Ahead of World Hepatitis Day (28th July) and part of NHS England’s plan to eliminate the blood borne virus in advance of 2030, a pilot programme has been launched which will use primary care records to accelerate the early diagnosis and treatment of the estimated 81,000 people unknowingly living with Hepatitis C in England. (1).
A recent UK Health Security Agency (UKHSA) report has indicated that most of the remaining infection – an estimated 50,000 people - may be from historic risk factors best found within the primary care population.
The pilot programme, led by NHS England (NHSE) in collaboration with MSD, will use Patient Search Identification (PSI) software, alongside EMIS Pathway which helps find patients with certain conditions, or those at risk of them, and manage their care.
Starting in Autumn the three-month programme will search an estimated 300,000 primary care records for patients who have a coded Hepatitis C virus positive test, but no treatment record, and those with at risk factors, such as intravenous drug use, blood transfusions or organ transplantation before 1992.
Once an at-risk patient has been identified, one of the seven Operational Delivery Networks (ODNs) signed up to participate in the programme will invite the patient for a review, screening and if appropriate, treatment.
Dr Ian Wood, a GP and EMIS Clinical Director, said: “At a time when primary care is enormously overstretched with both a workload and workforce crisis, it was critical that any new technology aiming to reverse and spearhead this did not exacerbate the capacity issue.
“The pilot aims to address this gap. It realises the value and power of primary care data, combined with EMIS-X Analytics, in identifying cohorts of patients across a region who might benefit from an intervention. This is a challenge that can be tackled well in multiple healthcare settings, so rather than keep these lists within the GP practice, all the necessary data permissions and safeguarding is in place to share with the most relevant healthcare team that can best meet those patients’ needs. It doesn’t have to be the GP - working together across the healthcare industry we can get the best care to the right patients in as efficient a way as possible.”
The pilot programme, which requires GP practices to simply agree to share only the relevant primary care data with specialist secondary care teams within the local ODN, comes after Hepatitis screening rates declined within primary care by 36 per cent during 2020 due to Covid-19 restrictions. (1)
Commenting on the importance of screening using primary care records Dr Stuart Flanagan, consultant physician of HIV and BBV Medicine, said: “Patients at risk from Hepatitis C within primary care are especially hard to reach. But it’s vital that we do.
“The virus can be asymptomatic for decades with many patients often unaware that they have the condition until it’s developed into far more serious, more difficult to treat conditions, and even fatal illnesses such as cirrhosis, liver disease or cancer.
“Combine this with there still being stigma attached to the virus, which means some patients may not feel comfortable sharing parts of their current or past lifestyle with their GP, and you’ve got a big hurdle we need to overcome.”
Dr Flanagan who works at the Mortimer Market Centre in London and is the Hepatitis Lead for Central and North West London NHS Foundation Trust, adds: “This isn’t just about eliminating Hepatitis C, it’s about preventing a treatable condition from developing into life threatening illnesses. We can’t afford to wait for patients to ask for help, by that time it’s far too late. We need to go to them."
