Table 6.

Key recommendations

Community-level

▪ Improve knowledge about the disease, and awareness of the disease in at-risk groups ▪ Raise awareness of the asymptomatic nature of disease ▪ Tackle misperceptions ▪ Tackle stigma both at the individual and community level ▪ Provide health system navigators and clarify entitlements to health services ▪ Explore developing family support to influence testing and longer term compliance

Healthcare practitioners and services

▪ Improve healthcare practitioners’ knowledge of the disease, and raise their awareness of risk groups ▪ Develop cultural competency of staff. Be aware of in-group diversity ▪ Provide language support with health literate interpreters ▪ Train staff in the use of interpreters ▪ Make greater use of informational aids and tools such as patient alerts in electronic health records

Commissioners, Service Managers and Policymakers

▪ Ensure adequate resourcing for implementation of testing ▪ Identify advocate to champion the issue to local decision-makers. ▪ Engender leadership and ownership of the agenda ▪ Develop a compelling narrative of need and the economic case ▪ Clarify roles and responsibilities for commissioning hepatitis B services for migrants ▪ Develop joint collaborative commissioning where the responsibilities are split ▪ Encourage and empower local innovation ▪ Recognise community diversity and tailor responses to local needs and context ▪ Look to make services sustainable ▪ Increase accessibility of services - community-based/outreach services may help ▪ Explore collaboration with other agencies and the voluntary sector