The Hep C Wessex Van Project: Addressing Stigma & Removing Barriers to Treatment.

Hep C U Later commenced their Wessex Clinical Outreach Van project in April 2021, in the hope of realising their elimination agenda with a find, test and treat approach. This project is led by Inclusion, an NHS Community Drug and Alcohol Misuse Service (run from Midlands Partnership Foundation Trust (MPFT)), and Hep C U Later.


By June 2021, the van service was up and running with the support of various stakeholders, including 8 hospitals, 9 Housing Providers and 2 charities: The Hepatitis C Trust and Liver 4 Life. Data collected between then and October indicates a very successful outcome for the project; 316 people were tested out of the 409 individuals who accessed the service.


The Wessex Clinical Outreach Van has so far visited over 30 locations, which are targeted

specifically to reach as many people in need as possible. An advantage of using a mobile

testing centre such as a van means that the system is extremely fluid - it can be taken from one particular location to another depending on where the need is within that same day.


“The reality is it’s basically a clinical setting on wheels so we can take it to where the need is

and we can cater to the individual. It’s been a game-changer, it really has.” (Alan Howard, Hep C Hants P2P Coordinator for Inclusion Hampshire). Getting the presence of the van known to local communities has relied heavily on word of mouth, and also on forming relations with multiple stakeholders, for example, substance misuse services and hospitals. This allows the team to communicate their presence with those who need it.


 

“The reality is it’s basically a clinical setting on wheels so we can take it to where the need is and we can cater to the individual. It’s been a game-changer, it really has.”

 

How it addresses stigma and removes barriers to treatment:


Many of the clients tested in the van may not have accessed health care services for some time. “For anyone who doesn’t have a medical history, we can do an antibody test there and then and give them the results within 15 minutes. If they’re positive or known positive, we can then use the Cepheid machine”. (Sean Caddy, Wessex Clinical Van Coordinator) The Cepheid machine is a cutting edge medical tool that offers quick, accurate and easy diagnostic testing; it can provide results within an hour.


Anxiety can play a major role in deterring those in need of testing, and these methods have

been revolutionary in removing this barrier to treatment. “The thought of having someone prod around and take blood can be a massive barrier” (Alan), but the screening methods the team use allow them to accurately test individuals with poor venous access in a non-invasive way. This addresses a significant barrier and health inequality.


The Wessex Van Team explained it can often reach large volumes of people at a time - Alan told us that “in Southampton the other month there was a pharmacy HITT (high-intensity test and treat)... and 32 people were tested on that day.” However, many people who more urgently require testing are often difficult to reach and require a little more support. This is why the van project has proven instrumental in treating those who need it the most - and even though the team may see fewer of these people in one day compared with the former example, in targeted outreach they’re more likely to treat people who they would not have seen in a typical clinical testing setting.


The Wessex Clinical Van has been helping to reduce the impact of stigma around Hepatitis C by raising awareness of the condition. It makes the elimination mission visible to wider society, and no longer hidden within a clinical setting - during public events, the team uses a magnetic sign to display the Hep C U Later logo on their vehicle. Additionally, it helps to remove certain barriers to treatment and enables stigmatised individuals to receive the same parity of healthcare as anyone else with a physical health condition.


The van can also provide discretion to those who are anxious about coming forward with their health needs - during localised treatment events the sign is removed. It’s this fine balance between publicity and privacy that is enabling the team to slowly chip away at the stigma. There is still a long way to go before the stigma around Hepatitis C is completely removed from society. Ultimately, the Hep C U Later team shares the APA’s hope that one day, hepatitis C will be seen as a health condition like any other.


The success of the Wessex Clinical Outreach Van can be seen clearly in the data. Many people who would otherwise go untreated have been seen by the team and had access to the specialist health care they need. Additionally, with the project being led by Inclusion Substance Misuse Services, it provides a unique opportunity to follow people’s treatment journeys from start to end and minimises the risk of duplication of testing data or individual’s being lost to follow up. The van’s mobility, discretion and cutting edge interventions allows the team to test high numbers of clients who are difficult to reach, often belonging to marginalised communities and excluded from mainstream health services, making the Wessex van project unique, and consequently so vital.

 

#Stigma #Addiction #HepC #HepCULater