Sections News

Operational Delivery Networks for Hepatitis C

Friday, 01 May 2015 14:02

NHS England is seeking Expressions of Interests from providers that can implement Operational Delivery Networks for hepatitis C that meet the specific terms set out in the NHS England Service Specification, which includes:

  • Establishment of formal Operational Delivery Networks (ODN)
  • Coordination of drug therapies through an expert Network Virtual Multi- Disciplinary Team (MDT)
  • Commitment to collect the national dataset
  • Positive engagement with patients and patient groups

Instructions in applying for this Expression of Interest

In making an EoI, potential providers of this service must have the ability to:

  • Meet the contract terms set out in the NHS Standard contract: www.england.nhs.uk/nhs-standard-contract/15-16/
  • Act as a the Lead Centre and be able to establish appropriate partnership arrangements to support the required level of patient access
  • Deliver an expert clinical service through a Network, MDT, demonstrating expertise in the management of patients with hepatitis C

Deadline for registration: 7th May

HCV in Cirrhosis - An Update on Treatment Access

Friday, 01 May 2015 11:53

Peter Moss (Chair HCV CRG) & Graham Foster (Vice Chairman HCV CRG)

Dear Colleagues,

We are writing to update you on access to treatment for patients with chronic HCV infection. As you know the first review of the Early Access Program was presented at EASL last week. These data show that therapy for patients with decompensated cirrhosis has been very successful and this program will continue.

NHS England has confirmed that access to treatment should be extended, and the CRG have completed a proposal for a new scheme to offer the best available oral antiviral therapy to all patients with cirrhosis. There is a formal sign off step to be completed but we anticipate that the scheme will be up and running by late May. However given the inevitable slippage in delivery times it may be prudent to advise patients that treatment may not commence until early June 2015. The precise details of how treatment will be delivered are still under discussion but we envisage a network approach, and details of centre selection will be circulated as soon as possible, probably within the next 10 days.

BSG supported STOPAH study shows a lack of evidence for drug treatments

Wednesday, 29 April 2015 08:22

The survival of patients with alcohol-related hepatitis is not being significantly improved by the main drugs currently widely used in treatment of this condition, according to a major new National Institute for Health Research sponsored study supported by members of the British Society of Gastroenterology.

Senior health professionals are highlighting an 'urgent need' for investment into research for the prevention and treatment of alcohol-related liver disease. Documented in the New England Journal of Medicine¸ a trial of over 1,000 patients using prednisolone and pentoxifylline did not achieve a statistically significant reduction in mortality after 28 days, 90 days, or a year.

The alarming findings come at a time when the incidence of alcohol-related liver disease is rapidly increasing, however the report does also show that the overall mortality has fallen compared to studies done in the past which suggests that specialist in hospital care of these very sick people can improve outcomes, and what could be achieved more widely contrasting with the 2013 NCEPOD report on the care of cirrhosis where care was often found to be lacking.

Commenting, British Society of Gastroenterology Vice President (Hepatology), Dr Stephen Ryder, said:

"STOPAH has answered some key questions in the treatment of alcohol-related hepatitis and highlighted the urgent need for research into the prevention and treatment of alcohol-related liver disease, which is on the rise.

Whilst the study does suggest that patients are receiving better care than reported in previous reviews, unfortunately it also shows that neither steroids or pentoxifylline are effective treatments and there is no real indication now for their use.

The stark finding in STOPAH remains the high late mortality related to resumption of alcohol intake and emphasises the need for universal implementation of the BSG recommendations on alcohol care teams, that seems likely to be a far more effective intervention than any medical therapy for the acute episode.

One of the great successes of this study was to show that UK hepatologists and gastroenterologists from over 50 UK centres can collaborate to deliver important large scale clinical studies aimed at improving outcomes for patients with liver disease."

 

Consensus Meeting on Therapy for Chronic Hepatitis C

Friday, 17 April 2015 09:46

London, March 3 2015

Background

The treatment options for patients with chronic hepatitis C are expanding rapidly. To guide clinicians and commissioners the national societies (BASL, BHIVA BIA, BSG, BVHG) representing clinicians with an interest in this area convened a meeting to provide evidence based treatment and management recommendations.

Methods

A nominated individual outlined the background data (both published and outcome data from the English early access program) and presented proposals for therapy. These were discussed by the 80 attendees and a consensus was reached. This document outlines the consensus recommendations.

Dr Stephen Ryder, BSG Vice-president Hepatology, April 2015.

Treatment of HCV in Cirrhosis

Thursday, 09 April 2015 11:48

Professor Graham Foster - Barts and the Royal London NHS Trust

Dear Colleagues,

I am writing to update you on the progress of accessing all oral antiviral therapy for patients with chronic hepatitis C. At present patients with decompensated cirrhosis are offered treatment with all oral agents as part of the Early Access Programme. This is delivered through 17 centres and the programme will continue for the foreseeable future. We hope to extend the offer of all oral antiviral therapy to all patients with cirrhosis in the very near future and, towards the end of the year, we hope to be able to offer these treatments to patients with less advanced fibrosis. We intend to deliver therapy to patients with cirrhosis and less advanced fibrosis through networks with patients managed and treated at their local centre.

As you know we had hoped to offer therapy to patients with cirrhosis in April but I am afraid that this deadline has now slipped due to the processes and committees such policies need to go through at NHSE and although we hope to be able to start patients on treatment in May there may be some further slippage and I think it would be prudent to advise patients that treatment is likely to commence in June. The CRG will continue to work with NHS England to ensure that these therapies are made available as quickly as possible.

I will continue to update physicians as more information is available and look forward to seeing many of you at the EASL meeting in Vienna.

 

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