Hepatitis C Micro-Elimination in a Deprived Coastal Town: Lessons From Blackpool

Blackpool is the most deprived local authority district in England and consistently has one of the highest rates of hepatitis C virus (HCV) nationally. This study describes a multi-stakeholder approach to address low levels of HCV testing within drug and alcohol treatment services in Blackpool and evaluates the outcomes of this.

This study is a rapid evaluation utilising the UK Health Security Agency's rapid evaluation model. Individual-level data were extracted from adult drug and alcohol treatment services in Blackpool for all clients accessing services between April 2024 and July 2025. Analysis consisted of descriptive statistics to determine testing and treatment outcomes against national HCV micro-elimination criteria and to describe the client population. Hypothesis testing was carried out to investigate differences between clients testing positive and negative, and binary logistic regression to identify factors associated with a positive HCV test.

Of 1294 clients attending services, 1071 had a valid HCV test result recorded during the period. Of these, 32 tested positive for active HCV infection (3%), >90% of whom initiated treatment. There was significantly greater heroin use, crack use and injecting behaviour amongst those testing positive. Injecting mediated the relationship with substance type and was the only factor independently associated with HCV infection.

All micro-elimination criteria were met, and drug and alcohol services in Blackpool achieved micro-elimination. Moving forwards, services must sustain the culture changes that have embedded HCV testing within standard practice.