Quality standard

Quality statement 4: Blood-borne viruses

Quality statement 4: Blood-borne viruses

Quality statement

People accessing drug treatment services are offered testing and referral for treatment for hepatitis B, hepatitis C and HIV and vaccination for hepatitis B.

Rationale

Blood-borne viruses can cause chronic poor health and can lead to serious disease and premature death. Rates of infection with blood-borne viruses are high among people with drug use disorders, specifically those who inject drugs. Vaccination can protect against hepatitis B and carrying out testing to diagnose infection with blood-borne viruses is the first step in preventing transmission and accessing treatment.

Quality measure

The following measures can be used to assess the quality of care or service provision specified in the statement. They are examples of how the statement can be measured, and can be adapted and used flexibly.

Process

a) Proportion of people accessing drug treatment services, not known to have hepatitis B, who receive testing for hepatitis B.

Numerator – the number of people in the denominator receiving testing for hepatitis B.

Denominator – the number of people accessing drug treatment services not known to have hepatitis B.

Data source: Data can be collected from information recorded locally by healthcare professionals and provider organisations, for example from patient records.

b) Proportion of people accessing drug treatment services who test positive for hepatitis B and are referred for treatment.

Numerator – the number of people in the denominator referred for treatment for hepatitis B.

Denominator – the number of people accessing drug treatment services who test positive for hepatitis B.

Data source: Data can be collected from information recorded locally by healthcare professionals and provider organisations, for example from patient records.

c) Proportion of people accessing drug treatment services, not known to have hepatitis C, who receive testing for hepatitis C.

Numerator – the number of people in the denominator receiving testing for hepatitis C.

Denominator – the number of people accessing drug treatment services not known to have hepatitis C.

Data source: The National Drug Treatment Monitoring System collects data on all clients receiving specialist treatment for their drug use; information on hepatitis C intervention status, tests and referral and hepatitis B intervention status is collected.

d) Proportion of people accessing drug treatment services who test positive for hepatitis C and are referred for treatment.

Numerator – the number of people in the denominator referred for treatment for hepatitis C.

Denominator – the number of people accessing drug treatment services who test positive for hepatitis C.

Data source: The National Drug Treatment Monitoring System collects data on all clients receiving specialist treatment for their drug use; information on hepatitis C intervention status, tests and referral and hepatitis B intervention status is collected.

e) Proportion of people accessing drug treatment services, not known to have HIV, who receive testing for HIV.

Numerator – the number of people in the denominator receiving testing for HIV.

Denominator – the number of people accessing drug treatment services not known to have HIV.

Data source: Data can be collected from information recorded locally by healthcare professionals and provider organisations, for example from patient records.

f) Proportion of people accessing drug treatment services who test positive for HIV and are referred for treatment.

Numerator – the number of people in the denominator referred for treatment for HIV.

Denominator – the number of people accessing drug treatment services who test positive for HIV.

Data source: Data can be collected from information recorded locally by healthcare professionals and provider organisations, for example from patient records.

g) Proportion of people accessing drug treatment services who are vaccinated against hepatitis B (either by the service or previously).

Numerator – the number of people in the denominator who are vaccinated against hepatitis B.

Denominator – the number of people accessing drug treatment services who are not known to have hepatitis B.

Data source: The National Drug Treatment Monitoring System collects data on all clients receiving specialist treatment for their drug use; information on hepatitis C intervention status, tests and referral and hepatitis B intervention status is collected.

Outcome

a) Rate of hepatitis B infection in people with drug use disorders.

Data source: Data can be collected from information recorded locally by healthcare professionals and provider organisations, for example from patient records.

b) Rate of hepatitis C infection in people with drug use disorders.

Data source: Data can be collected from information recorded locally by healthcare professionals and provider organisations, for example from patient records.

What the quality statement means for different audiences

Service providers ensure systems are in place for people accessing drug treatment services to be offered testing and referral for treatment for hepatitis B, hepatitis C and HIV, and vaccination for hepatitis B.

Healthcare professionals ensure people accessing drug treatment services are offered testing and referral for treatment for hepatitis B, hepatitis C and HIV, and vaccination for hepatitis B.

Commissioners ensure they commission services that offer people accessing drug treatment services testing and referral for treatment for hepatitis B, hepatitis C and HIV, and vaccination for hepatitis B.

People accessing drug treatment services are offered tests and, if needed, referral for treatment for hepatitis B, hepatitis C and HIV, and vaccination for hepatitis B.

Definitions of terms used in this quality statement

Accessing drug treatment services

The term is defined as being in contact with any drug service, including needle and syringe programmes. [Expert opinion]

Testing

Testing should not be performed only once. It should be repeated when necessary because a person's situation may change.

People with drug use disorders who are vaccinated against hepatitis B should receive the full course, which consists of 3 injections of hepatitis B vaccine over a period of 4 to 6 months. [Department of Health and Social Care's guideline on drug misuse and dependence, sections 6.2.2.2 and 6.2.3.2]