Homeless populations targeted for hepatitis C testing and treatment throughout England during the Covid-19 pandemic

In recent weeks, two reports have been published evaluating hepatitis C interventions targeted at homeless populations in England during the Covid-19 pandemic. In March 2020, the Government instructed English local authorities to move everyone sleeping rough and in communal shelters into a safe place to reduce the risk of Covid-19 and prevent transmission. Named ‘Everyone In’, this policy offered a unique opportunity for health professionals, social workers, third sector organisations and others to come together and offer people services at a time when the relative stability afforded by reliable accommodation might make it easier for them to engage.

One report by Public Health England evaluates the hepatitis C test and treat interventions targeted at homeless populations outside London, while the other by the London Joint Working Group on Substance Use and Hepatitis C focuses on interventions delivered within London. While these reports evaluate the testing initiatives delivered during the first lockdown in the spring and summer of 2020, this work continues, both in terms of delivery and monitoring.

The data from seven areas across England (excluding London) showed that 1,263 people were tested for hepatitis C, of whom 11% (114) were found to have an active infection. As a result, 83 people had been initiated onto treatment at the time of analysis (December 2020). The London-specific report found that 1,054 people were tested for hepatitis C over the course of 98 testing events between May and August. Seven per cent (72) of those tested were found to have an active infection, resulting in 43 people having begun treatment at the time of analysis (November 2020).

Both reports identify the importance of building strong partnerships and delivering a whole-person approach as key to the success of these initiatives. In addition, peers from The Hepatitis C Trust and the Find & Treat team were found to be pivotal in engaging people in the service. While efforts must continue to cement joined-up working, overall the hepatitis C testing and treatment interventions delivered to people housed in temporary accommodation were viewed as a huge achievement, and have been critical to England sustaining progress towards elimination.

Tom Coffey, Senior Health Advisor to the Mayor of London, called it “one of the truly positive things to come out of this year”, while Stuart Smith, Director of Community Services at The Hepatitis C Trust, commented that, “it has been fantastic to see how, under extremely demanding circumstances, organisations have been able to come together and provide such high value health services to the homeless population at such a time of need.”

You can read the England-wide report here, and the London report here.