Only 662 community pharmacies out of more than 11,800 in England have registered to deliver the Hepatitis C Antibody Testing Service since it was launched in September 2020, according to data obtained by The Pharmaceutical Journal.
The figures, provided by NHS England in response to a freedom of information (FOI) request on 6 September 2021, also revealed that participating community pharmacies had carried out just 119 hepatitis C antibody tests since the service’s launch as of 30 April 2021.
Community pharmacy representatives have said the service was “hindered by launching in the middle of a global pandemic”.
The Hepatitis C Antibody Testing Service is an advanced service through which community pharmacies are able to offer testing for the hepatitis C virus to people who inject drugs, but who are not currently accessing community drug and alcohol treatment services.
It had been expected to launch in April 2020, but faced delays owing to the COVID-19 pandemic and was instead launched on 1 September 2020.
NHS England’s FOI response said that 679 community pharmacies had registered to deliver the service between its launch and 22 August 2021, 17 of which had later de-registered — leaving 662 pharmacies providing the service.
Alastair Buxton, director of NHS services at the Pharmaceutical Services Negotiating Committee, said the service “was always expected to be somewhat of a niche service that would be of most interest to those contractors who were already providing a locally commissioned needle and syringe programme”.
“It was of course further hindered by launching in the middle of a global pandemic. Given the service is part of a wider NHS initiative to eliminate hepatitis C as a major public health threat by 2025, the committee was disappointed that the NHS insisted upon a pricing point which failed adequately to cover contractor’s costs in performing the service. That was a missed opportunity,” he added.
Participating pharmacies are reimbursed £36 for each point-of-care hepatitis C test performed.
Ryan Buchanan, associate professor of hepatology at the University of Southampton, said there were “some fairly key ingredients for success which I think are not present [within the service]”.
“A fundamental flaw with the service is [that] community pharmacies are not allowed to test people who are engaged with opiate substitution therapy services at another care provider,” he said.
“It’s that cohort that community pharmacists have a fantastic relationship with because they are sometimes picking up their methadone every day and they’re often waiting there for the pharmacist to dispense their methadone, so there’s an opportunity to do the test.”
“The main group that are eligible are people accessing needle exchange in community pharmacy but needle exchange tends to be a quick interaction. The likelihood of there being the relationship or the time to talk to someone about a test for viral hepatitis is not really there.”
He added that “pharmacy-based testing is one of the settings where targeted testing must continue” to meet and maintain NHS England’s target of eliminating hepatitis C by 2025.
“It’s not going to be completely eradicated like small pox … it will still be leaking in to our at-risk populations, and if you completely take your foot off the gas, when you reach that point of elimination, over the next five to ten years, it will come back,” he said.
According to the service specification, the service will initially run until 31 March 2022. Prior to that date, the service will be reviewed and, if it is found to be effective, may be extended until later in 2022 or into 2023. The specification adds that it is time-limited because the national hepatitis C testing programme is an “elimination exercise”.
The UK is also a signatory to the World Health Organization’s goal of eliminating hepatitis C by 2030.