At Change Grow Live we recognise the impact that COVID-19 has had on blood borne virus (BBV) testing and treatment pathways. To support people who both work in and use our services we developed a BBV toolkit to ensure testing remains a high priority. It’s vitally important that we work collaboratively with our partners to continue to work towards the elimination of Hepatitis C. The BBV toolkit includes tools and resources that have helped us relaunch testing in a COVID world. Feel free to take a look at what we have developed if it will be of benefit to you, your service or organisation.
The following points outline how you can implement testing within your service, including an important tool to help you identify priority groups:
- Identify a lead/key person in your service to oversee the implementation of the Dry Blood Spot Testing (DBST)
- The Service Lead ensures all staff are fully informed about the re-starting of DBST, have access to all supporting documents and have watched the dry blood spot testing ‘how-to’ video
- The Service Data Analyst/Data Admin produces a report identifying priority groups as listed in the BBV screening Priority Matrix and distribute to staff
- Complete a stock check of dry blood spot testing kits, reordering if needed
- The most appropriate person contacts pharmacies to enlist their support with providing dry blood spot testing kits to people who use our services
- Staff familiarise themselves with PPE guidance for testing in service and check PPE stock levels
- Allocate a single point of contact for staff (that is office based). If staff identify a service user that requires a postal kit, the person responsible will manage the postage of the kit and will ensure the request form is completed with correct details and guidance is sent
- Staff implement BBV testing pathways; testing in service or providing kits for individuals to self-test.
Please see our FAQs document about service implementation.
How to prioritise testing
This BBV screening priority matrix serves as a guide to support a structured approach to BBV screening in your service. It is important however to use all opportunities to offer screening to the people that need it, prioritising people who are identified as a previous or current injector, as well as those people who have engaged in any high risk practices. You may see an individual who is considered a lower priority before someone in the highest risk group. All those at risk should be offered screening at the earliest opportunity. Local Data Analysts/Data Administrators will produce these reports for staff regularly.
Please note: at Change Grow Live we use our own colour coding system (red, grey, amber) to categorise people in accordance with the standard definitions used within the sector. This colour coding system as well as definitions are outlined within the table for clarity.
Doing your testing
Consider the best option for testing an individual. Once decided, follow the guidance below:
Option 1 - Self-screening (to be posted within 48 hours)
Dry Blood Spot Test pack sent to an individual’s address. Individual to self-complete and post the kit directly to the lab
Option 2 - Self-screening drop-off/pick up, e.g. as part of Needle Exchange mobile delivery (to be posted within 48 hours)
Individual requests for Dry Blood Spot Test pack to be delivered by staff member as part of outreach provision
Option 3 - Collection of Dry Blood Spot Test pack (to be posted within 48 hours)
Individual opts to collect a kit from an agreed location e.g. from service (by themselves or other nominated other) or a pharmacy
Option 4 - On site (planned)
Individual attends service for a planned appointment (e.g. Medical review), Dry Blood Spot Test is completed in service with the appropriate PPE
Option 5 - On site (opportunistic)
Individual attends the service without an appointment. Staff are available to complete Dry Blood Spot Test if appropriate/required with the appropriate PPE
In order to support the delivery of the chosen testing option, it’s important that you develop a bespoke risk assessment that is individual to the person being tested/completing the self-test. The risk assessment will identify how to keep people safe and how to mitigate risks, whether that be linked to an on-site specialist HCV nurse or a staff member conducting an onsite BBV test in full PPE.
The person who is offering the test should discuss the following with the service user:
- Go through the consent form verbally with the individual. Agree on how the individual will receive their results.
- Explain that the dry blood spot test form will have their unique ID number on it. The only time a name will be required will be on the envelope sent out with the kit.
- Ensure the kit is out of reach of children, although risks associated are minimal.
- Discuss what support is required to complete the test.
- Step by step instructions will be sent with all kits, contained in the BBV self-test information letter. This includes both a video and written instructions.
- A staff member can call/video call an individual if needed. It is important that the service user completing the self-test feels supported throughout the process and knows that we are only a phone call away.
- When the service user accepts the self-test, contact the person responsible within your service to arrange for the kit to be posted. The worker then follows up to ensure the kit has been received.
Get in touch
If you are part of an organisation that supports people to be tested for BBV’s, whether in the UK or overseas, we would be really interested to find out what you are doing, especially regarding Hepatitis C testing and treatment pathways. Please tweet us at @changegrowlive or use our 'contact us' page.