GPs’ mobile outreach clinic transforms Hep C treatment

In 2016, after PBS changes allowed GPs to prescribe direct-acting antiviral (DAA) medication for hepatitis C treatment, two GPs in Brisbane’s south had an idea.
 
Dr Joss O’Loan and his colleague Dr Matt Young, based at Medeco Medical Centre Inala, recognised how simple, effective and life-changing diagnosing and treating hepatitis C could be. They also realised that the barriers to accessing medical care meant that many people remained undiagnosed.
 
Together Dr O’Loan and Dr Young co-founded the Kombi Clinic, a mobile outreach clinic equipped with everything required to test and treat hepatitis C, including medical staff, point-of-care testing and a FibroScan.
 
‘It’s really simple to treat, has a profound impact on the patient’s life and has a profound impact on the way they view and feel about themselves as stigma is a real issue,’ Dr O’Loan told newsGP.
 
‘The barriers to hepatitis C treatment are no longer medical – they’re social.
 
‘For a lot of patients [it’s] really difficult to jump through all the hoops of a “traditional” model of care … asking [them] to go and get a blood test or go down the road to get an ultrasound and then come back and see me and then do this and then do that.
 
‘So Kombi Clinic was invented to streamline the approach and really make it as much of a one-stop-shop as possible.’
 
In reaching populations that may not engage with traditional models of care, Dr O’Loan and Dr Young have embraced the unconventional. Originally running out of a 1975 bright yellow Kombi Van that has since been retired, the team now operate from a new vehicle that has been retrofitted to keep with the Kombi Clinic theme and ‘do it all in Hawaiian shirts and play rock and roll music’.
 
But while the methods are different, Dr O’Loan explains allowing people to drop into their clinic, get tested, and – if required – a script for DAA medication, can be incredibly effective.
 
‘I saw a bloke 12 months ago on Kombi, he tested positive for hepatitis C,’ he said. ‘We started him on treatment [but] then didn’t see him for months and months and months.
 
‘We tried to contact him to get him back in to do his treatment bloods … [and eventually] he came in [and] tested negative. He’s cured’.
 
The mobile clinic services communities where prevalence of hepatitis C is potentially higher than the general population, such as Drug and Alcohol clinics, homeless drop-in centres and halfway houses. It has also recently expanded to visit prisons where they can test and treat up to 100 people per day.
 
The Department of Health and Aged Care is currently consulting on its Sixth National Hepatitis C Strategy 2023–2030, with a vision to eliminate hepatitis C as a public health threat in Australia by 2030.
 
To achieve this, the RACGP says there needs to be a strong focus on hard-to-reach populations, including through innovative services like the Kombi Clinic.
 
And while mobile outreach may seem like a solution out of reach for most general practices, Dr O’Loan believes it is possible for GPs to use their existing infrastructure to implement similar strategies and meet the healthcare needs of their local communities. 
 
‘I guess in essence, we saw a need that was a unmet in the community, and we had skills and the equipment to meet that need so we did it,’ he said.
 
‘We don’t have to go far to see unmet needs in healthcare in Australia. And you also don’t need to go far outside your postcode to find things that you can do as a GP in your local community that isn’t otherwise being done.’
 
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Hepatitis C Kombi Clinic public health treatment access