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Background
Welsh Government tasked prisons in Wales to achieve elimination of Hepatitis C as a public health threat by 2030 in line with World Health Organisation targets; i.e. 100% of the prison population offered a test, 90% uptake in testing and 90% of those diagnosed with Hepatitis C starting treatment. A monitoring process was required to enable evaluation of the progress towards elimination. and to announce micro-elimination.
Description
All prisons use the electronic healthcare record; SystmOne. This holds clinical information, documented in templates and data items coded as “read codes” (acting as a thesaurus of clinical terms). Collaborative working enabled the roll out of a uniformed approach to documenting the offer and uptake of blood borne virus (BBV) testing using existing templates. Colleagues with expertise to interogate the data, created a cohort of reports using the read codes held within the BBV templates so allowing prisons to view their progress to elimination in real time and facilitate reporting of appropriate metrics. The reports can be used at both prison and national level.
Effectiveness
The reports provide prison level data that allow prisons to evaluate their progress and amend / tailor their systems at local level to improve progress towards micro-elimination. The reports can also be analysed at patient level to determine who has not yet been offered, taken up a test or is due a repeat test. The system includes a tool for checking inconsistency in data quality.
Conclusion
Progress to elimination within the prisons can now be evaluated through a uniform approach to documentation and data analysis. The reports identify where the offer and uptake of testing is successful and where quality improvement initiatives are needed. As an All-Wales tool, reports are directly comparable with each prison on a national level and can identify prisons that are working well and those that need intervention.
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