Blood borne viral hepatitis action in Wales Presenter: Dr Marion Lyons, Josie Smith Health Protection

Background A long, long time ago ….. 2005 - 2007 Extensive research across Wales Summary evidence reports Available at: http://www.wales.nhs.uk/sites3/page.cfm?orgid=457&pid=25483

2010 Minister for Health announces £1.377 recurrent funding for Blood borne viral Hepatitis Action Plan for Wales

Contributors Welsh Assembly Government Health Service Planners Health Boards - NSE and health promotion Health Boards - Primary Care Health Boards – Treatment and care Local Authorities The National Offender Management Service Non statutory organisations including patient groups Public Health Wales

Public Health Wales Roles and responsibilities Supporting developments aimed at increasing awareness, development of training and education programmes Development of communications plan Implementation of national data collection system for needle and syringe programmes Development of diagnosis via dried blood spot testing Supporting and monitoring Health Boards in delivery of local action plans Supporting sub and task/finish groups Supporting Welsh Assembly Government

Structures

Prevention, education and awareness raising Harm reduction database Lack of evidence re. prevalence of injecting drug use in Wales  denominator data required for incidence and modelling potential burden of disease Evidence of ‘patchy’ NSP provision across Wales Primary means of accessing, informing and preventing onward transmission amongst most at risk groups System live in statutory and voluntary sector needle exchange services (including mobile services) 1st September 2010 To date over 2000 injectors registered Next steps – roll out in community pharmacy based services

Prevention, education and awareness raising Development of endorsed BBV training programmes: Level 1 – all individuals working with those currently or potentially at risk of infection with blood borne viruses (HBV, HCV and HIV) Level 2 – all individuals responsible for diagnosing and treating individuals for blood borne viruses

Prevention, education and awareness raising Ongoing work focusing on: Improving BBV services for offender populations in Wales Research project – ‘How best to deliver health care messages re. BBVs’ Targeted and generic awareness raising programme

Diagnosis & Surveillance Dried blood spot testing (DBS) Pilot study in North West Wales CDT Means of testing for BBVs without need for venepuncture (in first instance) Same protocol as utilised in prevalence and incidence study 2005-2007 (700+ current IDUs) Improved uptake of testing amongst most high risk groups Behavioural / risk behaviour questionnaire to support evidence of transmission UK wide

Diagnosis & Surveillance Strengthening of existing surveillance systems – e.g. Co-surv Development of new patient management tools Active case finding tools in primary care Data matrix available at: http://www.wales.nhs.uk/sites3/page.cfm?orgid=457&pid=25483

Treatment and care pathways Each of seven treatment centres in Wales develop local action plan Establishment of testing and treatment in Community settings e.g. Drug services, primary care Development of clinical networks and consensus on treatment for HBV and HCV

Stakeholder engagement and events BBV workshop – 18th Nov 2010 Aimed to identify existing best practice and areas for improvement Opportunity to achieve consensus on treatment for BBV hepatitis in Wales Lead clinicians from all treatment centres in Wales BBV nurse specialists BBV Leads from all drug services

Stakeholder engagement and events BBV Action in Wales Conference on World Hepatitis Day July 2011 Open to all stakeholders and interested parties Progress to date Areas for improvement Evaluation of interventions Next steps

Contact details Marion.lyons@wales.nhs.uk Josie.smith@wales.nhs.uk Noel.craine@wales.nhs.uk Jane.salmon@wales.nhs.uk Copy of Action Plan available at: http://wales.gov.uk/docs/phhs/publications/100226actionplanen.pdf