Research findings to support the implementation of the NHS England Hepatitis C Virus Elimination Initiative in Primary Care

NHS England’s programme to eliminate the hepatitis C virus

NHS England are funding an ambitious programme of initiatives with the aim of eliminating the hepatitis C virus (HCV) as a public health threat by 2025. One of these initiatives aims to increase identification, testing and treatment of high risk individuals in primary care. In partnership with the pharmaceutical company MSD, an algorithm has been developed for use in GP practice electronic records systems to identify patients with risk factors for HCV. Regional HCV Operational Delivery Networks (ODN) will then work with GP practices to contact at-risk patients to offer them testing and refer them for treatment as necessary. 

Learning from the HepCATT trial

Researchers from the University of Bristol’s NIHR Health Protection Research Unit in Behavioural Science and Evaluation and Centre for Academic Primary Care previously investigated a similar algorithm to identify patients at risk of HCV in primary care through the HepCATT (Hepatitis C Assessment Through to Treatment) randomised controlled trial. The intervention was found to be effective, acceptable to staff and highly cost-effective for the NHS.  

When conducting HepCATT we learnt some useful lessons about how to implement the intervention, which we hope will be helpful to staff in the ODNs and GP practices taking part in the NHS England programme. 

We have created this short video explaining the findings of HepCATT and giving some tips on how to support implementation. Or you can download our one page lessons learnt summary (PDF).

Published findings from HepCATT 

The findings of the study are described in more detail in these publications:

Roberts, K. Macleod, J. Metcalfe, C. Hollingworth, W. Williams, J. Muir, P. Vickerman, P. Clement, C. Gordon, F. Irving, W. Waldron, C. North, P. Moore, P. Simmons, R. Miners, A. Horwood, J. Hickman, M. (2020) Cost effectiveness of an intervention to increase uptake of hepatitis C virus testing and treatment (HepCATT): cluster randomised controlled trial in primary care, BMJ, 368:m322. 

Horwood, J. Clement, C. Roberts, K. Waldron, C. A. Irving, W. Macleod, J. & Hickman, M. (2020). Increasing uptake of Hepatitis C virus infection case-finding, testing and treatment in primary care: HepCATT (Hepatitis C Assessment Through to Treatment Trial) qualitative evaluation. British Journal of General Practice, bjgp20X708785.

Find out more about HepCATT

If you want to know more about HepCATT and what we learnt about increasing testing for hepatitis C in primary care, please get in touch with us:

Dr Kirsty Roberts (

Dr Clare Thomas (

Prof Matt Hickman (