Customer Story | Collaborating to eliminate Hepatitis C

Our exciting partnership with NHS England (NHSE) and MSD is supporting new ways of working between primary and secondary care teams to proactively reach at-risk patients. Piloting our Pathway solution across three GP practices in the Cheshire and Merseyside area has already enabled two patients living with Hepatitis C to start life-saving treatment for the first time.

"Between each of those numbers there’s a life that is valued, so they need to be found and they need to be treated.”

Kuldip Sembhi
National Programme Lead - HCV Elimination, MSD

The NHS England Hepatitis C (HCV) elimination programme is working to eliminate Hepatitis C as a major public health issue in England, ahead of the World Health Organisation (WHO) goal of 2030. To achieve this, the Cheshire and Merseyside Operational Delivery Network (ODN), based at The Royal Liverpool University Hospital, has been exploring innovative approaches to finding and treating those with the virus. This includes outreach in addiction services, visiting prisons and hostels, and even taking their services on the road in a clinical van.

Alongside the other 23 ODNs across England supporting the programme, they’ve seen a huge success since inception, with 37% reduction in deaths from the virus, 52% reduction in the number of liver transplants, and more than 70,000 patients successfully treated. As they progress toward their elimination goals, they believe a final cohort of patients are still yet to be reached – and many lie hidden within primary care data.

There is no way we would have achieved all the things that we've achieved so far without working really closely in partnership and collaborating. It's got us to where we are now, and it's what will get us over the line to elimination.”

Mark Gillyon-Powell
Head of Programme - HCV Elimination, NHS England

Harnessing data-driven insights

We’ve been working in partnership with NHSE and MSD to deploy a solution to meet this challenge and find a way to uncover the estimated 20,000 patients yet to be found in primary care data. Taking the ‘Patient Search Identification (PSI)’ tool developed by MSD and deploying this into our Pathway solution has enabled the ODN teams to search primary care data for coded Hepatitis C risk factors in patient records to identify potentially at-risk patients for review, testing and treatment.

Tools like Pathway show that there is a new way to work with primary care. We’re no longer waiting for GPs to refer into us - we're actively going out, finding those patients in primary care, and bringing them to us.”

David Byrne
ODN Manager, Cheshire & Merseyside ODN

Pathway uses clinical intelligence to identify at-risk patients and enable healthcare teams to refer these patients onto the appropriate care pathway. Supported by data sharing agreements, Pathway enables primary care teams to seamlessly share relevant patient information with the organisations best placed to deliver care.

Uncovering hidden cohorts

In February of this year, Cheshire and Merseyside ODN started piloting Pathway with three GP practices in their local area in the first step to identifying patients. 465 patients in the cohort met the risk factor criteria in the search, and a further 47 patients had a confirmed diagnosis of the virus with no recorded treatment in their primary care record.

Further investigation by the ODN confirmed seven patients from this group of 47 had no record of treatment on any healthcare database. These seven patients are currently being followed up by the ODN with their GP practice to confirm their Hepatitis C status. Two of these patients have subsequently started treatment as a direct result of this pilot, both of whom had historic risk factors and would not have been picked up from other Hepatitis C screening services.

The peace of mind I've got from not having it, it's just unbelievable. And I want to offer that to people daily.”

Darren Shields
Peer Support Lead - Cheshire & Merseyside, The Hepatitis C Trust

Identifying these patients in such a relatively small local area has shown the wider team the possibilities of deploying Pathway nationally to help in the fight for Hepatitis C elimination. Cheshire and Merseyside ODN are now in the process of rolling this solution out more widely within their local area and are sharing their learnings with other ODNs for a rollout across England.

We are in the business of prevention, and we know that the only way to do that is to in-reach into GP practices and offer them interventions as soon as possible. We think Pathway could be an excellent tool, right across our network.”

David Byrne
ODN Manager, Cheshire & Merseyside ODN

Proactive patient care

The success of the pilot program in Cheshire and Merseyside ODN highlights the enormous potential of Pathway in improving health outcomes. By harnessing the power of clinical intelligence and data sharing, Pathway can play a vital role in identifying patients at risk of other conditions and diseases, enabling healthcare teams to intervene earlier and provide timely treatment.

We all understand the challenges. We're all becoming increasingly aware of inequalities and how much of a role they play in health outcomes. The new connectivity between Life Sciences, the NHS and tech companies is going to be crucial to facilitate the development of new models of care.”

Dr Paul Richardson
Consultant Hepatologist and ODN Clinical Lead, Cheshire & Merseyside ODN

Useful links

Access primary care resources from the British Liver Trust.

Find out more about NHS England's free, at home self-testing kit for Hepatitis C.

Map of Hepatitis C Operational Delivery Networks and clinical leads.

This article reflects our collaboration with MSD as part of NHS England's Hepatitis C Elimination Programme at the time of publication, and was part of MSD’s committed investment towards the programme. This partnership has since concluded.