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Suggested factors underlying lower Hepatitis C incidence in Walsall Metropolitan Borough
Hugh Jobber, Assistant Director of Operations (West Midlands), Addaction

Abstract

ISSUE:

Addaction Walsall is a community-based, integrated harm minimisation service that has operated in its present form since 2001. Data from the UK Government Health Protection Agency's (HPA) national saliva survey of blood borne viruses showed Walsall's Hepatitis C (HCV) incidence to be 15 per-cent in 2006 (n=82) and 19.6 per cent in 2007 (n=97) against a mean HCV incidence of 45 per-cent for all centres in England in 2005 (HPA data). Can tentative lessons be elicited about how this service's design and operation positively influenced Hepatitis C incidence in Walsall?

INTERVENTIONS:

Addaction Walsall provides an agency needle & syringe progamme with a wide choice of injecting paraphernalia, an on-site hepatitis vaccination and health clinic and regular Harm Minimisation Workshops for service users on such topics as safer injecting, overdose awareness and safer sex. There is an emphasis on service accessibility and user input in relation to injecting paraphernalia procurement. In addition, structured recruitment and development of a multi-skilled staff team occurs, including ex-service users, since motivated, well-trained employees are seen as central to effective service delivery. There is evidence of low levels of both staff turnover and unplanned absence, which enhances service continuity to presenting injectors.

LESSONS:

Presentation would highlight underlying 'intangible' factors that seem to have contributed to lower HCV incidence in Walsall Borough. This would include how process and service design has been blended with a particular approach to staff selection, induction, personal development, performance management and employee participation. 'How we work' not 'what we do'.

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Biography
Hugh Jobber is Addaction's Assistant Director of Operations, based in the West Midlands. He has worked for Addaction, a UK not-for-profit organisation specialising in substance misuse treatment, since March 2000, designing and establishing the charity's harm minimisation service in Walsall when Service Manager. In his present role, he manages services in Walsall, Birmingham, Staffordshire and Warwickshire, three of which incorporate low-threshold, harm minimisation interventions.

Before joining Addaction, Hugh worked for the YMCA in Wolverhampton for three years (1997-2000), where he helped develop a community-based drug treatment and training service. Prior to his work with the YMCA, Hugh had an eight-year career in the National Health Service, holding various managerial positions at the former West Midlands Regional Health Authority. These included Regional Drug Treatment Development Manager
(1990-1994).

After three years study, with Addaction's support, Hugh was awarded an Master of Business Administration with Distinction by the Open University Business School in December 2006. He is a member of the International Harm Reduction Association and will be advising NICE on the implementation tools for their planned Guidance on Needle and Syringe Programmes (expected February 2009).