Theme: Models of Care Year: 2022
Background:
People with Significant Mental Illness (SMI) often report engaging in risk behaviours including
injection drug use (IDU) and are therefore at increased risk of acquiring hepatitis C virus (HCV).
Limited integration between mental and physical healthcare services frequently means that this
population neither accesses nor receives appropriate care for HCV, increasing their risk of
developing advanced liver disease.
Description:
A pilot project initiated by Hep C U Later targeted patients under the care of Community Mental
Health Team (CMHT) services within Dorset to: undertake point of care (POC) testing and support
those with active HCV infection to access treatment services; and educate all CMHT staff on the HCV
elimination agenda. Working in partnership with a representative from the local Clinical
Commissioning Group (CCG), we created a HCV Elimination Strategic and Operational Board to
better coordinate the work of the pan-Dorset teams, and to provide strong governance for the
various bids and HCV initiatives.
Effectiveness:
Although the pandemic hindered delivery of the project, under the Board’s guidance, regular clinics
were established within one CMHT, where 5 patients with active HCV infection were directly linked
into treatment. A further 10 patients with active HCV infection were assertively engaged and
supported to access treatment. Training workshops were delivered to 85+ CMHT staff, with
resources created on HCV and poor mental health. HCV care pathways were reviewed, negotiated
and established.
Conclusion and next steps:
The pilot demonstrated that, through enhanced joint working with CMHT, patients with SMIs can be
supported to access HCV services more effectively; and valuable insights into the experience of
patients who bridge substance misuse and mental health services can be obtained. The board will be
examining where there are further opportunities to align more strongly across CMHT and CCGs to
provide those with SMIs better access to HCV care.
Disclosure of Interest Statement:
This project has been supported through an Association of the British Pharmaceutical Industry (ABPI)
‘Joint Working’ initiative between Gilead Sciences Ltd. NHS Addictions Providers Alliance (Hep C U
Later) and NHS England.