Asked by: Baroness Randerson (Liberal Democrat - Life peer)
Question to the Department of Health and Social Care:
To ask Her Majesty's Government whether they have established the cross-agency expert group on viral hepatitis to provide strategic direction and advice around hepatitis C and other viral hepatitis, as announced in March.
Answered by Lord O'Shaughnessy
With the support of the Department and the Chief Medical Officer, Public Health England (PHE) has established a national cross-agency expert group, the National Strategic Group on Viral Hepatitis, to provide strategic direction and advice around all types of viral hepatitis, including hepatitis C. It will provide advice to PHE, the Department, NHS England and to the wider health system. The new group is committed to working towards the World Health Organization goal to eliminate viral hepatitis as a major public health threat and brings together partner organisations to improve health services, minimise the number of new infections and reduce the health consequences of viral hepatitis for people in England. A priority is addressing the cross-system operational barriers in case finding and treatment capacity.
Asked by: Baroness Randerson (Liberal Democrat - Life peer)
Question to the Department of Health and Social Care:
Her Majesty's Government how much was spent by the NHS on commissioning treatments for hepatitis C in the financial year 2016–17.
Answered by Lord O'Shaughnessy
The hepatitis C drug treatment bill for 2016-17 was in excess of £200 million.
Asked by: Baroness Randerson (Liberal Democrat - Life peer)
Question to the Department of Health and Social Care:
Her Majesty's Government how many people commenced treatment for hepatitis C in the financial year 2016–17 broken down by operational delivery network area.
Answered by Lord O'Shaughnessy
The following table shows the number of people who commenced treatment in the financial year 2016-17 broken down by operational delivery network (ODN) area. The data has been collected by NHS England and was previously unpublished.
Network(ODN) | Actual |
Barts | 494 |
Birmingham | 748 |
Bristol and Severn Hep C ODN | 326 |
Cheshire and Merseyside | 347 |
Eastern Hepatitis Network | 586 |
Greater Manchester and Eastern Cheshire | 687 |
Humberside and North Yorkshire | 377 |
Kent Network via Kings | 154 |
Lancashire and South Cumbria | 330 |
Leicester | 255 |
North Central London Viral Hepatitis Network | 730 |
North East and Cumbria | 395 |
Nottingham | 383 |
South Thames Hepatitis Network | 870 |
South Yorkshire | 340 |
Surrey Hepatitis Services | 154 |
Sussex Hepatology Network | 241 |
SW Peninsula Hepatitis C ODN | 328 |
Thames Valley Hep C ODN | 347 |
Wessex Hep C ODN | 341 |
West London | 562 |
West Yorkshire | 445 |
Total | 9,440 |
Asked by: Baroness Randerson (Liberal Democrat - Life peer)
Question to the Department of Health and Social Care:
To ask Her Majesty’s Government, further to the Written Answer by Lord O’Shaughnessy on 22 March (HL5975), what steps they are taking to ensure that more precise figures on the number of people with undiagnosed Hepatitis C are made available.
Answered by Lord O'Shaughnessy
Most recent estimates suggest that around 160,000 people in England are living with chronic hepatitis C (HCV) infection. Published figures of the number who remain undiagnosed are not available although surveillance data and modelling are used to generate estimates for healthcare planning assumptions.
An estimate of the proportion of people who inject drugs who are diagnosed can be obtained from the Public Health England survey entitled Data tables of the Unlinked Anonymous Monitoring Survey of HIV and Hepatitis in People Who Inject Drugs. A copy of this survey is attached.
In this survey, only around one half of people injecting psychoactive drugs sampled are aware of their HCV antibody positive status (53% in 2015), and this figure has remained relatively stable at this level (averaging 52%) over the past decade.
Asked by: Baroness Randerson (Liberal Democrat - Life peer)
Question to the Department of Health and Social Care:
To ask Her Majesty’s Government what assessment they have made of the effectiveness of peer support in increasing the number of people engaged in hepatitis C care pathways.
Answered by Lord O'Shaughnessy
Most recent estimates suggest that around 160,000 people in England are living with hepatitis C (HCV) infection. Precise figures of the number who remain undiagnosed are not available, however, an estimate of the proportion of people who inject drugs who are diagnosed can be obtained from the Unlinked Anonymous monitoring survey. In this survey, only around one half of people injecting psychoactive drugs sampled are aware of their HCV antibody positive status (53% in 2015), and this figure has remained relatively stable at this level (averaging 52%) over the past decade.
The precise number of people diagnosed since reporting began is not available. However, over nearly two decades there has been a steady increase in the number of laboratory confirmed reports of HCV (ever-infected) in England, with a more than fivefold increase between 1996 and 2015. In 2015, 11,605 laboratory reports of individuals testing positive for antibodies to HCV were reported.
No specific assessment has been undertaken of the effectiveness of peer support in increasing the number of people engaged in HCV care pathways.
NHS England has a specification for 22 HCV Operational Delivery Networks (ODNs) to develop local partnerships with a range of stakeholders in order to maximise appropriate uptake and completion of HCV treatment and to cure more people of infection.
One requirement of the ODN is to develop links to third sector services to support adherence, peer support and self-management programmes.
Asked by: Baroness Randerson (Liberal Democrat - Life peer)
Question to the Department of Health and Social Care:
To ask Her Majesty’s Government how many people in England (1) have been diagnosed with hepatitis C, and (2) are engaged with specialist hepatitis C services.
Answered by Lord O'Shaughnessy
Most recent estimates suggest that around 160,000 people in England are living with hepatitis C (HCV) infection. Precise figures of the number who remain undiagnosed are not available, however, an estimate of the proportion of people who inject drugs who are diagnosed can be obtained from the Unlinked Anonymous monitoring survey. In this survey, only around one half of people injecting psychoactive drugs sampled are aware of their HCV antibody positive status (53% in 2015), and this figure has remained relatively stable at this level (averaging 52%) over the past decade.
The precise number of people diagnosed since reporting began is not available. However, over nearly two decades there has been a steady increase in the number of laboratory confirmed reports of HCV (ever-infected) in England, with a more than fivefold increase between 1996 and 2015. In 2015, 11,605 laboratory reports of individuals testing positive for antibodies to HCV were reported.
No specific assessment has been undertaken of the effectiveness of peer support in increasing the number of people engaged in HCV care pathways.
NHS England has a specification for 22 HCV Operational Delivery Networks (ODNs) to develop local partnerships with a range of stakeholders in order to maximise appropriate uptake and completion of HCV treatment and to cure more people of infection.
One requirement of the ODN is to develop links to third sector services to support adherence, peer support and self-management programmes.
Asked by: Baroness Randerson (Liberal Democrat - Life peer)
Question to the Department of Health and Social Care:
To ask Her Majesty’s Government what is their estimate of how many people in England are infected with hepatitis C but have not yet been diagnosed.
Answered by Lord O'Shaughnessy
Most recent estimates suggest that around 160,000 people in England are living with hepatitis C (HCV) infection. Precise figures of the number who remain undiagnosed are not available, however, an estimate of the proportion of people who inject drugs who are diagnosed can be obtained from the Unlinked Anonymous monitoring survey. In this survey, only around one half of people injecting psychoactive drugs sampled are aware of their HCV antibody positive status (53% in 2015), and this figure has remained relatively stable at this level (averaging 52%) over the past decade.
The precise number of people diagnosed since reporting began is not available. However, over nearly two decades there has been a steady increase in the number of laboratory confirmed reports of HCV (ever-infected) in England, with a more than fivefold increase between 1996 and 2015. In 2015, 11,605 laboratory reports of individuals testing positive for antibodies to HCV were reported.
No specific assessment has been undertaken of the effectiveness of peer support in increasing the number of people engaged in HCV care pathways.
NHS England has a specification for 22 HCV Operational Delivery Networks (ODNs) to develop local partnerships with a range of stakeholders in order to maximise appropriate uptake and completion of HCV treatment and to cure more people of infection.
One requirement of the ODN is to develop links to third sector services to support adherence, peer support and self-management programmes.
Asked by: Baroness Randerson (Liberal Democrat - Life peer)
Question to the Department of Health and Social Care:
To ask Her Majesty’s Government, further to the Written Answer by Lord O’Shaughnessy on 27 January (HL4700), on what estimation or data the Operational Delivery Network run rates were based, and whether this data will be made available.
Answered by Lord O'Shaughnessy
NHS England is funding access to new hepatitis C treatments in accordance with guidance from the National Institute for Health and Care Excellence (NICE), apportioned to local Operational Delivery Networks (ODNs) based on estimated local health needs. The numbers in the NICE costing template have been used to estimate a progressive rollout, starting with the treatment run rate of 10,000 patients in 2016/17.
Public Health England has published an interactive template hepatitis C commissioning template for prevalence and treatment which has been used as the basis for apportioning treatment run rates based on the estimated hepatitis C virus prevalence at local authority level, mapped to ODNs. Manipulation of the template is required to derive the required information. A copy of this template is attached.
Asked by: Baroness Randerson (Liberal Democrat - Life peer)
Question to the Department of Health and Social Care:
To ask Her Majesty’s Government, further to the Written Answer by Lord O’Shaughnessy on 5 January (HL4284), what estimate they have made of when hepatitis C will be eliminated as a serious public health concern in England, in the light of NHS England's current approach to the delivery of new direct antiviral treatments for hepatitis C.
Answered by Lord O'Shaughnessy
The World Health Organization (WHO) defines elimination as a reduction to zero of incidence of disease or infection in a defined geographical area and has set out a goal of eliminating hepatitis C as a major public health threat by 2030. The WHO Global Health Sector Strategy on viral hepatitis targets, relevant to the hepatitis C virus in the United Kingdom, include reducing the incidence of new cases of chronic hepatitis C infection in 2020 and 2030 by 30% and 80% respectively.
In the UK, new, highly effective, interferon-free anti-viral treatments for hepatitis C will contribute to this goal. Many affected have already been treated with the new therapies under the early access schemes operated by NHS England from 2014 to the start of 2016. Public Health England and NHS England continue to work collaboratively with stakeholders on the prevention, diagnosis and treatment of hepatitis C.
Asked by: Baroness Randerson (Liberal Democrat - Life peer)
Question to the Department of Health and Social Care:
To ask Her Majesty’s Government, further to the Written Answer by Lord O’Shaughnessy on 6 January (HL4286), whether they will publish a national improvement framework for hepatitis C or a national strategy for hepatitis C.
Answered by Lord O'Shaughnessy
There are currently no plans for a national improvement framework. The United Kingdom has a comprehensive surveillance system in place combining laboratory diagnoses data, risk and behaviour data, outcome data, statistical modelling and service evaluation. This enables us to monitor the care pathway, detect outbreaks, and generate burden estimates.
Prevention efforts focus on minimising harm in people who inject drugs through access to opiate substitution therapies with National Institute for Health and Care Excellence (NICE) guidance needle and syringe exchange programmes supporting these interventions. Further NICE guidance Hepatitis B and C testing: people at risk of infection has also been published to improve uptake of testing for hepatitis C in various settings. NHS England leads on treatment and continues to support National Health Service-led Operational Delivery Networks to provide NICE approved treatments for hepatitis C. Copies of the NICE guidance documents have been attached.
Public Health England supports the government’s efforts by publishing hepatitis C metrics in their report Hepatitis C in the UK 2016 report - Working towards its elimination as a major public health threat. A copy of this report is attached.