May 2017

NSP client input shapes Western Sydney liver clinic

The Western Sydney Local Health District has been running a liver clinic service at its Mount Druitt and Blacktown Needle and Syringe Programs (NSPs) since May last year.

Ashley Ubrihien, HIV and Related Programs Unit Manager for the Western Sydney Local Health District, says that the service is designed to be as easy to access as possible.

“When we initially set up the clinic we did a short survey of NSP clients, asking them where they would prefer to access treatment,” explains Ashley. “There was an overwhelming indication from clients that they wanted to access treatment in the same spot as they were accessing their NSP equipment. We took that feedback on board.”

Aimed at marginalised populations who often find accessing traditional health services difficult, the service is built around a specialist nurse who attends the clinics three days a week, a consultant gastroenterologist one day each month, and several fibroscan machines that are shared across the district.

There’s no rigid booking system or anything like that. People come in and are assessed when they arrive.

Ashley Ubrihien

“There’s no rigid booking system or anything like that. People come in and are assessed when they arrive. The nurse will conduct a fibroscan on the spot and refer them to a pathology provider that’s just across the road,” describes Ashley.

“The gastroenterologist sees each patient before they get their script, talks through any issues that might have come up through any of the tests that have been ordered, and writes them their script. She’ll see them again in 12 weeks once they’ve finished treatment.”

As of March the service has seen 44 patients across the two sites, of which 36 per cent are people from Aboriginal backgrounds. “That’s something that we’re quite pleased about because we’ve been partnering with the local Aboriginal Community Controlled drug and alcohol service to attract some of our patients through that avenue,” says Ashley.

Promotion for the liver clinic is predominately by word of mouth. “We want the word to get out there organically,” explains Ashley. “Obviously we’ve got fliers, posters, things like that in our NSP, but we really want to get people within these networks who might have picked up hepatitis C from sharing equipment in the past. I guess we’re really encouraging people to bring their friends in.”

For some NSP clients the benefit of the new DAA treatments are obvious and they’re happy to take up the treatment right away. For others, says Ashley, “It might be a slow burn. It will be NSP staff engaging them over a period of maybe years.”

Gideon Warhaft