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‘Extend national hep C test service beyond needle exchange’

Rekha Shah: Moving towards a service-based future is a positive step for pharmacy
Rekha Shah: Moving towards a service-based future is a positive step for pharmacy

The hepatitis C testing service announced in the five-year funding settlement should be extended beyond needle and syringe programmes, an LPC lead has said.

Up to £2 million a year has been set aside from April 2019 to March 2021 for a pharmacy hepatitis C testing service in the funding contract to support the national programme to eliminate the condition.

Further details on the nationally commissioned service are still being negotiated, but current plans are for it only be accessed by people using locally commissioned needle and syringe programmes in pharmacies, the Department of Health and Social Care (DH) said.

Rekha Shah, pharmacy immunisations lead for Kensington, Chelsea and Westminster local pharmaceutical committee (LPC) in London – who has overseen two phases of a successful pharmacy hepatitis C pilot – said the service should be extended to any pharmacy offering a substance misuse service.

It is a “no brainer” to commission community pharmacies to offer a hepatitis C testing service, Ms Shah told C+D last week (August 5).

However, some areas of the country have decommissioned their pharmacy needle exchange schemes, so limiting the service could leave whole areas without access to hepatitis C testing, she claimed.

“If this is going to work, it needs careful thinking and it needs to be targeted from a wider number of outlets,” Ms Shah said.

If the DH and NHS England expand the criteria to include all pharmacies providing methadone or buprenorphine services, those patients could be tested for the condition at the same time, she explained.

“That is the beauty of pharmacy – easy access,” Ms Shah added. “So the chance of [identifying] the condition is far greater…if you open it up to more pharmacies.”

Ms Shah eagerly awaits further details of the hepatitis C test service so she can encourage contractors in her area to get involved, she said.

“Brilliant” focus on services

Commenting on the new funding contract, Ms Shah said its focus on clinical services is “brilliant”, and she wishes it had come sooner in her pharmacy career.

“Obviously all of us could [do] with a heck of a lot more [funding],” she said.

But being paid to provide services is a “positive step” and hopefully more funding will follow once some of the service pilots outlined in the contract are completed, Ms Shah added.

4 Comments
Question: 
Does your pharmacy offer a needle and syringe programme?

Mayank Patel, Superintendent Pharmacist

This is an interesting service and after today’s news of stereotyping is quite amusing to limit the service to a particular cohort of patients. In reality this should be a national service that is properly funded and thought out and open to all that would like to get tested.

Yes Hepatitis C is most common in the injecting community but others are at risk too 

Below is a cut and paste from the NHS.UK pages 

https://www.nhs.uk/conditions/hepatitis-c/diagnosis

Who should get tested?

You should consider getting tested for hepatitis C if you're worried you could have been infected or you fall into one of the groups at an increased risk of being infected.

Hepatitis C often has no symptoms, so you may still be infected if you feel healthy.

The following groups of people are at an increased risk of hepatitis C:

ex-drug users and current drug users, particularly users of injected drugs 

people in the UK who received blood transfusions before September 1991 

UK recipients of organ or tissue transplants before 1992 

people who have lived or had medical treatment in an area where hepatitis C is common – high-risk areas include north Africa, the Middle East and central and east Asia 

babies and children whose mothers have hepatitis C 

anyone accidentally exposed to the virus, such as health workers 

people who have received a tattoo or piercing where equipment may not have been properly sterilised 

sexual partners of people with hepatitis C 

If you continue to engage in high-risk activities, such as injecting drugs frequently, regular testing may be recommended. Your doctor will be able to advise you about this.

 

Farhat Ahmed, Locum pharmacist

Why is their a restriction on which pharmacies can offer help c testing, the clinical services in this 5 year contract are being sold to us as part replacement of losing murs. I haven't read anywhere that there is a restriction on the pharmacies that are having murs taken away!!!
I wasn't allowed to take on supervised services because too many pharmacies in my area already ran the service, so now I cant do hep c testing either. Please PSNC explain how your newly negotiated contract is an even playing field?

SP Ph, Community pharmacist

I don't think they have put any restrictions on Pharmacies. Instead they have cleverly put the clause that this service applicable only to Patients who use needle exchange. In other words Addicts who are not currently being treated for de-addiction or those who are being treated but still use illegal drugs. So if you can get hold of any of these patients then you can provide the service.

As I had said earlier elsewhere, the new contract is full of air and no substance. In fact all these services are run as pilots for a good year or two before being implemented nationwide. Hence, we don't have a contract that is service based, but one where no one knows what services will be commissioned at all in next 5 years. Moreover, looking at the services list, there is no one service that we can implement through all Pharmacies irrespective of the patient profile, hence they cannot be called National Services. These services could have been commissioned locally depending on the need and mix of the population. 

So they have done a daylight robbery by facing out the MURs and establishment payment for nothing in return. And all of the pharmacy bodies and many Pharmacists are jumping with Joy that at last we are now so called Service Based Pharmacies (French Style) Are we?? Naaaahhhhhh

SP Ph, Community pharmacist

""pharmacies providing methadone or buprenorphine services,""

Very positive thinking.

But, yes a big but, the DHSC logic says why fund the Pharmacies when these testings can be done at the addiction help centres (origin of the prescription for meth & bup) for a paltry amount or better include that as a MUST in their contract.

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