Theme: Models of Care Year: 2024
Background: Needle and Syringe Programmes (NSPs) are crucial in minimizing hepatitis C, HIV, bacterial infections and other harms among people who inject drugs (PWID). UK NSP coverage is estimated at 30-35%. Barriers to more effective coverage include the loss of discrete, anonymous NSP arising from integrated recovery services. Consequently, the number of people sharing and re-using injecting equipment remains high, with a third of PWID sharing and reporting they don’t have sufficient access to NSP.
Programme of work: Change Grow Live (CGL) is the largest provider of substance use treatment in the UK, delivering a third of all treatment across 106 services. Its programme to achieve and sustain micro-elimination of Hep C includes:
•NSP re-promotion within CGL and across the treatment sector, supporting staff’s continued professional development.
•Participating in the UKHSA working group to standardize measuring of NSP coverage.
•A full harm reduction re-training program aimed at frontline workers.
•Working with the harm reduction social enterprise Exchange Supplies providing an online ordering system (NSP Direct) delivering sterile equipment to people’s home address.
•A strategic refocus on NSP/ blood borne virus (BBV) interventions as standardized operating procedures, with named Harm Reduction Leads in services.
•A network of Pharmacy Liaison leads across CGL driving quality improvement.
•Contributing to the UK’s NHS hepatitis C elimination strategy through the Treatment Services Hepatitis C Provider Forum.
Effectiveness: Over 35,000 people were tested for hepatitis C and other BBV in CGL services between April 2022 and March 2023 – with over 1,400 going on to access treatment. Six services and two hubs achieved hepatitis C micro-elimination.
Conclusion and next steps: A renewed focus on NSP coverage and harm reduction is required to sustain recent success in Hep elimination. To achieve this, we need sector-wide collaboration to the level achieved in the micro elimination of Hep C.