinic • Nurse-led service testing for blood borne viruses • 2-step access to treatment for positive cases: 1st appointment DBST, 2nd appointment treatment • Working in partnership with Homeless GP Surgery/Drug services/Street intervention Team/Hepatitis C Trust/Pharmacies/Probation. • Safe, warm, friendly, non-judgmental, confidential clinic • Reducing Stigma of Hepatitis C by raising awareness. • Signposting to other agencies such mental health, A&E as required Effectiveness: May 2019- Mar 2020 No. Tested HCV AB + HCV RNA + Commenced HCV Treatment Quarter 1. (May/June) 132 45 28 (62%) 19 Quarter 2. (July/Aug Sept) 64 27 15 (55%) 11 Quarter 3. (Oct/Nov Dec) 66 24 14 (58%) 13 Quarter 4. (Jan/Feb/Mar) 45 27 15 (55%) 11 Total 307 123 72 54 Conclusion and next steps: A mobile clinic set up in areas targeting those hardest to reach allows us to move to different locations. As the Bus developed over the months, we have moved from solely dry blood spot testing and treatment to being able to assess Liver staging and obtain venous sampling. Cirrhotic patients have been referred into local hospital for surveillance. Next step will be to re-locate the mobile clinic outside a Homeless Hostel in Birmingham. Disclosure of Interest: None
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