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Hepatitis C Action Plan 2008-11. Local Authorities…… ….and how to engage them. Hepatitis C Action Plan 2008-11. “It is not possible to manage and treat Hepatitis C infected persons without considering their social care, and any drug/alcohol problem, needs.” However
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Hepatitis C Action Plan 2008-11 • Local Authorities…… • ….and how to engage them
Hepatitis C Action Plan 2008-11 • “It is not possible to manage and treat Hepatitis C infected persons without considering their social care, and any drug/alcohol problem, needs.” • However • “There is a paucity of local authority (social care) involvement with Hepatitis C infected persons across Scotland.” • “…only one-quarter (of Scotland’s main Hepatitis C treatments centres) have outward referral links with social care services.”
L.A.s – Areas of strength • Difficult to reach patient group • Chaotic individuals in chaotic contexts • Complex and varying needs • Difficult to support • L.A.s in contact with many patients • L.A.s - multifaceted role • Complementary/partnership role • Integral to engagement and retention • L.A.s can support – given resourcing
More than Social Care? • Education • Housing • Youth work • Community work • Innovative and holistic approaches • Role in prevention? • Awareness raising • …and case finding??????
Fife - a mixed bag Advantages • Coterminous LA/HB boundaries • (Relatively) small pond • (Relatively) developed networks Disadvantages • Dispersed semi-rural area • (Relatively) small pond • Tendency to reinvent the wheel
Fife Positive Support • Fife Council Social Work Service • Hepatitis and HIV • Integrated with BBV clinic • Good links - GUM/Addiction Services • Stat & Vol orgs - broad links • Work flexibly - diverse cohort • Social work/support function/finance • Housing support/care (up to 24/7)
Fife Positive Support - services • Pre- and post-test discussion • Information and prevention • Practical and emotional support • Facilitating access to services • Support with childrens issues • Carer/family information and support • Advice on safer practices • Flexible housing support • Case finding/outreach testing
More services • Assistance in accessing housing • Access to legal/immigration advice • Support with mental health issues • End of life/bereavement support • Training - design and delivery • Local/national strategy & policy input • Comprehensive • Enabling • Flexible
FPS Strategic Links • Fife BBV Task Group • Fife Sexual Health Strategy Group • Hep C Resource Centre Scotland • Action Plan TTCS Working Group • Fife Drugs Forum • etc
Engaging Local Authorities • Obstacles (in L.A.s) • Burden of statutory responsibilities • Competing priorities • Trench thinking - BBV = NHS issue • Cultural and attitudinal • Lack of “big picture” thinking
Engaging Local Authorities • Obstacles (in Health sector) • Burden of statutory responsibilities • Competing priorities • Trench thinking - BBV = NHS issue • Cultural and attitudinal • Lack of “big picture” thinking
Phase II Solutions • Financial allocation to increase capacity in relation to Hep C (Action 6) • Workforce development aims to address understanding, role and context (Action 4) • Underlined by engagement between NHS and LA (Actions 8 and 9)
Phase II Solutions - Engagement • Action 9: “Each Local Authority will identify a Strategic and Operational lead for Hepatitis C infection” • This might be sufficient (initially) if…… • Committed leads are identified • Strategic and operational • Leads have sufficient knowledge • Leads prioritise Hepatitis C • Adequate resources were available
Facilitating engagement? • Use of existing infrastructure? • E.g. Executive Leads write to L.A.s • E.g.. Engage LA Chief Execs • Little existing national infrastructure … • Use of new infrastructure? • National LA Leads Network • National facilitation activity? • Role for the LA Leads Network Chair? • National Coordination/Liaison Post? • Sessional work undertaken by the Chair? • Combination of the above….