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<p>We recognise the unique opportunity that custody offers to identify and encourage
individuals with Blood Borne Viruses (BBVs) to engage in treatment. NHS England are
responsible for commissioning and delivering health services in prisons and Her Majesty’s
Prison and Probation Service (HMPPS) are responsible for enabling access to healthcare
services for those in custody. We are fully supportive of the work being done by NHS
England and Public Health England to meet the 2025 target for the elimination of Hepatitis
C in England.</p><p> </p><p>An opt-out policy for BBV testing was introduced in 2013,
under the previous National Partnership Agreement for Prison Healthcare in England
(NPA) between NHS England (NHSE), Public Health England (PHE) and HMPPS (then NOMS).
Full implementation of the opt-out testing policy for BBVs in all adult prisons in
England was achieved in March 2018. Since opt-out testing was introduced, the uptake
of BBV testing in prisons has increased from a baseline of 4% to 29%. This figure
is an aggregate for all prisons, with some far exceeding the average uptake. This
shared commitment to tackling the spread of infectious diseases, including Hepatitis
B, Hepatitis C and HIV, in prisons was reaffirmed in the new NPA between NHSE, PHE,
HMPPS, the Department of Health and Social Care (DHSC) and MoJ, published in April
2018.</p><p> </p><p>We continue to work with our health partners to identify points
of attrition and barriers to testing uptake, as well as with organisations, such as
the Hepatitis C Trust, to raise awareness among prison staff and prisoners about the
importance of testing for BBV.</p><p> </p><p>We are currently reviewing the process
by which defendants access essential medication whilst in the custody of the Prisoner
Escort and Custody Services to ensure that it is fit for purpose and to consider further
improvements. Additionally, current processes for Discharge Planning will be enhanced
as a part of the Hepatitis C Pathways work being carried out by NHS England. This
will ensure that individuals diagnosed with Hepatitis C who leave prison, transfer
between prisons and attend court have their medication with them and have detailed
instructions about accessing treatment specialists in the community. Treatment for
Hepatitis C uses high value drugs, and ensuring that the full course follows the individual
through the criminal justice system is a high priority for NHS England. Current processes
will also be augmented by Hepatitis C Trust community peer workers engaging with people
leaving prison, and through enhanced continuity of care arrangements under RECONNECT
as outlined in the NHS Long Term Plan.</p>
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