Hannah Family is a Research Fellow in Qualitative and Behavioural Science at the University of Bristol based in the NIHR Health Protection Research Unit in Evidence & Behavioural Science and the NIHR Applied Research Collaboration West (ARC West). She is also the Programme Manager for EPIToPe, and leads the follow-on study, PROACTIVE (hePatitis c Reinfection: Optimising surveillAnCe for deTectIon and preVEntion).

Abstract

Qualitative/behavioural science insights on success of (and barriers to) implementing hepatitis C virus (HCV) treatment scale-up in the community

What can we learn from the scale up of HCV testing and treatment that can be applied in other settings? We report findings across multiple studies integrating HCV and drug treatment services in England and Scotland, and draw parallels with findings from a recent realist review of NSP and OAT provision. Central to the success of the scale-up has been a clearly communicated, nationally and internationally supported goal to reach HCV elimination and monitoring of progress towards this goal, which enabled commissioners to mobilise resources, clinical teams and operational delivery networks (ODNs) to coordinate service provision across a region. In some areas, community services struggled to prioritise scale up amongst a range of competing demands, a background of funding cuts, staff shortages and turnover. A flexible approach to scale up, plus support / resources to overcome specific operational barriers facilitated scale up, training had less impact. ODNs and peer worker teams also mitigated the impact of community teams not engaging in the scale up, through coordinating mass testing events. Peer workers were central to engaging and supporting people through testing and treatment, and were vital links between services, enabling teams to keep track of who still needed testing and treatment.