Embed Size (px)
Citation preview
Professor David Nu/ LJWG Chair and Professor of Neuropsychopharmacology
Imperial College London
The challenge of hepa77s C in substance misuse in London
Governance of the LJWG
Group Members Func7on Execu7ve group Prof David Nu= [Chair]
David Badcock [Treasurer] Dee Cunniffe Policy Strategy Facilitator and LJWG Pilot Projects Manager Claire Munro Director Dovetail Strategies
Reports to commi=ee; manages day-‐
to-‐day acLviLes
Scien7fic Steering Commi/ee
Prof David Nu= [Chair] Dr Kosh Agarwal, Consultant Hepatologist, King's College Hospital David Badcock [Treasurer], AddacLon Dr Owen Bowden-‐Jones, Consultant Psychiatrist, Central and North West London NHS FoundaLon Trust Dr Ashley Brown, Consultant Hepatologist, St. Mary’s and Hammersmith Hospitals Janet Ca=, Lead Viral HepaLLs Nurse, Royal Free Hampstead NHS Trust Dr David Davies, GPwSI in Substance Misuse, Lewisham PCT Charles Gore [Vice-‐Chair] Chief ExecuLve, HepaLLs C Trust Dr Emily Finch, Consultant AddicLon Psychiatrist, South London and Maudsley NHS FoundaLon Trust
Sets LJWG strategy; is the final arbiter for
any LWJG acLvity
Governance of the LJWG
Pilot Working Group Dee Cunniffe
Dr Owen Bowden-‐Jones Kath Oakes, Lead HepaLLs Nurse, King’s College Hospital Grainne Nixon, Nurse Consultant, London HepaLLs Lead, Health ProtecLon Agency (HPA) Alison KeaLng, London Regional Manager, NaLonal Treatment Agency (NTA) Magdalena Harris, London School of Hygiene and Tropical Medicine Leila Reid, Research & CommunicaLons Manager, HepaLLs C Trust
Develops and monitors the
pilot programme; reports to the commi=ee
Pilot Project Team Dee Cunniffe – Project Manager
Claire Russell -‐ Research Psychologist – Data CollecLon Stakeholder group RepresentaLves from the pharmaceuLcal industry, Public Health
England, the London Drug and Alcohol Policy Forum, Public Health, Homeless Health, the London School of Hygiene and Tropical Medicine, the prison service and Substance Misuse Management in General PracLce (SMMGP)
Provides guidance and support to LJWG on
implementaLon
LJWG Vision and Mission
Vision • No hepaLLs C in the drug user populaLon in London
Mission
• To eliminate hepaLLs C in drug users and those engaged in drug services in London
LJWG Short Term Objec7ves
Short Term (1-‐3 years) Implement the LJWG consensus recommenda7ons by:
• DisseminaLng the consensus document • Engaging service users, providers and commissioners • Influencing local policy makers • Establishing a baseline level of need through comprehensive data collecLon
• Assessing the effecLveness of our recommendaLons through the se^ng and monitoring of clear measurable outcomes
• Sharing current knowledge and best pracLce
LJWG Medium Term Objec7ves
Medium term (4-‐10 years)
• Establish a best-‐pracLce, person-‐centred model for idenLficaLon, diagnosis and treatment that ensures equity of access to high-‐quality care in all parts of London
• Achieve reducLons in HCV incidence, prevalence and related morbidity, through appropriate prevenLon & treatment
• Establish effecLve research procedures resulLng in published outcomes
LJWG Long Term Objec7ves
Long Term (10-‐20 years)
• IdenLfy, and offer treatment to, all people living with hepaLLs C and a history of substance misuse
• Observe a sustained decrease in HCV-‐related mortality in this populaLon
• Make London an internaLonally-‐recognised model of excellent care delivery in a ‘global city’
Complicated treatment area
• New landscape: NHS England, Public Health England, CCGs
• Growing alcohol harms and new treatments for alcohol misuse that impact on hepaLLs C
• Medically assisted treatment: methadone, buprenorphine, buprenorphine/naloxone
• Co morbidity – medical and psychiatric
Major LJWG Achievements 3 years on
• LJWG London Consensus Health Service Journal 2011
• Public Health Report for Commissioning HCV in PWID Health Service Journal 2012
• LJWG Pilot Projects 2013
• Gilead Fellowship Grant for ‘App’ development 2013 to 2014
The LJWG London Consensus
Pilots and Leads
• Croydon: Mercy Nimako
• Haringey: Linda Somerville
• Islington: Victoria Leenders
• Lambeth: Kath Oakes
LJWG Pilot Projects Highlights
• HepaLLs C Training and Van
• (PREVENT) ‘bundle’
• Focus Groups to produce a Treatment Decision Making Aid April, July 2013
• Prison Pathways ConsultaLon
• Deputy Mayor of London visits the pilots to explore health inequaliLes
Research Psychologist
A special thanks to Claire Russell for: • Data CollecLon per person ‘full data’ • Data CollecLon Summary Version ‘data lite’
• FacilitaLng interviews
• WriLng the report
LJWG Progress update
• LJWG stakeholder: NICE ‘HepaLLs B and C: ways to promote and offer tesLng to people at greatest risk of infecLon ’ 2012
• LJWG Pilot Projects completed July 2013
• Mayors Office, GLA and HepaLLs C Trust roundtable
• LJWG contributed to: Briefing for Councillors – LDAPF, Hep C Trust, Mayor of London.
• Pentonville Prison Pathway ConsultaLon PHE Health ProtecLon, Pentonville Substance Misuse Service, local Trusts, LJWG Pilot Leads,
• CollaboraLon with PHE Drug and Alcohol Team London: Joint Commissioners Group, Service Providers Group
Future Ambi7ons 1
• HCV and Medically Assisted Treatment for PWID: Literature Review in progress
• Stakeholders: NICE HepaLLs C Guidelines 2013
• Public Health England Workshop and ConsultaLon on ‘InfecLous Diseases and hard to reach populaLons’ October 2013.
• MulL morbidity tesLng partnership with Find and Treat (TB)
• Funding : applicaLons The Health FoundaLon, Partnerships: HTA bids with UniversiLes re prevenLon
• Cost Benefit Analysis of the LJWG Integrated Pathway
Future ambi7ons 2
• ConLnuaLon of Pilot Project collaboraLve work
• PHE London Alcohol Pathway
• Treatment Decision Making Aid for people who have just been told they have hepaLLs C
• CollaboraLon with the Centre for Research on Drugs and Health Behaviour, London School of Hygiene and Tropical Medicine to measure TDA and toolkit development
• Partnership development, homeless, hard to reach populaLons, mulL morbidity and research
Thank you
