Ending Hepatitis C in England

In my keynote speech at this week’s Hepatitis C Virus Elimination National Conference, I reflected on our elimination programme’s progress to date and how we’re taking initiatives further forward. The NHS and our partner organisations have made significant achievements, and as we celebrate 75 years of the NHS – I’m proud to say we are firmly on track to eliminate Hepatitis C as a public health threat by 2025.

During a recent visit to a hostel in Hackney in East London, run by homelessness charity St Mungo’s, I witnessed the success of the Hepatitis C Elimination Programme first-hand. The hostel provides accommodation for people at risk of homelessness or rough sleeping and runs a ‘find and treat’ clinic, in which clients are screened for Hepatitis C and those who test positive are supported through treatment.

In Hackney, I saw how challenging it can be to build trust and engage the community. But it was clear that the warmth and dedication of the peer workers, passionate volunteers who have recovered from Hepatitis C, was encouraging service users to engage with the service. The programme is transformative and potentially lifesaving, and meeting someone at the clinic who has been cured of the virus is a testament to that.

This would not be possible without the milestone contract we agreed with three pharmaceutical companies in 2019. Collaboration with pharmaceutical partners, charities, and other health groups, has put us on track to eliminate Hepatitis C – five years ahead of the World Health Organisation’s target of 2030.

While targets do provide added incentive, it is important to re-emphasise the importance of what we are doing. People with Hepatitis C can live symptomless lives for many years, but because the virus can lead to liver disease and cancer, it is extremely dangerous and a silent killer. I’m proud that we have reduced the number of cases by 43% and the number of deaths by 35% since 2015, but since every death is potentially preventable, we can’t slow down until we meet our ultimate goal of eliminating Hepatitis C entirely.

As patient numbers get smaller, each remaining case will be harder to find and cure. That is why we are introducing further initiatives across the healthcare system. A new web-based testing portal is also set to go live soon, while a new case-finding tool being piloted in Cheshire and Merseyside is allowing GP practices to identify those in need of testing and treatment. If successful, we expect to see this technology rolled out to more practices across the country.

Hepatitis C is an infection that greatly impacts some of our most vulnerable communities – with higher prevalence and risk among marginalised groups, including those experiencing homelessness and people with a history of injecting drugs. The NHS Long Term Plan outlined our commitment to reducing health inequalities. Our partnership with the justice system, addiction services, diverse communities, and beyond are crucial in doing just that.

Our elimination programme is also making strides in treating children with Hepatitis C. In 2021, we announced that we would be the first country in the world to offer treatment to younger children. And since the beginning of our programme, I am pleased to say, we have treated 200 children with lifesaving antivirals.

As we mark 75 years of the NHS on 5 July 2023, we’re looking back on the history of our organisation, the recent innovations that have changed how we provide care, the dedication of health and social care staff and volunteers, and the opportunities that lie ahead. It is clear that our progress to eliminate Hepatitis C ranks among the most significant NHS successes.

Finally, I cannot stress enough how the Hepatitis C Elimination Programme has remained a positive initiative during a difficult period for the NHS. Thanks to the dedication of our colleagues across the NHS, industry, government and the charity sector, it’s clear to see our elimination programme is growing with even stronger focus.

While there is still much more for us to accomplish, the passion and commitment of everyone involved, is accelerating us towards a significant healthcare milestone, and I for one cannot wait to see the day when we have eliminated Hepatitis C in this country.

For more information on Hepatitis C, please visit the patient information webpage.

Professor Stephen Powis

Stephen Powis is the National Medical Director of NHS England and Professor of Renal Medicine at University College London.

Previously he was Medical Director (and latterly Group Chief Medical Officer) of the Royal Free London NHS Foundation Trust from 2006 to 2018. Professor Powis was also a member of the governing body of Merton Clinical Commissioning Group for five years and a Director of Healthcare Services Laboratories LLP.

He is a past Chairman of the Association of UK Universities (AUKUH) Medical Directors Group and has been a member of numerous national committees and working groups, including the Department of Health Strategic Education Funding Expert Group. He is a past non-executive director of the North Middlesex University Hospital NHS Trust, including a period of eight months as acting chairman.

He is a past chairman of the Joint Royal Colleges of Physicians Training Board (JRCPTB) Specialty Advisory Committee (SAC) for Renal Medicine and a former board member of Medical Education England. He was Director of Postgraduate Medical and Dental Education for UCLPartners from 2010-13. He is a past treasurer and trustee of the British Transplantation Society and a former member of the UK Transplant Kidney Pancreas Advisory Group.

He has also served as a member of the Renal Association Executive Committee. He was Editor of the journal Nephron Clinical Practice from 2003 to 2008. In 2017 he became the inaugural Editor-in-Chief of the journal BMJ Leader. He has been a trustee of several charities, including the Royal Free Charity and the Healthcare Management Trust.