THE CHAMPIONS

At the height of the AIDS crisis during the 1980s people with the Hepatitis C virus were considered pariahs of society. The stigma of testing positive often prevented people seeking help.

Today in Liverpool, a team of health professionals has eliminated the deadly virus among their clients –the first NHS service to do so. Sheer perseverance and commitment to vulnerable people has meant that their enviable record still holds strong six months on, bringing them national acclaim.

Brook Place community drug team tests every client for Hepatitis C (Hep C), a virus which can cause serious liver damage, or worse. If found positive, they are offered treatment.

The programme has been driven by Recovery Coordinator and Hep C champion Hayley Curran (pictured centre above). She grasped the challenge of identifying clients who required testing, organising treatment, keeping track of results, and following up –all with the aim of helping some of society’s most vulnerable people regain control of their health and their lives (read Joan’s story on page 17).

Hep C is a blood borne virus affecting the liver. If left untreated, it can cause serious health problems including liver damage, cirrhosis (scarring of the liver), liver cancer and even death.

Hayley explains why testing is so important: “Hep C is most associated with drug users sharing equipment, but you can get it through rough sex – or simply sharing a toothbrush or a razor with someone who’s infected. It’s important that everyone in our care is tested.”

Back in the 80s treatment could be unpleasant, requiring a hospital stay. Today, testing and treatment is much simpler –a blood spot test and, if positive, a tablet taken every day for two to three months.

Hayley checks her appointment lists daily to see who is due an antibody swab or blood spot test. She works closely with agencies including Cheshire and Merseyside Operational Delivery Network (ODN), the national organisation Hep C U Later, the charity The Hepatitis C Trust and Liverpool University Hospital NHS Foundation Trust.

With many clients homeless or living in hostels, this wider team’s work is fully hands on. They organise events, offer voucher and goody bag incentives and will pick people up from where they are, and drive them to the test centre.

Hayley says partnership is key to success: “We don’t do this on our own – there is constant communication between us all and we meet regularly.”

Brook Place was recently awarded the Chief Medical Officer’s award for its commitment to high quality patient care.

Neil Meadows, specialist team manager paid testament to his colleague’s tenacity.

“Hayley’s passion, drive and determination are what’s got the team where we are now. She has put so much hard work into this.”

I’VE GOT PEACE OF MIND

Grief after the death of her husband and living in a hotel after the loss of her flat, led to a spell in hospital.

“I was very ill and the girls from the team visited me twice,” she said.

Joan had tested positive for Hep C about 30 years ago but further tests at the time indicated that her body had cleared itself of the disease.

About three years ago, she and her husband had both tested positive again but were not successful in taking medication.

“It’s difficult when you lead a chaotic life to remember to take medication after a meal,” says Joan. “Sometimes you don’t even have a meal.”

Joan was asked if she would be tested again recently, and following a further positive result, she agreed to take medication.

“The girls persevered”, said Joan. “They arranged for me to be picked up and taken to the hospital so that I

Sian James (pictured right), Senior Recovery Worker at Brook Place wants people to know the risks of Hep C, yet not be afraid to be tested. She says: “There is absolutely no reason for people to be infected with a blood borne virus that they could spread to others, which is so easily treated.”

It’s possible to become reinfected with Hep C so there is the constant task of sharing information on the virus, advising clients on reducing harm and offering safe needle exchange support.

Then there are new clients who need to be tested and treated. The team may take a moment to bask in the glory of success. But their work is far from over.

• The Brook Place approach is called micro elimination, (see panel below right).

Joan, a drug user for more than 40 years, is now Hep C free and in recovery.

Find Out More

If you want to learn more about Hep C elimination, or if you would like to refer yourself or somebody else for treatment for an opiate dependency, contact Brook Place on 0151 330 8260 (you must be a Liverpool resident).

You can also ask your doctor, nurse or mental health team to make a referral for you.

could be tested. I thought that they’d taken the trouble to come and see me when I was in hospital so why couldn’t I just take a few tablets every day to get myself well again.

“They made a big effort – they deserve a lot of praise.”

Joan has been off drugs for a year now and is settled in a flat, just 10 minutes away from her daughter.

“I had never told my family before that I was Hep C positive but when my daughter was with me in the hospital, I told her. She is so happy now, knowing she doesn’t have to worry about me.”

Joan continues to be supported by her recovery worker Claire Webster, she sees her daughter regularly and they go out shopping together.

“I’ve got peace of mind now,” she said. “Hep C never affected me physically; I didn’t even know I had it. But it was always in the back of my mind and now it’s gone.”

Brook Place, Orphan Drive, Tuebrook Liverpool, Merseyside L6 7UN

WHAT IS HEPATITIS C?

Hepatitis C (Hep C) is a blood borne virus affecting the liver. Treatable with a simple tablet, the virus, if left untreated, can cause serious health problems including liver damage, cirrhosis (scarring of the liver), liver cancer and even death.

WHAT IS MICRO ELIMINATION?

• All clients in structured treatment are offered a Hepatitis C test

• All those with a history of injecting have been tested for Hepatitis C

• 90 percent of current and previous injectors (at risk) have a Hepatitis C test date within the last 12 months.

* The definition of micro elimination was determined by a forum made up of drug and alcohol services, NHS England, Hepatitis C Trust and Gilead Sciences, who also co-developed quality standards. for micro elimination.