Using Service Design to help eliminate Hepatitis C
The Challenge
The World Health Organization (WHO) aims to eliminate Hepatitis C as a global health threat by 2030. The UK Government is targeting elimination in England by 2025. A key component of reaching this goal is public access to an online, self-order, home testing service.
We had 10 weeks to get something into development!
What We Did
Alex and his team worked with NHS England (and partners) to design a public access, online, self-order, home testing service.
Taking a user-centred, service design approach, they ensured the needs of primary risk groups were placed at the heart of the design. This approach also informed collaboration across a range of partners—critical for delivering an effective service and treatment pathways.
Headline Methodologies:
Inclusive design approach, focusing on areas with the lowest digital access
Field study-based user research to understand unmet needs within specific cohort environments and behaviours
Service blueprinting to co-create the end-to-end journey with all stakeholder groups
Using evidence-based influence to pivot the product roadmap and build the right outcome
Rapid prototyping following strict NHS style guide and service assessments
Developed an Urdu language version, based on insights from the South Asian cohort
Outcomes
Performance Data From May 13th, 2023 to April 15th, 2024
Total orders: 22,762
Return rate: 57%
Gender split: 58% Female, 41% Male, 1% Undetermined
Country of birth: 33% born outside UK (notably East & Central Europe, South Asia)
Deprivation Decile:
Roughly 10% even spread across all 10 deciles
Slightly higher usage in IMD 1–6* compared to 7–10
Shared drug paraphernalia was the most common RNA+** self-reported transmission route
This indicates the service is reaching those with:
Poorer health outcomes
Higher digital access needs
*IMD = Index of Multiple Deprivation
**RNA = Ribonucleic Acid test
Test Results:
88 RNA+ / true HCV positive cases
0.74% positivity rate
Consistent with previous rate of 0.75% (Sept)
70% of positive cases in IMD 1–4
Infected Blood Inquiry (2024)
Following the inquiry:
12,800 people requested testing kits in just over a week (from May 19th)
Compared to 2,300 for the entire month of April
All This Means:
More people are entering treatment
The service is reaching hard-to-reach risk groups
England has seen its lowest Hepatitis C mortality rate in the past 10 years
We are on track to eliminate Hepatitis C in England!