The Prison Peer2Peer Project


NHS England has committed to the delivery of the World Health Organisations (WHO) plans to eliminate hepatitis C by 2030. Within the prison environment this has been through, in part, the diagnosis and treatment of blood-borne viruses (BBV) in prisoners.  The BBV opt-out policy outlaid the screening programme, covering hepatitis C, hepatitis B and HIV. This has been has been operational since 2015/16, piloted across specific sites .In April 2017, the programme began to be rolled out nationally in phases overseen by Public Health England and is now being delivered and overseen by NHS England. 

NHS England Health & Justice also commissioned The Hepatitis C Trust to deliver the Prison Peer2Peer Project to raise awareness and reduce stigma surrounding BBV testing. This was to work in tandem with the BBV opt-out policy going live in London and these were both launched in April 2017. The model which is an adaptation of The Hepatitis C Trust’s successful community Peer2Peer project was developed to support the implementation of the national BBV opt- out policy. We work in partnership with the prison healthcare department and the substance misuse teams, raising awareness around hepatitis C in prison in order to reduce the risk of transmission, change the conversation and increase the number of people getting tested and treated. The main focus of the Peer2Peer project is hepatitis C, however, for those testing positive with hepatitis B or HIV we ensure support and pathways are in place.  

Prison Peer2Peer Project Objectives

The Prison Peer Project has three key objectives:

1.      To raise awareness, reduce stigma, “change the conversation” and provide support around hepatitis C in prisons.

2.      To deliver BBV awareness training to prison, healthcare and substance misuse staff.

3.      To provide literature including posters and information booklets across the prison estate.


How it works

The project activities are overseen and delivered by a Prison Peer Coordinator and Prison Peer Educators employed by The Hepatitis C Trust (HCT). The Peer Educators are all people with lived experience of hepatitis C, injecting drug use and been involved in the criminal justice system.

The project is multi-faceted to ensure it encompasses its aims. Both workers deliver BBV training to prison staff, prisoners in positions of influence and those engaging with substance misuse services. Within the training, many service users will self-identify to become HCT Prison Peer Educator. The criteria for being a peer for the HCT within prison is to have lived experience of hepatitis C and its treatments, or experience of taking risks that may have led to a hepatitis C transmission, for example, having received a prison tattoo.

 Anyone who wishes to be a HCT peer would then attend further training so they can deliver the Peer2Peer workshops independently of the Coordinator or Educator. The training ensures they are fully informed and able to answer any hepatitis C queries from their peers.

Peer2Peer (P2P) workshops are delivered by the Peer Educator primarily to those accessing drug or psychosocial support. The workshop format is a one hour group session which starts with a 20 minute talk using personal experiences to draw on key messages around hepatitis C. These are deliveredin a clear, concise and non-judgmental manner. This aims to dispel many of the myths about hepatitis C, encourage testing and provide harm minimisation and up-to-date information on treatment. A Q&A session follows the talk with attendees completing a simple and anonymous questionnaire to assess whether the key messages have been understood. To end the workshop, the questionnaire answers are reviewed as a way of correcting any misunderstandings and reinforcing the key messages.

Prison-based Peers are also identified through these workshops. As stated above, they are trained to deliver P2P workshops and provide one to one support to their peers accessing health or drug psychosocial support.

 The HCT Peer Educators and the Peer Coordinator provide support to the trained Peers through one to one or group meetings. They can also keep in touch via letter. In the event of a prison-based Peer being unavailable to deliver a workshop, the HCT Peer Educator will be able to deliver the workshop. All HCT trained Peers leaving prison receive a letter of support from their HCT Peer Educator, or linked into our community peer project.

The aim is that there will always be a network of Peer Educators across the prison estate at any onetime delivering education workshops, raising awareness and providing one to one support to those affected. Due to short sentences, training is delivered regularly in each prison to ensure the project delivery is continual.

Following the success of the London project in 2017/2018, NHS England Health & Justice have now commissioned the Prison Peer2Peer project to be rolled out nationally across the prison estate: London, Thames Valley/Surrey, Eastern/Kent, Midlands, Northern, Women’s, along with a designated National HITT team.