Table 2 Assessment of prisoner HCV treatment need and policy determining care in 5 European countries
| Â | Country | ||||
|---|---|---|---|---|---|
Spaina | England & Wales | France | Italy | Germany | |
Population | |||||
 Total prisoners (‘000 s) | 86 [78] | 79 [79] | 56 [80] | 64 [81] | |
 Prisoners requiring HCV treatment (‘000 s)b | 6 | 9 | 8 | 6 | 6 |
 Prisoners, custody sufficient for treatment ‘000 s, (%) | 4 (70) [82] | 5 (60) [78] | 4 (50) [79] | 3 (50) [83] | 3 (50) [81] |
Policy | |||||
 Law defines equivalence of prison healthcare (Year introduced) | 1996 [26] | 2003 [27] | 1994 [28] | 1998 [29] | 2009 [30] |
 HCV plan includes prisoners | Harm reduction; HCV Screening, Prevention & Diagnosis in prison [31] | Increase uptake & accessibility to HCV testing & treatment [32] | Harm reduction; Screening; DAA treatment; medical/ social coverage on release [33] | No HCV plan identified | Improve prevention, diagnosis and treatment of HCV [84] |
 Prison health plan includes HCV | Access to NEP; repeated HCV screening (inc pre-trial); HCV treatment; in situ specialist; continuity of care [40] | HCV testing on entry, during imprisonment; results provided to community-based GP, if consented [85] | Access to screening readily on entry & continuity of care [36] | Multidisciplinary team to promote awareness and provide support for HCV-infected inmates [38] | No prison health plan identified |
 Prisoner HCV clinical practice guidelines | All inmates offered HCV RNA test, liver biopsies without delay [41] | Access to opt-out DBS testing; in situ BBV specialist; referral & treatment via integrated care team [35] | Recommended annual HCV screening; access to DAA treatment with continuity on release/ transfer [86] | Increase HCV awareness & risk behaviour; access to screening & treatment [87] | No prisoner HCV clinical practice guidelines identified |
Practice | |||||
 Access to treatment | Widespread | Increasing but limited in some areas | Increasing but limited in some areas | Increasing but limited in some areas | Limited |
Governance | |||||
 Organization responsible for prison healthcare | Ministry of Interior | Ministry of Health | Ministry of Health | Ministry of Health | Ministry of Justice |
 Level of decision making | Regional | National | National | National | Regional |
 Funding | Ministry of Justice | NHS | NHS | NHS | 16 Ministries of Justice |