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Independents' Day

NHS England instructs GPs to do more hep C testing after blood scandal

NHS England has written to GPs asking them to do more testing to identify patients infected with viruses in NHS contaminated blood products used in the 1970s and 1980s, as a public inquiry into the scandal gets underway.

The two-year inquiry began this week with ‘harrowing’ stories from those who had been infected by HIV and hepatitis C from tainted blood used in treatment before screening began in 1991.

As part of the opening statements, it emerged that NHS England recently wrote to all GP practices to remind doctors to consider testing for hepatitis C in patients with unexplained generic symptoms, such as muscle aches and high temperatures, fatigue and loss of appetite.

The letter addressed to CCGs said: 'Hepatitis C often doesn't have any noticeable symptoms until the liver has been significantly damaged. This means many people have the infection without realising it.

'The only way to know for certain if these symptoms are caused by hepatitis C is to get tested.

'Clinical staff should therefore consider asking patients who present with nonspecific symptoms whether they may have had blood or blood products prior to 1991 (e.g. following RTA, Childbirth etc.) and offering them a screen for blood borne viruses.'

The hearing also heard that that it is estimated that during the mid 80s, between 0.6-1 per cent of the population was infected with hepatitis C.

Lead counsel for the inquiry Jenni Richards QC, said: ‘It is apparent from the statements that the inquiry has been studying that there are people who have been living with undiagnosed hepatitis C for years, even decades.’

‘It seems likely that there may be many people, potentially many thousands of people, who remain unaware that they may have been infected.’

Inquiry chair Sir Brian Langstaff called for wider testing to eliminate the ‘terrible disease’ and ensure it is eliminated faster.

Research from Public Health England suggests that up to 79,000 people are currently living with undiagnosed active hepatitis C infection.

In recent years there has been a drive to raise awareness of hepatitis C infection, particularly among people who may have injected drugs in the past, with figures suggesting an increase in the number of tests initiated by GPs.

Pulse reported that a campaign launched in November 2018 would give GPs a key role in identifying people with the infection who had not been diagnosed.

The UK Government has committed to a joint ambition with 193 other countries to eliminate the disease as a major public health threat by 2030.

Readers' comments (5)

  • This would be a great opportunity for Public Health England to get involved and set up free testing facilities and awareness campaigns. They could get the affected patients into the system and seen by secondary care.

    Of course, that's far too much effort for the penpushers so they'll just dump it on GPs because they are just sitting there twiddling there thumbs!


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  • Agree with above. This should be targeted to those who are at risk- I would imagine secondary care would have the best idea who these might be- and then over to Public Health to sort the screening out at local BTS facilities (if there is snything left of public Health that is).

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  • As above - sounds like a public health intervention - should be managed by PHE.

    If they do not have the manpower - they can commission the service.

    But asking GPs to do it for free is not right. It is like asking my bank to do my tax return, just because i have a current account with them.

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  • Surely the responsibility of the organisations that administered the contaminated products. Blood banks should have records of all the people give transfusions, I certainly don’t have a way of finding them. Agree with all above, this sounds like a public health job

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  • Its important to remember that perhaps 1/3 of patients can have chronic Hep C but normal LFTs including the ALT.My policy is to check Hep B+C status in any persistently elevated ALT even if trivial, along with a ferritin and HbA1c/lipids as a minimum (fatty liver etc/hemochromatosis) and test those with clear risk factors for these infections if risk factors are identified, with or without vague constitutional symptoms. Bear in mind that sharing a cigarette/spliff/toothbrush are risk factors which may not be recalled (or admitted to).

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