Regionally led integrated approach to the delivery of hepatitis C services
Regions are implementing an integrated approach to the delivery of hepatitis C services across primary and secondary care in New Zealand.
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The Ministry of Health funds hepatitis C assessment and treatment services in four regions.
These services are designed to provide integrated, accessible, and sustainable identification testing, assessment and treatment services delivered in the community wherever possible.
Hepatitis C Coordinators are in place in each region to support and coordinate implementation of the clinical pathway, integrated services, education and awareness, sharing innovation and reporting.
It is expected that districts will implement integrated hepatitis C services based on a nationally consistent clinical pathway and more people with hepatitis C will be diagnosed earlier, leading to improved outcomes for patients.
Other expected benefits include increasing hepatitis C health care delivery in primary and community environments and reducing the number of people with hepatitis C who develop cirrhosis and liver cancer.
A key objective is to increase testing and to support the delivery of services to high priority populations by providing educational opportunities and raising awareness of other key stakeholder groups and general practice teams to ensure that eligible hepatitis C patients have timely access to management, counselling and treatment as appropriate.
This includes a focus on increasing support for primary care and nurse prescribing and diagnosing the undiagnosed.
There is an equity focus on the detection, management and treatment of hepatitis C in populations who are at increased risk of infection.
Based on available data, Māori have higher prevalence of hepatitis C. Actions that promote improvements to health equity and Māori health aspirations should be prioritised.
Supporting primary care prescribing is a key priority for districts. This includes engaging and supporting diagnosis and treatment within high risk populations through the needle exchange services, community alcohol and drug services, opioid substitution treatment services and Corrections Department facilities.
Hepatitis C regional services delivered in the community
Regions are delivering a range of hepatitis C services in the community.
Northern Region
The Northern Region is delivering hepatitis C services, diagnosis, management, treatment and now cure into the community.
The region’s health districts and primary healthcare networks, representing their general practices, are working in partnership to make fibroscanning available as a simple diagnostic in various community settings without the requirement for a specialist appointment.
Coordination and collaboration across health services is fostered with a number of initiatives underway to engage previously diagnosed patients, as well as increasing awareness and promoting testing amongst potential patients at risk for hepatitis C.
Midland Region
The Midland Region Community Hepatitis C Service is a free mobile service covering the five Midland areas.
The service actively works to ensure geographical coverage and to reduce disparity. The Midland community hepatitis C nurse has extensive experience working with people with hepatitis C and two liver specialists provide clinical oversight of this service.
The service uses a ‘one stop shop’ approach as much as possible to reduce patient visits within the health sector. Clinics are held in the community so those with hepatitis C feel comfortable attending for example in needle exchanges and community centres.
Central Region
The Community Hepatitis C Programme in the Central Region takes referrals for fibroscans, and organises fibroscan clinics in the community, hospitals and prisons, with results being sent back to the referrer and/or referral to secondary care if appropriate.
Support and advice on treatment for hepatitis C is offered along with a wide ranging education programme. Hepatitis C testing clinics are held in all of the regions Needle Exchanges with referral on for treatment and support for those not engaged with medical care.
South Island Region
The Southern Region is delivering a range of hepatitis C services into the community.
Fibroscanning is available throughout the region in secondary care, general practices by appointment and via needle exchanges and community clinics by arrangement.
Coordination and collaboration across health services is fostered with specialist nursing resource based in secondary care and in the community supporting primary care.