Speak up for elimination: General Election 2017

Transcription

1 Speak up for eimination: Genera Eection 2017

2 A manifesto for eimination About The Hepatitis C Trust This manifesto outines what we woud ike the next UK Government to do in order to ensure that we eiminate hepatitis C as a major pubic heath threat by 2030, in ine with our goba commitment to do so. No matter the make-up of the next Government, hepatitis C must receive the attention that it deserves as a serious pubic heath issue that affects some of the poorest and most disadvantaged peope in our society. Despite the seriousness of the issue, hope springs from the fact that hepatitis C is one pubic heath issue we reay can do something about in a very short space of time. By diagnosing, treating and curing more peope, we can eiminate hepatitis C by 2030, so et s get on and do it. The Hepatitis C Trust is the nationa UK charity for peope with hepatitis C. Founded in 2001, we are patient-run and most of our board, staff and vounteers either have or have had hepatitis C. We provide a range of support services to peope affected by hepatitis C, and work with frontine services (such as prisons and substance misuse services) to improve their response to hepatitis C. We aso campaign for a more ambitious approach to be taken to addressing the virus, and engage with poicy-makers across the four nations of the UK to ensure that increased numbers of peope are tested, diagnosed and treated for this preventabe and curabe condition. Our overarching goa is for hepatitis C to be eiminated as a serious pubic heath concern in the UK by Key facts 214,000 peope in the UK are estimated to be chronicay infected with hepatitis C. An estimated 50% of peope with hepatitis C remain undiagnosed. Over the ast decade, hospita admissions from hepatitis C-reated iver disease have neary triped and deaths have doubed. Amost haf of peope who go to hospita for hepatitis C are from the poorest fifth of society. In May 2016, the UK Government pedged its support for the WHO s goa of eiminating hepatitis C as a major pubic heath threat by Speak up for eimination: Genera Eection

3 What is hepatitis C? Our vision Hepatitis C is a bood-borne virus affecting the iver. Four-fifths of those infected deveop chronic hepatitis C, which can cause fata cirrhosis and iver cancer if untreated. Around 214,000 peope are chronicay infected with hepatitis C in the UK, with 160,000 of these in Engand. Peope iving with hepatitis C no onger have to face stigma or discrimination as a resut of the virus. Peope diagnosed with hepatitis C receive appropriate support in order to ensure they are abe to cope with their diagnosis and be supported into the care pathway. Hepatitis C is transmitted through contact with infected bood. The majority of cases arise through injecting drug use, though there are other causes, incuding overseas medica care, tattooing and receipt of a bood transfusion or bood products in the UK prior to Peope are abe to ive without symptoms for decades after infection, but untreated cases can ead to severe iver probems. Liver disease is one of the five big kiers in the UK and is the ony one of these where mortaity is rising. Hepatitis C is the third most common cause of iver disease. Hepatitis C disproportionatey affects disadvantaged and marginaised communities, with amost haf of peope who attend hospita for hepatitis C coming from the poorest fifth of society. 50% of injecting drug users in Engand are infected with the virus. Other groups who are disproportionatey affected incude homeess peope, prisoners and migrant communities from countries with a high prevaence of hepatitis C, such as Pakistan and Poand. Hepatitis C testing is considered a routine part of heathcare, and heathcare professionas have a comprehensive knowedge of hepatitis C. New, curative hepatitis C treatments are avaiabe to everyone. Nationa pans for eiminating hepatitis C exist in each nation of the UK, with a view to eiminating hepatitis C by Current poicy andscape In May 2016, the UK joined 193 other member states at the 69th Word Heath Assemby in committing to eiminate hepatitis C gobay by New drug treatments for hepatitis C have been approved as cost-effective for use on the NHS in Engand by the Nationa Institute for Heath and Care Exceence (NICE). With high cure rates and few side-effects, these new treatments offer the opportunity to treat more peope and eiminate hepatitis C as a serious pubic heath concern in Engand. However, in many respects Engand is faing behind in terms of internationa efforts to address hepatitis C. Despite previous commitments by the Government to produce a nationa strategy for tacking the virus in Engand, no such strategy has emerged. In addition to the absence of any nationa strategy to address hepatitis C, NHS Engand has aso taken the unprecedented step of pacing a cap on the number of patients who can access treatment, specifying a imit of 12,500 treatment initiations for 2017/18. Together with oca run rates for treatment to which each area must adhere, this approach denies peope with hepatitis C their right to NICE-approved treatments as enshrined in the NHS constitution, and imits the potentia that exists to eiminate hepatitis C as a serious pubic heath concern. 03 Speak up for eimination: Genera Eection

4 What peope with hepatitis C need from the next Government Prevention The provision of hepatitis C awareness campaigns and prevention services varies across oca authorities, with budgetary pressures often cited as a factor behind cuts in support. Support for a treat a strategy (focused on providing treatment in community settings) which woud end the cap on the number of peope who can be treated and ensure an increase in the number of patients receiving NICE-approved hepatitis C treatments. Commissioning To protect and increase ring-fenced pubic heath funding to oca authorities, to ensure they are abe to fufi their duty to raise awareness of hepatitis C and providing effective prevention services, Testing such as neede exchanges. Currenty, there can exist confusion around commissioning responsibiities for hepatitis C services. As a resut, the pathway can often fai to reward investment and commissioners at certain points of the pathway (particuary Cinica Commissioning Groups) can be ess incined to view hepatitis C as a priority area. With ony around haf of a peope with hepatitis C in Engand diagnosed and a arge proportion of those aready diagnosed not in touch with services, we wi soon run out of peope to treat in some parts of the country, despite the rationing. To issue a paper carifying hepatitis C commissioning responsibiities, and to communicate these responsibiities to a reevant commissioning bodies. To deveop a hepatitis C action pan focused on deveoping the practica steps required to increase testing and diagnosis, in order to ensure the fufiment of the WHO s diagnosis and treatment targets. The pan must emphasise the importance of inking diagnosed patients into the treatment pathway and set out a strategy for re-engaging previousy diagnosed patients who have been ost to care. Treatment Prisons Hepatitis C prevaence in prisons is estimated to be around 20%. However, testing rates in prisons remain highy variabe, and the avaiabiity of treatment for prisoners is sti hugey inconsistent. The current cap on the number of peope abe to receive treatment each year endangers progress towards meeting the WHO target for 80% of a peope with hepatitis C to be treated by It aso causes severe harm to the physica and menta heath of those waiting for treatment, and risks patients disengaging from care. The most disadvantaged and marginaised peope may aso drop out of the care pathway entirey if made to wait for treatment. To engage with NHS Engand and prison governors on the issue, highighting good practice exampes and providing governors with data on prevaence within prisons and information about the opportunities afforded by new treatments. To re-introduce the Prison and Courts Bi in the new Pariament and amend it to incude the requirement for the Secretary of State s annua report on prison performance to provide an update on BBV testing and treatment rates in each prison. 05 Speak up for eimination: Genera Eection

5 What peope with hepatitis C need from the next Government Drug services Testing for hepatitis C in drug services is variabe, with some faiing to offer testing despite the high prevaence of the virus among injecting drug users. Whist hepatitis C treatment is deivered in some drug services, such provision is far from commonpace, with many peope who are often described as hard to reach sti facing significant barriers to accessing treatment. To encourage oca authorities to incude a requirement for opt-out testing for hepatitis C in commissioning contracts with drug services and neede and syringe providers. To work with NHS Engand and oca authorities to encourage the provision of hepatitis C treatment in drug services. Eimination The UK Government has signed up to the WHO target to eiminate hepatitis C by 2030 but there currenty exists no working definition of what eimination may ook ike in an Engish context, and the steps towards eimination have not yet been mapped out. To deveop a roadmap to eimination paper, identifying the short, medium and ong-term steps required to ensure the attainment of the WHO target. 07 Speak up for eimination: Genera Eection