Regionally led integrated approach to the delivery of hepatitis C services
An integrated approach to the delivery of hepatitis C services across communities, primary and secondary care in New Zealand is coordinated regionally
Pātiki and Waharua Kōpito patterns
Pātiki and Waharua Kōpito patterns
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Health New Zealand | Te Whatu Ora funds hepatitis C assessment and treatment services in the community.
These services are designed to remove stigma and provide integrated, accessible and sustainable testing for hepatitis C exposure, assessment and treatment.
Regional hepatitis C programme managers support and coordinate implementation of community bases services. This includes sharing innovation, providing educational opportunities and raising awareness in key stakeholder groups. They also support primary and community care services to ensure that eligible hepatitis C patients are identified and have timely access to management and treatment as appropriate.
A key objective is to increase testing and to support the delivery of services to high priority populations by providing educational opportunities and raising awareness of other key stakeholder groups and general practice teams to ensure that eligible hepatitis C patients have timely access to management, counselling and treatment as appropriate.
There is a nationally consistent hepatitis C HealthPathway that regions base their integrated services on. Each region has localised this pathway to ensure it has relevant information for the areas they cover. This approach aims to enable more people with hepatitis C to be diagnosed earlier, and provide more equitable access leading to improved health outcomes.
A key objective is to destigmatise and increase testing for hepatitis C exposure and delivery of services to high priority populations. Regional programmes are engaging and supporting diagnosis and treatment through the needle exchange services, community alcohol and drug services, opioid substitution treatment services and Corrections facilities so people at risk of hepatitis C can be tested and treated in a timely way.
The focus on increasing hepatitis C health care delivery in primary and community environments aims to reduce the number of people with hepatitis C who develop cirrhosis and liver cancer.
Services take an equity focus on the detection, management and treatment of hepatitis C in populations who are at increased risk of infection. Based on available data, Māori have higher prevalence of hepatitis C. Actions that promote improvements to health equity and Māori health aspirations are being prioritised.
Hepatitis C regional services delivered in the community
Regions are delivering a range of hepatitis C services in the community.
Northern Region
The Northern Region is delivering hepatitis C services, diagnosis, management, treatment and cure in the community covering Auckland, Counties Manukau, Waitemata and Northland.
The region’s health districts and primary healthcare networks, including pharmacy providers and NGOs, are working together to ensure hepatitis C testing and treatment is accessible and patients are appropriately supported during treatment.
Coordination and collaboration across health services is supported with a number of initiatives underway to support those that are diagnosed, as well as increasing awareness and promoting testing particularly amongst those that may be at a higher risk for hepatitis C.
Te Manawa Taki (Midland) Region
Te Manawa Taki Community Hepatitis C Service is a free mobile service covering Bay of Plenty, Lakes, Taranaki, Tairawhati and Waikato.
The service actively works to ensure geographical coverage and to reduce disparity. The community hepatitis C nurses have extensive experience working with people with hepatitis C with clinical oversight by liver specialists.
The service uses a ‘one stop shop’ approach as much as possible to reduce patient visits within the health sector. Clinics are held in the community so people with hepatitis C feel comfortable attending for example in needle exchanges, the mobile van and community centres.
Central Region
The Central Region Hepatitis C Programme covers Capital, Coast & Hutt Valley, Wairarapa, MidCentral, Whanganui and Hawkes Bay It accepts BPAC and email referrals for fibroscans, and provides fibroscan services in the community, hospitals and prisons. Results are being sent to the referrer for management and referral to secondary care if appropriate.
Support and advice on treatment for hepatitis C is offered along with a wide ranging education programme. Financial support is available for GP practices to offer a free hepatitis C consultation if required, as well as funded community treatment pathways. Weekly hepatitis C clinics are held in each regions needle exchanges with referral for treatment and support offered to those not engaged with medical care.
Free point-of-care (fingerpick) testing for hepatitis C exposure is offered throughout the region by the Community Hepatitis C Team and a range of contracted providers. The Team can also arrange finger-tip blood collection for HCV-RNA if venous access or needle phobia are an issue.
Please contact the Community Hepatitis C Team to arrange free testing for your community, support for clients into treatment, educational updates and resources: hepcservice@tuora.org.nz
South Island Region
The South Island Region is delivering a range of hepatitis C services into the community covering Nelson-Malborough, West Coast, Canterbury, South Canterbury and Southern.
Fibroscanning is available throughout the region in secondary care, and via needle exchanges and community clinics by arrangement.
As well as GP ordered testing, point-of-care testing is available through needle exchanges, mobile outreach services, Burnett Foundation, and some Alcohol and Drug services.
Coordination and collaboration across health services is fostered with specialist nursing resource based in secondary care and in the community supporting primary care.