Welsh Government responds to Health Committee hepatitis C recommendations

The Welsh Government has published its written response to the Welsh Assembly Health, Social Care and Sport Committee's June 2019 report, ‘Hepatitis C: Progress towards achieving elimination in Wales'. The report followed a January 2019 inquiry, which The Hepatitis C Trust provided oral and written evidence to.

The report recommended that the Welsh Government produce a comprehensive national elimination strategy, with clear ambitious targets, and workforce planning built in, and provide sustainable funding until elimination is achieved. The Committee also called for a targeted hepatitis C awareness-raising campaign, urged the Welsh Government to write to Local Health Board Finance Directors and Chief Executives to emphasise that national treatment targets for hepatitis C must be considered as minimum targets, to be exceeded wherever possible, and recommended that the Welsh Government provide additional investment to improve hepatitis C testing in Welsh prisons.

The only recommendation accepted in full by the Welsh Government was writing to Local Health Board Finance Directors and Chief Executives to emphasise that national treatment targets for hepatitis C must be considered as a minimum target.

On the recommendation to produce an elimination strategy, the Welsh Government says its policy “has moved away from very specific disease strategies because their limited focus, together with the administrative burden of a formalised strategy, create limitations”. They instead propose to issue further periodic Welsh Health Circulars for NHS Wales outlining progress and highlighting specific actions necessary to eliminate hepatitis C by 2030 at the latest.

Responding to the recommendation for a national awareness campaign, the Welsh Government states that clear evidence would be needed that a national campaign is effective at reaching hard to reach groups, and points to the need for health board investment in outreach services to engage with individuals not currently in contact with traditional services.

Finally, the Welsh Government says that any action in relation to prison testing must await the outcome of an ongoing inquiry into the provision of all health and social care services in prisons in Wales.

Rachel Halford, Chief Executive of The Hepatitis C Trust, said: “Whilst we welcome the Welsh Government making clear to Local Health Boards the need to exceed hepatitis C treatment targets, we are disappointed that they have not fully accepted the Committee’s other recommendations. These recommendations were based on evidence we and other organisations and individuals provided to the inquiry, and there was near-unanimity on the measures needed to achieve elimination.

“The Welsh Government response refers to a strategy as an ‘administrative burden’ and says that ‘it is known what is required to successfully eliminate hepatitis C: increased testing and treatment in the community’. This simplistic assessment ignores the fact that recent modelling work shows that Wales is not currently on track to achieve elimination by 2030 on current treatment rates, which is precisely why we believe an elimination strategy is needed. A strategy would set measurable targets, allocate responsibility and establish mechanisms for monitoring progress towards elimination.

“With NHS England having agreed an elimination deal with the ambition of achieving elimination by 2025, and the Scottish Government recently setting a target to achieve elimination by 2024, there is a very real danger of Wales being left behind in the race to achieve hepatitis C elimination without increased action.”

The Health, Social Care and Sport Committee's report can be read in full here, and the Welsh Government response can be read here.