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The NHS introduced an early access treatment programme for Hepatitis C for those with the greatest clinical need. This gave patients with decompensated cirrhosis access to sofosbuvir ahead of it being available in August 2015, as well as other new DAAs.

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Scotland introduced a policy of prioritising antiviral therapy for those with moderate to severe liver disease. The policy of prioritisation ended in 2018.

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Professor John Dillon, clinical lead for Hepatitis C in NHS Tayside, described the approach to treatment of Hepatitis C in Scotland.

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Funding for DAAs was provided through operational delivery networks across England. Each one was provided with a proportion of the budget for Hepatitis C treatment based on the estimated treatment figures for the area covered and the local prevalence of Hepatitis C.

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Professor Graham Foster explained the phases of NHS England's Hepatitis C elimination programme.

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Professor Graham Foster was asked about the services, including testing and treatment, offered to those identified via the Hepatitis C elimination programme. He explained that treatment services are dependent on the local area, however, broadly, patients are offered a liver fibrosis assessment and subsequently a multi-disciplinary meeting is held to discuss treatment needs.

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Professor Graham Foster responded to concerns about lack of consistency in monitoring of Hepatitis C in England. He favoured an individualised approach to management of Hepatitis C in consultation with the patient.

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Samantha May, Helpline Information and Support Service Manager for the Hepatitis C Trust, stated that when new treatments first became available, "we frequently heard from our callers that their consultants told them they were "lucky" to receive this new treatment and they should be "grateful" due to the initial high cost."

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Robert James, a campaigner involved in the field of patient involvement and treatment activism, stated that the rationing of DAAs by NHS England delayed the availability of effective Hepatitis C treatment to many people with haemophilia in England.

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A witness borrowed £60,000 to access Harvoni treatment privately. He explained "I couldn't bear the pain of not knowing how long I would have to wait. It felt like I was playing Russian roulette with my life." Ultimately the treatment was funded by the NHS.

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David Gort self-funded his Harvoni treatment because it was unclear when the NHS funded treatment would be provided.

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Kenneth Gray said he and his late wife would have self-funded Hepatitis C treatment if they had known it was possible, in order to have more time together.

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Julie Morgan MS, who campaigned on behalf of haemophilia patients in Parliament and then the Senedd, described access to Hepatitis C treatment in Wales as having been a "postcode lottery" but the announcement of £13.8 million for interferon-free treatment was a turning point.

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Caroline Leonard, on behalf of the Belfast Health and Social Care Trust, acknowledged that patients had had to wait, both for a hepatology referral and for treatment. By Autumn 2019, the waiting time for someone with HCV to be seen at clinic was reduced to around 8 weeks.

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Caroline Leonard explained all NICE approved specialist drug therapies are available for Hepatitis C in Northern Ireland.

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Caroline Leonard explained that in Northern Ireland patients who have a fibroscan suggestive of advanced fibrosis or cirrhosis are kept under long-term review at the liver clinic, with an ultrasound and blood test for AFP every six months and a six-monthly clinic review.

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Leigh Day solicitors submitted to the Inquiry that one of the most important issues for them in relation to their treatment was their ability to access monitoring and follow-up care for Hepatitis C (and related symptoms and conditions) after they achieved a sustained virological response, and had thus apparently "cleared" the virus.

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A witness described not being aware of, or offered, treatment for Hepatitis C until 2006 when he was treated with combination therapy of interferon and ribavirin.

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Thomas Farrell was told at the age of 64, he was too old to receive treatment for Hepatitis C, however, after contacting his GP, he was able to start a one-year course of Interferon.

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Christopher Meaden described his mother's difficulties accessing treatment with interferon, ribavirin and telaprevir in Wales.

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