Table 2 Primary care clinical staff knowledge, perceptions and practice regarding BBV testing and care for migrant patients

Which issues do you address when speaking to new migrant patients?

Vaccination history

All new migrants

167 (58.2, 52.4–63.7)

58 (41.7, 33.9–50.0)

109 (73.6, 66.0–80.1)

Asylum seekers / refugees only

9 (3.1, 1.7–5.9)

4 (2.9, 1.1–7.2)

5 (3.4, 1.5–7.7)

Never considered

14 (4.9, 2.9–8.0)

12 (8.6, 5.0–14.5)

2 (1.4, 0.4–4.8)

Situation specific

97 (33.8, 28.6–39.5)

65 (46.8, 38.7–55.0)

32 (21.6, 15.8–28.9)

Total

287

139

148

HIV risk assessment

All new migrants

86 (30.0, 25.0–35.5)

41 (29.5, 22.5–37.5)

45 (30.4, 23.6–38.2)

Asylum seekers / refugees only

7 (2.4, 1.2–4.9)

0 (0.0, 0.0–2.7)

7 (4.7, 2.3–9.4)

Never considered

23 (8.0, 5.4–11.7)

8 (5.8, 2.9–10.9)

15 (10.1, 6.2–16.0)

Situation specific

171 (59.6, 53.8–65.1)

90 (64.7, 56.5–72.2)

81 (54.7, 46.7–62.5)

Total

287

139

148

Hepatitis B risk assessment

All new migrants

85 (29.6, 24.6–35.1)

40 (28.8, 21.9–36.8)

45 (30.4, 23.6–38.2)

Asylum seekers / refugees only

11 (3.8, 2.2–6.7)

1 (0.7, 0.1–4.0)

10 (6.8, 3.7–12.0)

Never considered

24 (8.4, 5.7–12.1)

10 (7.2, 4.0–12.7)

14 (9.5, 5.7–15.3)

Situation specific

167 (58.2, 52.4–63.7)

88 (63.3, 55.0–70.9)

79 (53.4, 45.4–61.2)

Total

287

139

148

Hepatitis C risk assessment

All new migrants

78 (27.2, 22.4–32.6)

38 (27.3, 20.6–35.3)

40 (27.0, 20.5–34.7)

Asylum seekers / refugees only

12 (4.2, 2.4–7.2)

1 (0.7, 0.1–4.0)

11 (7.4, 4.2–12.8)

Never considered

29 (10.1, 7.1–14.1)

10 (7.2, 4.0–12.7)

19 (12.8, 8.4–19.2)

Situation specific

168 (58.5, 52.8–64.1)

90 (64.7, 56.5–72.2)

78 (52.7, 44.7–60.6)

Total

287

139

148

TB screening

All new migrants

82 (28.6, 23.7–34.1)

39 (28.1, 21.3–36.0)

43 (29.1, 22.3–36.8)

Asylum seekers / refugees only

13 (4.5, 2.7–7.6)

4 (2.9, 1.1–7.2)

9 (6.1, 3.2–11.2)

Never considered

34 (11.8, 8.6–16.1)

11 (7.9, 4.5–13.6)

23 (15.5, 10.6–22.2)

Situation specific

158 (55.1, 49.3–60.7)

85 (61.2, 52.9–68.8)

73 (49.3, 41.4–57.3)

Total

287

139

148

Sexual health advice and screening

All new migrants

80 (27.9, 23.0–33.3)

27 (19.4, 13.7–26.8)

53 (35.8, 28.5–43.8)

Asylum seekers / refugees only

7 (2.4, 1.2–4.9)

0 (0.0, 0.0–2.7)

7 (4.7, 2.3–9.4)

Never considered

18 (6.3, 4.0–9.7)

9 (6.5, 3.4–11.8)

9 (6.1, 3.2–11.2)

Situation specific

182 (63.4, 57.7–68.8)

103 (74.1, 66.2–80.7)

79 (53.4, 45.4–61.2)

Total

287

139

148

Family planning

All new migrants

86 (30.0, 25.0–35.5)

29 (20.9, 14.9–28.4)

57 (38.5, 31.1–46.5)

Asylum seekers / refugees only

7 (2.4, 1.2–4.9)

0 (0.0, 0.0–2.7)

7 (4.7, 2.3–9.4)

Never considered

14 (4.9, 2.9–8.0)

7 (5.0, 2.5–10.0)

7 (4.7, 2.3–9.4)

Situation specific

180 (62.7, 57.0–68.1)

103 (74.1, 66.2–80.7)

77 (52.0, 44.0–59.9)

Total

287

139

148

To the best of your knowledge, as of August 2017 which of the following services are free to all irrespective of migration status?

GP or nurse consultations in primary care

Yes

279 (76.0, 71.4–80.1)

130 (78.8, 71.9–84.3)

149 (73.8, 67.3–79.3)

No

56 (15.3, 11.9–19.3)

23 (13.9, 9.5–20.0)

33 (16.3, 11.9–22.1)

Don’t know

32 (8.7, 6.2–12.0)

12 (7.3, 4.2–12.3)

20 (9.9, 6.5–14.8)

Total

367

165

202

Operations or outpatient services in secondary care

Yes

100 (27.2, 22.9–32.0)

36 (21.8, 16.2–28.7)

64 (31.7, 25.7–38.4)

No

192 (52.3, 47.2–57.4)

98 (59.4, 51.8–66.6)

94 (46.5, 39.8–53.4)

Don’t know

75 (20.4, 16.6–24.9)

31 (18.8, 13.6–25.4)

44 (21.8, 16.6–28.0)

Total

367

165

202

Family planning

Yes

259 (70.6, 65.7–75.0)

115 (69.7, 62.3–76.2)

144 (71.3, 64.7–77.1)

No

32 (8.7, 6.2–12.0)

13 (7.9, 4.7–13.0)

19 (9.4, 6.1–14.2)

Don’t know

76 (20.7, 16.9–25.1)

37 (22.4, 16.7–29.4)

39 (19.3, 14.5–25.3)

Total

367

165

202

Hepatitis B and C testing, diagnosis and management

Yes

268 (73.0, 68.3–77.3)

120 (72.7, 65.5–78.9)

148 (73.3, 66.8–78.9)

No

18 (4.9, 3.1–7.6)

8 (4.8, 2.5–9.3)

10 (5.0, 2.7–8.9)

Don’t know

81 (22.1, 18.1–26.6)

37 (22.4, 16.7–29.4)

44 (21.8, 16.6–28.0)

Total

367

165

202

Treatment of mental and physical conditions caused by torture, FGM, domestic or sexual violence

Yes

299 (81.5, 77.2–85.1)

125 (75.8, 68.7–81.7)

174 (86.1, 80.7–90.2)

No

14 (3.8, 2.3–6.3)

12 (7.3, 4.2–12.3)

2 (1.0, 0.3–3.5)

Don’t know

54 (14.7, 11.5–18.7)

28 (17.0, 12.0–23.4)

26 (12.9, 8.9–18.2)

Total

367

165

202

Communicable disease services

Yes

305 (83.3, 79.2–86.8)

138 (83.6, 77.2–88.5)

167 (83.1, 77.3–87.6)

No

8 (2.2, 1.1–4.3)

4 (2.4, 0.9–6.1)

4 (2.0, 0.8–5.0)

Don’t know

53 (14.5, 11.2–18.5)

23 (13.9, 9.5–20.0)

30 (14.9, 10.7–20.5)

Total

366

165

201

Sexually transmitted disease services

Yes

305 (83.3, 79.2–86.8)

135 (81.8, 75.2–87.0)

170 (84.6, 78.9–88.9)

No

9 (2.5, 1.3–4.6)

5 (3.0, 1.3–6.9)

4 (2.0, 0.8–5.0)

Don’t know

52 (14.2, 11.0–18.2)

25 (15.2, 10.5–21.4)

27 (13.4, 9.4–18.8)

Total

366

165

201

Emergency departments (ED) and walk in centres

Yes

323 (88.3, 84.5–91.2)

147 (89.1, 83.4–93.0)

176 (87.6, 82.3–91.4)

No

17 (4.6, 2.9–7.3)

6 (3.6, 1.7–7.7)

11 (5.5, 3.1–9.5)

Don’t know

26 (7.1, 4.9–10.2)

12 (7.3, 4.2–12.3)

14 (7.0, 4.2–11.4)

Total

366

165

201

Which of the following would be a motivation or incentive to test for BBVs?

Performance payment structure

Yes

181 (76.1, 70.2–81.0)

91 (74.6, 66.2–81.5)

90 (77.6, 69.2–84.2)

No

21 (8.8, 5.8–13.1)

15 (12.3, 7.6–19.3)

6 (5.2, 2.4–10.8)

Don’t know

36 (15.1, 11.1–20.2)

16 (13.1, 8.2–20.2)

20 (17.2, 11.4–25.1)

Total

238

122

116

Local targets

Yes

164 (69.2, 63.1–74.7)

74 (61.2, 52.3–69.4)

90 (77.6, 69.2–84.2)

No

41 (17.3, 13.0–22.6)

31 (25.6, 18.7–34.1)

10 (8.6, 4.7–15.1)

Don’t know

32 (13.5, 9.7–18.4)

16 (13.2, 8.3–20.4)

16 (13.8, 8.7–21.2)

Total

237

121

116

National goals

Yes

133 (56.1, 49.8–62.3)

56 (46.3, 37.6–55.1)

77 (66.4, 57.4–74.3)

No

58 (24.5, 19.4–30.3)

45 (37.2, 29.1–46.1)

13 (11.2, 6.7–18.2)

Don’t know

46 (19.4, 14.9–24.9)

20 (16.5, 11.0–24.2)

26 (22.4, 15.8–30.8)

Total

237

121

116

CCG recommendations

Yes

174 (73.1, 67.1–78.3)

80 (65.6, 56.8–73.4)

94 (81.0, 73.0–87.1)

No

35 (14.7, 10.8–19.8)

28 (23.0, 16.4–31.2)

7 (6.0, 3.0–11.9)

Don’t know

29 (12.2, 8.6–17.0)

14 (11.5, 7.0–18.3)

15 (12.9, 8.0–20.2)

Total

238

122

116

PHE recommendations

Yes

174 (73.1, 67.1–78.3)

84 (68.9, 60.2–76.4)

90 (77.6, 69.2–84.2)

No

29 (12.2, 8.6–17.0)

21 (17.2, 11.5–24.9)

8 (6.9, 3.5–13.0)

Don’t know

35 (14.7, 10.8–19.8)

17 (13.9, 8.9–21.2)

18 (15.5, 10.0–23.2)

Total

238

122

116

NICE guidance

Yes

161 (67.4, 61.2–73.0)

75 (61.0, 52.1–69.1)

86 (74.1, 65.5–81.2)

No

39 (16.3, 12.2–21.5)

31 (25.2, 18.4–33.5)

8 (6.9, 3.5–13.0)

Don’t know

39 (16.3, 12.2–21.5)

17 (13.8, 8.8–21.0)

22 (19.0, 12.9–27.0)

Total

239

123

116

NHSE recommendations

Yes

105 (44.5, 38.3–50.9)

51 (42.5, 34.0–51.4)

54 (46.6, 37.7–55.6)

No

50 (21.2, 16.5–26.8)

39 (32.5, 24.8–41.3)

11 (9.5, 5.4–16.2)

Don’t know

81 (34.3, 28.6–40.6)

30 (25.0, 18.1–33.4)

51 (44.0, 35.3–53.0)

Total

236

120

116

CMO letter

Yes

104 (43.7, 37.5–50.0)

50 (41.0, 32.7–49.9)

54 (46.6, 37.7–55.6)

No

53 (22.3, 17.4–28.0)

39 (32.0, 24.4–40.7)

14 (12.1, 7.3–19.2)

Don’t know

81 (34.0, 28.3–40.3)

33 (27.0, 20.0–35.5)

48 (41.4, 32.8–50.5)

Total

238

122

116

HBsAg + HBcAb

76 (33.9, 28.0–40.4)

39 (35.8, 27.4–45.1)

37 (32.2, 24.3–41.2)

HBsAg

73 (32.6, 26.8–39.0)

36 (33.0, 24.9–42.3)

38 (33.0, 25.1–42.1)

HBcAb

10 (4.5, 2.4–8.0)

5 (4.6, 2.0–10.3)

5 (4.3, 1.9–9.8)

Not known

45 (20.1, 15.4–25.8)

17 (15.6, 10.0–23.6)

27 (23.5, 16.7–32.0)

Other, please specify

20 (8.9, 5.9–13.4)

12 (11.0, 6.4–18.3)

8 (7.0, 3.6–13.1)

Total

224

109

115

Anti-HCV + HCV RNA

32 (14.3, 10.3–19.5)

17 (15.6, 10.0–23.6)

15 (13.0, 8.1–20.4)

Anti-HCV

56 (25.0, 19.8–31.1)

36 (33.0, 24.9–42.3)

20 (17.4, 11.5–25.3)

HCV RNA

24 (10.7, 7.3–15.4)

11 (10.1, 5.7–17.2)

13 (11.3, 6.7–18.4)

Not known

86 (38.4, 32.3–44.9)

32 (29.4, 21.6–38.5)

54 (47.0, 38.1–56.0)

Other, please specify

26 (11.6, 8.0–16.5)

13 (11.9, 7.1–19.3)

13 (11.3, 6.7–18.4)

Total

224

109

115

Anti-HIV

118 (52.7, 46.2–59.1)

72 (66.1, 56.8–74.3)

47 (40.9, 32.3–50.0)

Not known

71 (31.7, 26.0–38.1)

20 (18.3, 12.2–26.6)

50 (43.5, 34.8–52.6)

Other, please specify

35 (15.6, 11.5–21.0)

17 (15.6, 10.0–23.6)

18 (15.7, 10.1–23.4)

Total

224

109

115

Yes

21 (9.4, 6.2–13.9)

6 (5.5, 2.5–11.5)

15 (13.0, 8.1–20.4)

No

172 (76.8, 70.8–81.8)

89 (81.7, 73.4–87.8)

83 (72.2, 63.4–79.5)

Don’t know

31 (13.8, 9.9–19.0)

15 (13.8, 8.5–21.5)

16 (13.9, 8.7–21.4)

Total

224

109

115

These questions relate to diagnosed patients

Are all patients with hepatitis B referred to secondary care?

Yes

176 (78.9, 73.1–83.8)

99 (91.7, 84.9–95.6)

77 (67.0, 57.9–74.9)

No

13 (5.8, 3.4–9.7)

8 (7.4, 3.8–13.9)

5 (4.3, 1.9–9.8)

Don’t know

34 (15.2, 11.1–20.5)

1 (0.9, 0.2–5.1)

33 (28.7, 21.2–37.5)

Total

223

108

115

Are all patients with hepatitis C referred to secondary care?

Yes

180 (80.7, 75.0–85.4)

102 (94.4, 88.4–97.4)

78 (67.8, 58.8–75.7)

No

9 (4.0, 2.1–7.5)

5 (4.6, 2.0–10.4)

4 (3.5, 1.4–8.6)

Don’t know

34 (15.2, 11.1–20.5)

1 (0.9, 0.2–5.1)

33 (28.7, 21.2–37.5)

Total

223

108

115

Do you receive information or check whether a patient has attended?

Yes

123 (55.2, 48.6–61.5)

67 (62.0, 52.6–70.6)

56 (48.7, 39.8–57.7)

No

37 (16.6, 12.3–22.0)

26 (24.1, 17.0–32.9)

11 (9.6, 5.4–16.3)

Don’t know

63 (28.3, 22.7–34.5)

15 (13.9, 8.6–21.7)

48 (41.7, 33.1–50.9)

Total

223

108

115

Do you follow up patients that have not attended secondary care appointments?

Yes

104 (46.6, 40.2–53.2)

57 (52.8, 43.4–61.9)

47 (40.9, 32.3–50.0)

No

51 (22.9, 17.8–28.8)

37 (34.3, 26.0–43.6)

14 (12.2, 7.4–19.4)

Don’t know

68 (30.5, 24.8–36.8)

14 (13.0, 7.9–20.6)

54 (47.0, 38.1–56.0)

Total

223

108

115

Are close contacts of HBV cases offered testing?

Yes

161 (72.2, 66.0–77.7)

80 (74.1, 65.1–81.4)

81 (70.4, 61.5–78.0)

No

13 (5.8, 3.4–9.7)

9 (8.3, 4.4–15.1)

4 (3.5, 1.4–8.6)

Don’t know

49 (22.0, 17.0–27.9)

19 (17.6, 11.6–25.8)

30 (26.1, 18.9–34.8)

Total

223

108

115

Are close contacts of HBV cases offered vaccination?

Yes

165 (74.0, 67.9–79.3)

79 (73.1, 64.1–80.6)

86 (74.8, 66.1–81.8)

No

14 (6.3, 3.8–10.3)

9 (8.3, 4.4–15.1)

5 (4.3, 1.9–9.8)

Don’t know

44 (19.7, 15.0–25.4)

20 (18.5, 12.3–26.9)

24 (20.9, 14.4–29.2)

Total

223

108

115