High Intensity Test & Treat (HITT) programme

The HITT team was formed in September 2019. The aim is to ensure every prisoner in every prison in England receives a hep C test. If they are found to be positive, they are fast tracked onto medication. The deadline is less than two weeks for any follow up and to ensure that the BBV testing at reception is robust.  Although, the two week period is a deadline, most prisons follow up even quicker.

Once each prison has completed a HITT testing 95% of its population they are in a good place to work towards micro elimination. It is vital each prison has the correct reception testing procedures in place prior to a HITT to ensure all new arrivals are tested to maintain the eliminated status.

The Hepatitis C Trust is in partnership with CareUK and Gilead to ensure all prisons where CareUK are the healthcare provider, undertake a HITT prior to 2022. CareUK aims to eliminate hep C from its sites by the end of 2022.

With the support of NHS Health & Justice, HMPS, Operational Delivery Networks (ODN’s) and other healthcare providers, a dedicated testing team will target all individual prisons and depending on the number ofprisoners, test everyone over a set period of time. 
 
Progress within the first 6 months:

The team completed two female prison HITT’s in January at Low Newton and HMP Foston Hall, the uptake from the women wanting to be tested was amazing, with both prisons reaching over 99% of the population of over 300 women.

They also completed three male prison HITT’s in the latter part of last year at HMP Leeds, HMP Warren Hill and HMP Stafford, again the uptake was great and between the three prisons there was an average 90% uptake from those that the test was offered to.

Peer support, to reassure individuals, is a key element within the whole testing programme as is partnership working. This really is about prison staff, healthcare staff and other partners working as one to achieve the same goal – hepatitis C elimination.
 
There are also a couple of prisons that have already screened their whole population prior to the HITT’s, these are HMP North Sea Camp and HMP Morton Hall.

By the end of 2019/2020 financial year,  they had a further 13 HITT’s completed with  HMP Swinfen, HMP New Hall, HMP Bullingdon, HMP Askham Grange and HMP Hull.

Case study: HMP Stocken 'HITT's back at hepatitis C!

HMP Governor Neil Thomas (left) with members of the Hep C HITT team having his test as part of the programme.

In early October 2020, HMP Stocken began a week of high intensity testing and treatment for both staff and prisoners by offering everyone who lives and works there a hepatitis C test. 

Hepatitis C is known to have a higher prevalence in prison settings and can be transmitted in many ways from drug use to hair clippers. It is also a silent condition, with only half of those living with hepatitis C being diagnosed. Although it is silent, the long term health complications of going undetected can be devastating – so HMP Stocken in partnership with Practice Plus (formerly Care UK), the Hepatitis C Trust and Gilead Pharmaceuticals worked to mass test their community and become a hep-C micro elimination site (the marker for this being a 95% test rate).

HMP Stocken achieved a 96.18% test rate, completing an incredible 744 tests in one week.

How did it happen?

During course of the HITT (High Intensity Testing and Treatment) week, staff from Practice Plus and the Hepatitis C Trust went cell to cell offering the opportunity for a point of care test, whereby the results were available within 15 minutes.

The Governor, Neil Thomas, also agreed that operational and former operational staff could be tested too, so following training from the Hepatitis C Trust, HMP Stocken have been able to offer the test to staff too, with currently 73 staff being tested.  This will be ongoing at present to ensure all staff have had the opportunity to access the test.

HMP Stocken are the only site to have offered staff the opportunity to test for hepatitis C as part of the HITT.

Why is this important?

Lucy Morris, the Health and Wellbeing lead spoke about the significance of this partnership working;

“Micro-elimination is a strategy to achieve national elimination through initiatives that eliminate hepatitis C.

We had the exciting opportunity to be part of this at HMP Stocken, and through the partnership working of all organisations we have been able to change the lives for men who are in our care – by ensuring the men who tested positive are now getting the treatment they need (which they often did not know they needed), and by preventing the onward spread of hep C – ultimately making our jail safer for all who live and work here.”

 

Fore more details on planned HITTS or to arrange a HITT for your site, contact:

Director of Prison Services – Sean Cox

National Prison Partnership HITT Manager – Lee Christensen