Hepatitis C testing service
Hepatitis C testing service
The Community Pharmacy Hepatitis C Antibody Testing Service was added to the Community Pharmacy Contractual Framework (CPCF) in 2020, commencing on 1st September. The introduction of this new Advanced Service was originally trailed in the 5-year CPCF agreement, but its planned introduction in April 2020 was delayed by five months because of the COVID-19 pandemic.
The service is focused on provision of point of care testing (POCT) for Hepatitis C (Hep C) antibodies to people who inject drugs (PWIDs), i.e. individuals who inject illicit drugs, e.g. steroids or heroin, but who haven’t yet moved to the point of accepting treatment for their substance use. Where people test positive for Hep C antibodies, they will be referred for a confirmatory test and treatment, where appropriate.
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Introduction
The UK Government is a signatory to the World Health Assembly resolution and World Health Organization (WHO) goal of eliminating HCV as a major public health threat by 2030.
In 2015, NHS England established 22 Operational Delivery Networks (ODN) to support treatment and testing efforts across the country and over 50,000 patients have been treated so far with around 95% being cured of the disease.
The Advanced service is part of NHS England and NHS Improvement’s national programme to eliminate Hep C virus by 2025, five years earlier than the World Health Organization goal. The service uses community pharmacies to target PWIDs for testing, as they are the healthcare venue most likely to be visited by that group of people.
The overall aim of the service is to increase levels of testing for HCV amongst PWIDS who are not engaged in community drug and alcohol treatment services to:
- increase the number of diagnoses of HCV infection;
- permit effective interventions to lessen the burden of illness to the individual;
- decrease long-term costs of treatment; and
- decrease onward transmission of HCV.
As the national Hepatitis C Programme is an elimination exercise, the service will be time limited. In the first instance ran until 31st March 2022, but in March 2022, NHS England and NHS Improvement, the Department of Health and Social Care and PSNC agreed that the service should continue to be commissioned until 31st March 2023.
Any pharmacy that meets the service requirements can provide the service, but it will be of most interest to contractors that provide a locally commissioned needle and syringe programme service, with a sufficient number of clients, to make the investment in provision of the service worthwhile.
Pharmacy contractors considering providing the service should first read the service specification and then consider the likely costs of providing the service and the number of PWIDs they are likely to be able to test.
Commenting on the launch of the service, Alastair Buxton, Director of NHS Services at PSNC said:
“The commissioning of this new Advanced service provides an excellent opportunity for the sector to participate in an incredibly important national and global public health initiative to eliminate Hep C virus and the harm it causes to so many people in our society.
“In the UK, those at highest risk of contracting HCV are people who inject drugs and community pharmacy is the healthcare provider with the best access to that group of people. The commissioning of this service underlines the importance of the access to healthcare that is provided through the community pharmacy network.
“Pharmacy contractors who provide a needle and syringe programme to a significant number of clients will be best placed to provide this service and to ensure its provision will also work from an economic perspective.”
Service specification, documentation and guidance
Hep C Antibody Testing Advanced service specification
PSNC guidance for contractors on the service
Point of care testing in community pharmacies guide
NHS England and NHS Improvement Training video for the service (CPPE website)
Guidance for community pharmacy teams on how to use the Hepatitis C Registry
Recording of a webinar on Hepatitis C and community pharmacy (The Hepatitis C Trust)
Case study
Ordering the test kits
The POCT kit to be used by pharmacy contractors in the service is the InTec Rapid AntiHCV Test. This is distributed in the UK by Matrix Diagnostics (01992 762678).
With their first order, contractors will need to set up a new account by completing page 1 of the account set up form which can be accessed here.
Orders can be emailed to Orders@matrixdiagnostics.co.uk, including the full contact details and delivery address for the pharmacy and a purchase order number, where used.
Information on the product can be found on their blood-borne virus test product page.
Frequently Asked Questions (FAQs)
Q. How much are the tests?
A. £5 + VAT each and they are in boxes of 10.
Q. Are there any delivery charges?
A. £14 + VAT per order – this is signed for next working day delivery.
Q. Do pharmacy contractors need to set up a new supplier account?
A. Yes – to get an account set up and to order kits follow the below steps:
- Complete page 1 only of the account set up form and return this to orders@matrixdiagnostics.co.uk; and
- Include in the email the following: The product code MHCV. How many boxes of kits you would like to order.
The order will then be processed and sent out.
Please note that once an account is set up, contractors ordering will not need to complete this form again and can just email to order more boxes of tests as and when required.
Q. Once ordered how long do they take to arrive at the pharmacy?
A. All orders sent in to Matrix Diagnostics by 2pm will arrive the next working day.
Q. Are there any returns or refund policies?
A. No. Matrix Diagnostics do not accept returns or refunds of these kits.
Funding and claiming payment
Contractors will be able to claim a payment of £36 per test performed on an eligible PWID, plus the cost of the test kit at the manufacturer’s list price (including VAT).
Claims for payments for this service should be made monthly, via the NHS Business Services Authority’s (NHSBSA) Manage Your Service (MYS) portal.
Hepatitis C testing service statistics
PSNC clinical service statistics dashboard
The dashboard presents data on the Hepatitis C testing service (as well as other Advanced services) at three levels (national, LPC and individual pharmacy) for each quarter. The dashboards are based on the NHS Business Services Authority’s (NHSBSA) Dispensing Contractors’ data.
NHSBSA Dispensing Contractors’ data
Data on the Hepatitis C testing service (as well as other Advanced services) can be found by clicking on the ‘Pharmacy and appliance contractor dispensing data’ dropdown tab.
Frequently Asked Questions
Q. Can I provide a Hepatitis C test to a patient for whom we supervise their consumption of medication as part of a treatment programme if I know that they are still injecting?
No. Patients who are already in treatment for substance use will be offered testing via the drug treatment service. They are not eligible for a test via the community pharmacy service.
Q. Will I be supplied with the test kits to provide the service?
No. Contractors will need to source the InTec Rapid Anti-HCV Test POCT test themselves via the UK supplier (contact details above) or a wholesaler. The contractors will be reimbursed at the manufacturer’s list price as part of their payment claim for a completed test.
Q. Do I need written or verbal consent from the PWID for this service?
Verbal consent is all that is required, but contractors can collect written consent if they wish.
Q. How often should a PWID be tested for Hepatitis C?
If a PWID has previously been tested and the result was negative, it is recommended that they are retested 6 months later.
Q. My staff member wants to be vaccinated against Hepatitis B to minimise their risk when providing the service. Who is responsible for covering the cost of Hepatitis B vaccination to protect staff providing the service?
The responsibility to provide an appropriate occupational health service, including Hepatitis B vaccination, sits with the employer of the staff.
Q. The service specification says that where a pharmacy temporarily or permanently ceases to provide the service, they should, as soon as possible, update their NHS website profile to reflect that the service is no longer available. If my pharmacy is not able to provide the service for a day or so, do we still need to amend our NHS website profile?
No. in those circumstances there is no need to update the profile.
