Georgia, Hepatitis C Worker & Jess, Bloodborne Virus Nurse
Bristol has reached micro-elimination of Hepatitis C!
This is a huge step forward for Bristol’s services, and the people they support.
Our journey to micro-elimination began four years ago and continued through the pandemic. While this was challenging, we persevered and evolved as a service to get to where we are now. We completely remodelled Blood-Borne Virus (BBV) testing, allowing us to send test kits to people’s homes, which was a first for our service. This flexibility not only enabled testing to continue but also provided testing to people who may have otherwise had to wait years to be tested face-to-face.
With the help of our partner organisations, BDP’s continued commitment to BBV testing over the last four years has made micro-elimination possible.
Reaching micro-elimination of Hepatitis C is a massive achievement for Bristol and more importantly for our service users, many of whom are very vulnerable and find accessing health care services extremely challenging.
What is micro-elimination?
Jess Oke, BDP’s Bloodborne Virus Nurse describes what micro-elimination actually means for Bristol.
“It means we have a very clear picture of who has been tested and we can safely say over 90% of people who need treatment are actually accessing it. This means people are being cured of Hep C and once this happens they can’t pass it on. Letting people know their treatment has been successful is one of the best parts of my job.
I’d like to say a personal thank you to every staff member who has gotten behind this initiative. It’s not been easy, but we have all worked together to make it happen. There’s been commitment at all levels. Multi-agency working has helped us achieve our goal — UHB Hepatology, Hep C Trust, Hep C U Later, and organisations allied to ROADS.
Being part of Hep C elimination in Bristol is a once-in-a-career experience that I’m incredibly proud of, and maintaining our elimination status will be the next challenge.”
What is Hepatitis C?
Hepatitis C (Hep C), is a blood-borne virus that affects the liver and is transmitted when the virus enters the bloodstream.
The most common mode of transmission in the UK is injecting drug use. Equipment used to inject like needles, spoons and water become contaminated with Hep C and when used by someone else, can be transmitted or passed on. Other risks include unprotected sex, mother-to-child, and sharing razors or toothbrushes.
The Hep C virus attacks your liver, which is the second biggest organ in your body and is responsible for many different functions. Over time, Hep C can cause liver inflammation and scarring that can lead to moderate liver damage (fibrosis) and severe liver damage (cirrhosis). Cirrhosis can be fatal, and those living with cirrhosis are at higher risk for liver failure and liver cancer.
Symptoms:
Symptoms of Hep C can vary. Most people who have Hep C are asymptomatic, but some common symptoms include:
Fatigue
Muscle and joint aches and pains
Nausea
“Brain fog”
Mood swings
Depression
Anxiety
Indigestion or bloating
Itchy skin
Abdominal pain
Testing and treatment
If you’re concerned you’ve been at risk of contracting Hep C, you can access testing from these places in Bristol:
Hepatitis C is treated with Direct-Acting Antivirals (DAAs), which are oral medications or ‘pills’ that are safe, effective, and have few side effects.
Accessing treatment in Bristol is very straight forward with short waiting times and a medication delivery service for vulnerable people. Treatment courses are 8 to 12 weeks long with most people being prescribed one pill a day. Efficacy or cure rates are around 95%.
In 2023 Bristol Drugs Project was involved in a Safer Inhalation Pipe (SIP) project, where we were able to distribute crack pipes to the people of Bristol for the duration of the study, with the aim of reducing health harms among people who use crack.
This was a major step forward for drug and alcohol harm reduction services, and we’re pleased to announce that we are now able to continue distributing the pipes!
“Not only can pipe provision through drug treatment services help to reduce health harms among people who use crack, but it can enable a point of connection and recognition for this highly stigmatised population. This is a landmark moment in UK harm reduction.”
Magdalena Harris – London School of Hygiene & Tropical Medicine
But why crack pipes?
Pipes used for smoking crack cocaine are often homemade or repurposed from cans, bottles or inhalers, which can heighten the risk of respiratory health complications.
Photo taken from Exchange Supplies
The SIPs are designed to be a safer alternative, with a heat-resistant glass tube to prevent shattering and burning, a detachable rubber mouthpiece to decrease the transmission of infection and illness, and a steel gauze designed to prevent the inhalation of metal fragments, common with makeshift filters.
But beyond the design of the pipes themselves sits a larger sense of autonomy for our service users. Merely having the option of a Safer Inhalation Pipe is a huge step forward for BDP in our effort to meet the needs of people who use drugs.
“We’re excited to be one of the first UK sites to provide Safer Inhalation Pipes to people who smoke crack. We know that the health needs of people who use crack are often overlooked by services and it’s great to be able to provide equipment that can support people in reducing some of the harms caused by crack.
We’re really grateful to the service users who helped us to make decisions about which SIPs to stock and look forward to continuing to work with our service users to develop further services that work for people who use crack”
Lydia Plant – Director of Operations, BDP
We hope that by providing our service users with a safer alternative with which to smoke crack, we continue to increase harm-reductive conversations around drug use, facilitating a stronger relationship and sense of trust and connection between BDP and its service users.
Want a Safer Inhalation Pipe?
Pipes are available to collect from our Needle Exchange during our opening hours at:
11 Brunswick Square (the big pink door!) St Pauls BS2 8PE
A colourful art piece created by one of BDP’s 50 Plus members.
The 50 Plus Art Group is a new peer-led group for people engaging in BDP’s 50 Plus Crowd, with lots of different mediums for people to get creative!
The Over 50s Crowd usually hang out twice a week to enjoy a range of social activities, from crosswords to music to picnics, but the new Over 50s Art Group takes a different approach.
With an arty and creative focus, the group has a more intentional direction and provides all sorts of enjoyment for its members. The space offers a safe environment for expression and community without any social expectations – a super appealing factor for a lot of people!
The idea to form an Over 50s Art Group sprung from the mind of Lawrence, the 50 Plus facilitator, who in attempt to showcase the skills of the group members advocated for Phil, an avid 50s member, to share his artistic gifts and lead the group.
During our 50 Plus Crowd get-togethers, I noticed that we had several members who would sit and doodle, or dig in to the art cupboard and create some phenomenal pieces. I’d always envisaged the members of the group being the ones to lead the activities, so I was very excited that Phil was up for taking the lead on an art group. The work that has been produced so far has blown me away, I’m incredibly impressed by the talent shown; it’s a great space for people to be themselves and let their thoughts and feelings out in a creative and expressive way.
Lawrence Bacon, 50 Plus facilitator.
Phil has been doing art since he was a child, he says it “Pulls together so much of what I know, and what I’d like to know”.
The benefits of the group are as varied as the art itself! Many of the members expressed that art allows people to get “wrapped up in your own world without having to worry about what’s going on outside these four walls”, and that’s certainly true for the 50 Plus Art Group, there is a freedom to the creative process that facilitates self-expression in a way words can’t always do justice.
For many people, this is what draws them to the group, providing an outlet for their feelings in amongst the creative process!
“50 Plus has been invaluable to me for 8 years now, through some of the worst and most difficult years of my life so far.
Since you [Lawrence] have been leading and transforming, it has been so inspiring watching our precious little group grow into the AMAZING thing it has become, it’s just so beautiful and I’m blessed to feel part of something so unique and special.” – 50 Plus member.
Want to get involved?
If you want to get involved with the Over 50s Crowd, or want to find out more, email Lawrence at 50plus@bdp.org.uk.
BDP’s Nurse Kirsten Roberts meets with a patient in BDP’s nursing room.
BDP offers a range of services to meet the varying needs of people who use drugs.
The use of substances can cause increased health risks such as heightened risk of HIV and Hepatitis C infection, poor mental health and vulnerability to illness.
People who use drugs can also be more vulnerable to structural barriers to healthcare services including homelessness, imprisonment and discrimination.
In attempt to remove these barriers to healthcare and break the stigma, BDP offer a drop-in nursing service 5 days a week.
Meet our nurses
Matt and Kirsten provide the clinical service at BDP. Kirsten is a nurse, and Matt is a specialist paramedic.
They provide a nursing service Monday to Friday with a drop-in at BDP and an outreach service, often liaising with other professionals involved in the client’s journey.
Matt and Kirsten provide most services you would receive at a GP; from helping people with minor injuries and illness to chronic diseases, substance use, mental health and housing problems.
Our nurses can also help you register with the homeless health service if this is something you need or want.
How can our nursing service help?
Our nurses provide a range of different support including:
Wound care, cleaning and dressing
General advice
Help with general illness/injury
Navigation of healthcare pathways and services
Advocacy with other healthcare providers
Diabetes
Chronic disease management
Health checks
Vaccinations
Pabrinex
Prescribing
Safeguarding
Renal problems
Street sex work
Pregnancy testing
Sexual health testing
Outreach
What if I already have a GP?
Our nurses can assess and treat people who have their own GP but may be finding it difficult to access appointments. Some people will have one-off consultations and some will be seen for many months, depending on the need.
How have our nurses helped?
“We often see people with complex problems. One client we saw ‘James’ was street homeless and had large leg wounds. Over time James trusted us and allowed us to dress his legs, they’re nearly healed now and much less painful.”
Kirsten and Matt visited James in hospital when he had an emergency admission and helped him access support and housing upon his discharge. James also struggled with his breathing and was given treatment to improve his cough. Matt and Kirsten helped him to access a regular GP and now drops into BDP occasionally to say hello, or to bring his friends in for care too!
Our nurses are informal, friendly, non-judgemental and trauma-informed. We know how hard it can be to navigate health and social care and are happy to advocate for you.
“We are not scary and will never lecture you! We appreciate it can be hard to ask for help, but we’re here if you need it.”
