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'Hepatitis C has been accepted as not being a dirty word'

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Educating inmates about hepatitis C is rewarding for Kim Mudd, Marie Hair, Jayne Dodd and Sharon Pyatt

Hepatitis C is curable. Yet, it is responsible for some 86,000 deaths in Europe and 9 million people are infected, according to the World Health Organization. Tackling this are four nurses at HMP Forest Bank in Greater Manchester who are testing, treating and educating prisoners.

Jayne Dodd, hepatitis specialist nurse for prisons in Greater Manchester, is responsible for assessing suitability for treatment as well as comprehensive care and monitoring of patients being treated. Marie Hair is the lead nurse and works with Kim Mudd, healthcare assistant, to screen and treat patients until they are discharged. Sharon Pyatt, primary care manager, accesses, facilitates and funds training for the nurses.

Recognised by WHO this year for a Best Practice Award, the team also received a Sodexo Services Star Award for continuous improvement in hepatitis C service. Since 2009, it has increased awareness and testing in the prison and throughout Greater Manchester.

Ms Dodd works at a different site or one of the area’s four prisons each day, and in clinics at the general hospital two days a week. She says: “I am part of a team of specialist nurses at the Infectious Disease Department [of] North Manchester General Hospital who all have different roles. Our client group is, in general, chaotic to look after; this makes you think outside the box.”

Ms Mudd and Ms Hair are based at HMP Forest Bank and treat general patients and those with hepatitis C. Ms Mudd says: “On Wednesday, a typical day is being based in the blood-borne virus (BBV) clinic. Here we screen for hepatitis B, C and HIV, and test about 16 prisoners a week. If results come back positive for hepatitis C, we refer the patient to Jayne Dodd.

“I have the added role of dealing with prisoners’ general health issues when working with the GP or nurses. The rest of my week is based around general HCA duties, helping the doctors and nurses in clinic and screening new prisoners who enter the prison from court.”

Prisoners are given information about treatment on arrival and, if tested, get results within 2-3 weeks. But testing and treatment is voluntary and the negative connotation associated with hepatitis C can be a deterrent. Ms Pyatt says: “It’s important for [prisoners] to get treated because [hepatitis C is] easy to pass on. We need to treat everyone and let them know the outcome if they do or don’t get treatment.”

Awareness sessions teach prisoners about BBVs on Mondays and Wednesdays, and a change in the negative mindset of prisoners has been seen. “There’s a shift towards more positive attitudes because [hepatitis C] has been accepted as not being a dirty word or virus,” says Ms Dodd. She goes on to say that prisoners are “not afraid to get treated.” They’re also not afraid to share their stories and encourage other patients to get tested.

Every week a support group is offered. Ms Dodd says: “The service is operated for, and led by, the prisoners. It provides a platform for them to share their experience and, so far, it’s working well. It helps them prepare for treatment and it’s all confidential. They talk through their anxieties and fears, which helps a lot.” Ms Hair agrees: “Patients get one another’s perspectives. There are different stories all the time and it seems to help them through treatment.”

Many referrals are now people who have accessed the service outside of prison as well as in custody so the team is capturing a wider audience. Specific numbers cannot be disclosed, but they have risen markedly since the service’s launch in 2009.

“It’s rewarding to see the patients being treated, and we have nurses coming in to see the work we are doing and how it’s developing in the prison,” says Ms Pyatt. And as Ms Dodd concludes: “People will always choose their own lifestyle but if we can give them the education to practise safe behaviours and not risk others, we have succeeded.”

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