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Working to eliminate Hepatitis C in prisons

Tuesday 28 July is World Hepatitis Day.  The Day aims to raise awareness of what is often an undiagnosed illness and this year, is calling on people across the world to take action and find the ‘missing millions’ who are living with hepatitis unaware.  

Nottinghamshire Healthcare’s prison and immigration removal centre healthcare teams have been working incredibly hard and with great success to identify and eliminate Hepatitis C in the prison population.  By raising awareness and holding special screening events where testing and treatment is offered to all prisoners, the teams are making headway in their goal to achieve micro-elimination of this condition.  

Micro-elimination involves eliminating a virus in defined segments of the population as a way to incrementally achieve national elimination. The approach sets out realistic elimination goals, is less complex and less costly than a full scale country-level initiative and can build on and share best practice and models of care. Last year, the healthcare teams achieved micro-elimination in HMP North Sea Camp and Morton Hall Immigration Removal Centre in Lincolnshire.

Even the Covid-19 pandemic has not stopped the teams’ efforts to tackle Hepatitis C in the prison population.  Over a two week period in May, the healthcare team at HMP Lowdham Grange ran a High Intensity Test and Treat programme, offering all 887 prisoners dried blood spot testing and relevant follow up treatment.  This test can identify a number of blood borne viruses including Hepatitis C.  The mammoth task was a coordinated approach between the prison and the healthcare team, offering pop up clinics on the wings.  There was also a campaign to raise awareness of the virus and how the men could take steps to prevent catching it. This coupled with an incentive of telephone credit for the prisoners proved to be a large part of the successful uptake.  

This huge effort resulted in 81% of the prison population being tested and has contributed to HMP Lowdham Grange’s progress on achieving micro elimination in the prison population and contributing to the national drive for the eradication of Hepatitis C . 

The Hepatitis Trust has been kept informed of the work and will be holding focus groups in the future with those prisoners who have repeatedly declined to have the the testing. 

The team at HMP Lincoln has also been working hard in their aim to achieve micro-elimination.  Special screening days have been held on each wing to offer testing to everyone for Hepatitis C as well as Hepatitis B and HIV.  This was a collaborative effort with the prison, the Hepatitis C Trust, United Lincolnshire Hospitals NHS Trust and Lincolnshire Partnership NHS Trust, enabling the testing programme to be supported by peer support, experience and training and mentorship.  The prisoners were also offered Incentive Earned Privileges for engagement in the programme.

The combined efforts of everyone involved has proved successful with 343 out of 560 prisoners agreeing to testing so far and the team has high hopes that this success will continue towards eradication of Hepatitis C. 

Susan Elcock, Executive Director of Forensic Services, Nottinghamshire Healthcare said:  “The Trust could not be prouder of the achievements of all of our prison and immigration removal centre healthcare teams in their work towards achieving micro elimination of Hepatitis C.  I have been out visiting the teams and their commitment towards providing a high level of care to the patients is inspiring, particularly in what have recently been incredibly challenging times. I want to thank everyone for all of your hard work.”

The positive cases that have been identified through this work are now receiving treatment to cure their Hepatitis C. This demonstrates the effectiveness of the screening and the direct effect this has had on patient outcomes, reducing the risk of significant complications later on in life. 

 

Pictured - some of the team at HMP Lincoln with awareness raising materials

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