St Vincent’s prison hepatitis team earns state accolade

Statewide Hepatitis Award

Above, from left: Anne Craigie, Lucy McDonald and Amy Edwards were recognised with the 2020 Organisational Award from Hepatitis Victoria/LiverWELL (photo taken prior to COVID-19 restrictions) 

A group of nurses from St Vincent’s has gained state recognition for their work in delivering hepatitis clinical care to prisoners.

Lucy McDonald, Anne Craigie and Amy Edwards were recently presented with the 2020 Organisational Award from Hepatitis Victoria/LiverWELL for their collaborative efforts in reducing the prevalence of hepatitis in one of the highest at-risk groups.

Through the Statewide Hepatitis Program (SHP) – an initiative funded by the Victorian’s Government’s Department of Justice and Community Safety, and run by St Vincent’s Hospital Melbourne’s Gastroenterology Department – this team of healthcare workers has provided much-needed support to people in custody living with the virus.

“The program aligns well with our values at St Vincent’s as we are working compassionately with vulnerable members of our community,” says Lucy.

Model of care

New treatments for hepatitis C are very effective and more than 70,000 Australians were treated with these medications by the end of 2018. However, about 130,000 people in Australia are still living with chronic hepatitis C.

The major risk factor for transmission of hepatitis C is injecting drug use, and the challenge for elimination now is to increase testing and treatment among marginalised, vulnerable people who inject drugs.

Hepatitis C is very common in Australian prisoners, with an estimated 40 per cent testing positive.

According to Lucy, many of these people have never sought help or treatment for hepatitis C before being incarcerated, highlighting the essential work carried out by the SHP team that also involves educating prisoners about the associated health risks.

Prison provides an opportunity for hepatitis treatment, and more than 30 percent of treatments for hepatitis C are now delivered in the prison setting.

Left untreated, acute hepatitis C can lead to chronic disease in up to 75 per cent of cases, including the risk of progressive liver fibrosis, cirrhosis, liver failure and hepatocellular carcinoma.

Today, treatment is as simple as taking a daily tablet for up to 12 weeks, with a 95 per cent cure rate and very few side effects. During this time, the SHP team will regularly monitor the patient’s health and conduct wellbeing checks. 

“It is an important model of care that is working towards the goal of eliminating hepatitis C,” Lucy explains.

Although the treatment does cure infected patients, there is a chance of becoming reinfected if they engage in activities that put them at risk.

Lucy sees the program as a stepping stone for many people towards making more positive decisions in their life.

“They are able to make this health choice themselves and know they are going to succeed because the tablets work. It can be a really positive start to their journey forward,” she adds.

“When speaking to some of the those who had been on the treatment, they tell me they feel so lucky to be able to go on the tablets; that someone is caring about them.”

Team players

Since the program was launched in 2015, the team has assessed over 3600 people, treated more than 2300 patients and provides clinical services to all the prisons across the state.

The group works closely with Hepatitis Victoria/LiverWELL and other organisations across the viral hepatitis sector to pursue the World Health Organisation’s aim to eliminate Hepatitis C by 2030.

A collaborative focus is at the heart of the program’s success and what makes it so easy to integrate into the prison system as well, explains Lucy.

“We have our nurses on the ground visiting the prison medical centres to run the clinics and partner with the healthcare teams there; as well as having our St Vincent’s doctors overseeing the program and our pharmacy team helping, too – we all work really well together,” Lucy adds.

An award citation from Hepatitis Victoria/LiverWELL Chief Executive Officer Melanie Eagle described the group’s work as “a critical part of our fight to eliminate viral hepatitis in this state and an exemplary model across the country”.

The COVID-19 pandemic has added a new set of challenges for the SHP team of nurses in not being able to provide the face-to-face care in prison, but they have overcome this hurdle by using telehealth to manage ongoing treatments.

Lucy feels the SHP program is a good example of St Vincent’s commitment to providing compassionate care, especially for those less fortunate.

“Through this program we have been able to reach out and connect with people from marginalised groups that may not otherwise see a doctor for help,” she says.