Theme: Models of Care Year: 2024
Background: We have an established in-reach service for BBV screening and treatment within NHS Lothian prisons, provided by the WGH BBV team ensures patients are seen quickly when moving between community and prison.
We recognised a gap in care between community and prison: police custody; many who attend custody do not end up in prison and may not attend other services. Therefore contact with nurses in custody may be their only healthcare input; it is an opportunity to see those at risk of BBVs, for harm reduction interventions and BBV screening.
Description of model of care/intervention/program: A BBV CNS and BBV CSW attended a 2 hourly weekly clinic in Edinburgh’s central police station to offer BBV screening. From Jun-Dec 2023 31 detainees were seen in this clinic for BBV screening. Average monthly throughput in this station is 476-700 people; around half attend at weekends. Training and supporting nursing staff within custody was key, to providing BBV screening 24 hours a day 7 days a week, ensuring equity of care and targeting the busier times over weekends.
Effectiveness: Improved patient outcomes and communication between services.
Reduced stigma about BBVs.
A custody specific BBV risk assessment and a direct referral pathway with BBV treatment team at local hospital was established.
Conclusion and next steps: Identifying ‘BBV champions’ within the police and NHS teams was instrumental in driving this project forward.
Custody nursing staff now offer BBV screening to detainees in police custody. It has been a slow process with many hurdles so ongoing review and support from BBV team to ensure BBV screening in police custody becomes embedded within the service.
No other service providing this care in the UK, this model joins the gap between community, police custody and prison, improving continuity of care for our patients.