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‘It probably adds up to a few months
every year,’ says Hepatitis C Trust
outreach officer Jim Conneely of the
time he spends travelling the
country in the trust’s testing van.
‘It’s exhausting but I enjoy it. When
people are really pleased to see you
and you’re helping out the local
nurses it makes it worthwhile.’
The service launched just over two
years ago (
DDN
, November 2011,
page 19) with the aim of reaching
those at risk of hepatitis C but unable,
or reluctant, to access testing. The
brief is to cover the whole of the UK,
visiting drug services and hostels, as
well as community centres for people
from high-prevalence countries. ‘Some
places have excellent services for hep
C, so it’s pointless us going there,’
says Conneely. ‘Whereas other places
really need a boost.’
Clients are offered a mouth swab
test to determine the presence of
antibodies that show if they’ve ever
had the virus – but not if they currently
do – with the results available in 20
minutes. If this proves positive, blood
tests will then need to be carried out
to determine if the person has the
virus now. Everything is confidential,
and so far more than 1,400 people
have been tested in the van, of whom
around 100 have identified hep C
antibodies.
‘I was recruited specifically for the
role,’ says Conneely. ‘The funding to
initiate the van was through the
Department of Health, so the trust
bought it, equipped it and recruited me
because they wanted someone with a
clean licence who’d had hepatitis C.
I’d worked in drug services for years
and I just jumped at it.’
Properly publicising the visits in
advance is vital, he stresses. ‘You
can’t just turn up somewhere. There’s
only me to organise it so I have to do
the back office stuff, the database and
the event planning.’ Before a visit, the
trust will email posters to the venue,
talk to substance misuse staff and
make sure there are clear pathways in
place for people who test positive.
‘We get nurses coming in and
local GPs with an interest in hep C
come along as well,’ he says. ‘We try
to get out a couple of days a week
and we’ve been pretty successful at
doing that, depending on where we
are, but there’s one van for the whole
of the UK so we tend to go where
people have requested us to go. Plus
everything’s so localised now that
people don’t know what’s happening
30 miles away – we’ll find great
practice at one place and then you go
down the road and they’re completely
ignorant around hep C. The gaps in
provision are crazy, but we’re trying to
target those.’
The first step is to take clients
through the basics, he says,
explaining the risk factors and finding
out if they’ve been tested before. ‘If
they have and they’re positive in any
way it’s pointless me testing them – as
the test I do is just an antibody test to
show they’ve been in contact, they’ll
need a blood test. I’ll go through all
the risks with them and, if they’ve
injected, it’s “get yourself tested”.
Everyone’s at risk who’s injecting, but
you also get the worried well coming
in – I won’t put them off because I
also believe that some people won’t
say why they need a test.’
There are two people in the van
wherever possible, he explains.
‘Sometimes it’s just me, depending on
whether there’s help at the project, but
if you get a queue of people you’ll
need one person doing the testing
and one on crowd control. We’ve
never had any hostility – maybe local
drug dealers occasionally, but once
people realise we’re not the police it’s
usually fine.’
Inevitably, some clients can react
badly to a positive result, he says,
which means a proper discussion
before the test is vital so people can
understand the implications as well as
establish in advance if key workers
and GPs can be informed. ‘Their GP
might want to know what tests we
did, so I write letters to the GPs and I
also like to contact people after, but I
won’t do that unless they specifically
give me their consent.’
Consent can be a tricky issue with
the client group, however. ‘You need
to be careful,’ he says. ‘Consent is a
judgement call with people who are
drinking and taking drugs, so it’s
about whether I can have an ordinary
conversation with them, regardless of
how much they might smell of alcohol
– you just have to judge it. Strictly
speaking you could say, “I can’t talk to
you, you’ve been drinking”, but we
live in the real world and if people are
drinking every day then that is their
real world. It doesn’t mean they’re not
able to communicate and give
consent, but it’s crucial they sign the
With hepatitis C still massively under-prioritised,
DDN
hears how
The Hepatitis C Trust’s testing van is taking services out on the road
News focus |
Analysis
HEP VAN MAN
6 |
drinkanddrugsnews
| January 2014
www.drinkanddrugsnews.com
‘What we’d really like, rather than
us doing this, is to get the local
authorities to do it, because it
makes economic sense and hep C
is a public health issue...’
JIMCONNEELY