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

2. Background A long, long time ago ….. 2005 - 2007
Extensive research across Wales
Summary evidence reports
Available at:

3. 2010
Minister for Health announces £1.377 recurrent funding for Blood borne viral Hepatitis Action Plan for Wales

4. 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

5. 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

6. Structures

7. 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

8. 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

9. 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

10. 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 (700+ current IDUs)
Improved uptake of testing amongst most high risk groups
Behavioural / risk behaviour questionnaire to support evidence of transmission UK wide

11. 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:

12. 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

14. 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

15. 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

16. Contact details Marion.lyons@wales.nhs.uk Josie.smith@wales.nhs.uk
Copy of Action Plan available at: