What was the issue that required change?
People at risk of contracting Hepatitis C are often a marginalised and vulnerable group due to homelessness, mental health problems, injecting drug use, engaging in sex work or coming from a minority ethnic group.
They can often face significant health issues due to lack of engagement with mainstream services. They can find the barriers hard to navigate and therefore often have huge unmet health needs.
Led by Mina O’Hara, Blood Borne Virus Nurse Team Manager, the main aim of this project was to provide opportunistic testing for Hepatitis C to detainees in Police Custody in Edinburgh.
The Three Bridges project aimed to reduce barriers for patients by linking services together so patients can access BBV care easily.
How did you tackle it?
This project provided resources from a team of nurse specialists based in both hospital and community settings to support the police custody nursing team to identify, assess, and deliver Hepatitis C testing and referral to treatment to the most high-risk and vulnerable people.
The project aimed to reduce losses and missed opportunities for the testing, care and treatment of Blood Borne Viruses, mainly Hepatitis C. It embedded BBV testing as part of a package of care provided primarily by the clinical forensic nurses, who are based in the custody suite. Working in such a way means patients who are most at risk of BBVs will be identified early and referred to specialist services. This project completes the care pathway for those entering into criminal justice services and works in collaboration with clinics in prisons and DTTO services (Drug Treatment and Testing Orders).
What was the outcome?
Although the project has seen small numbers so far the impact is significant in that those identified have engaged with Hepatitis C treatment services after many years of being disengaged. The overall aim is to include BBV testing as part of a package of care and embed an opt-out testing model which will help to reduce some of the stigma and inequalities around Hepatitis C care and treatment.
Bringing three different nursing teams together in this way ensures every element of the care pathway is covered by highly trained nursing staff.