Theme: Models of Care Year: 2018
In Lothian, Scotland all Hepatitis C (HCV) assessment and treatment has historically been
delivered via secondary care services, which have a high “non attendance” rate. Many of the
barriers to HCV treatment have now gone: treatment is shorter in duration with minimal side
effects and better treatment outcomes. In order to improve treatment uptake we liaised with a
local GP surgery that has a number of HCV positive patients who had not attended the hospital
service but attend the GP surgery for opiate substitute prescriptions or other routine medical
Description of model of care/intervention:
Our aim was to move our HCV service from secondary to primary care, thus improving
treatment accessibility. We developed a shared care protocol with a GP with a special interest
in HCV. The GP is responsible for assessing patients and carrying out baseline investigations.
Fibro scans can be carried out either at the GP clinic or in secondary care. All individual cases
were discussed at a weekly MDT which the GP attended in person or via tele conference.
Attendance at the GP primary care clinic has been good. Since the clinic commenced in
October 2017, out of 28 HCV positive patients, two have completed treatment, five are
currently on treatment, one has been approved for treatment but hasn’t yet started and a
further four are attending the clinic for assessment.
Conclusion and next steps:
This shared care protocol has helped to improve the uptake of HCV treatment in a patient
group who were not accessing HCV services. The clinic was also an opportunity to discuss
other aspects of health related to HCV such as alcohol and drug use, and to ensure
appropriate support and/or referrals. We hope that this model can be replicated in other GP
surgeries in Lothian.
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