Research and analysis

Hepatitis B in the North West: 2025 report

Published 14 May 2026

Applies to England

Introduction

Hepatitis B virus (HBV) is a blood-borne virus that can cause an acute or chronic infection of the liver. Chronic infection can lead to liver cirrhosis, liver cancer, and even death.

Prevention and treatment efforts have been combined to combat HBV infection and progress towards elimination of HBV as a public health threat by 2030 (set out in the World Health Organization (WHO) Global Health Sector Strategy on Viral Hepatitis). The National Strategic Group on Viral Hepatitis, a cross-agency expert advisory body supported by the UK Health Security Agency (UKHSA) provides strategic guidance on viral hepatitis in England, and supports progress toward achieving the WHO goal of HBV elimination.

The UKHSA publishes a national report on the scale of HBV infection and related disease in England (the latest report for Hepatitis B in England), presenting disease surveillance and programme data to support monitoring of England’s progress towards WHO HBV elimination targets.

This report complements the UKHSA Hepatitis B in England report and presents further information on HBV disease surveillance, trends in HBV diagnosis and testing and related diseases in North West UKHSA region with data up to the end of 2024. Although this report uses national data sources, regional figures may differ from the national figures for a given metric. For further details about data sources see information on data sources.

Summary

Trends in HBV testing and diagnosis in the general population and risk groups

Main trends are:

• 1,736 new laboratory reports of hepatitis B in residents of the North West, representing a rate of 22.4 reports per 100,000 population in 2024 
• increased testing activity through new ‘opt-out’ blood-borne virus testing programme in selected emergency departments. Combined with improvements in laboratory reporting systems, this is valuable context to understand the increase in the number of new laboratory reports received, by 52.7% between 2023 and 2024, and by 122.6% over the past 10 years 
• in 2024, the number of new laboratory reports in males was 1,094 (63.3%) and in females was 635 (36.6%) 
• in 2024, the highest number of new laboratory reports was in males aged 35 to 44; in females most reports were in those aged 35 to 44 and 25-34
• in 2024, the number of new laboratory reports by upper tier local authority of residence ranged from 0 in Westmorland and Furness to 499 in Liverpool. Rates were highest in Liverpool at 98 new laboratory reports per 100,000 population and lowest in Westmorland and Furness with 0 per 100,000 population 
• the estimated incidence of acute (or probable acute) infection was 0.6 per 100,000 population. This was higher than the England average of 0.5 per 100,000 
• 104,669 individuals were tested for hepatitis B surface antigen (HBsAg) in sentinel laboratories in the North West UKHSA region in 2024, of which 0.97% tested positive; the total number of tests conducted has increased since 2022 as a result of a new ‘opt-out’ blood-borne virus testing programme in selected emergency departments

Monitoring HBV-related morbidity

Main trends are:

• there were 1200 hospital admissions for individuals with a diagnosis code for acute or chronic hepatitis B in the North West UKHSA region in 2024 which was higher than the number of admissions in 2023 (995) 
• the number of hospital admissions with a diagnosis code for hepatitis B-related end-stage liver disease (HBV-related ESLD) and hepatitis B-related hepatocellular carcinoma (HBV-related HCC) was 110 and 35 respectively in 2024 

Prevention of infection by immunisation

Main trends are:

• routine hepatitis B vaccine coverage of 3 doses at 24 months in North West UKHSA region was 92.2% for 2024
• vaccine coverage of 3 doses at 24 months decreased by 0.1% between financial years 2023 to 2024 and 2024 to 2025
• reported level of hepatitis B vaccine uptake among people who inject drugs (PWID) in the North West UKHSA region was 61.8% for 2023 (the most recently reported data)
• reported level of hepatitis B vaccine uptake among PWID has increased by 2.7% between 2022 and 2023

Trends in HBV testing and diagnosis in the general population and risk groups

Estimated prevalence of HBV

Table 1. Estimated hepatitis B prevalence and number of people living with chronic hepatitis B, UKHSA regions and England, 2024

Region	Estimated number of individuals with chronic hepatitis B, (95% confidence interval (CI))	Estimated HBsAg prevalence (%), (95% CI)	Estimated SSBBV coverage (%)
England	268,767 (227,896 to 314,004)	0.58 (0.50 to 0.68)	45
East of England	19,584 (6,282 to 48,679)	0.38 (0.12 to 0.95)	40
East Midlands	7,584 (3,633 to 15,369)	0.19 (0.09 to 0.38)	64
London	99,067 (78,415 to 120,263)	1.39 (1.10 to 1.69)	75
North East	7,950 (2,700 to 20,289)	0.36 (0.12 to 0.93)	32
North West	25,406 (17,060 to 37,303)	0.42 (0.28 to 0.62)	43
South East	25,678 (12,326 to 53,207)	0.34 (0.16 to 0.70)	34
South West	15,978 (8,336 to 32,977)	0.34 (0.18 to 0.70)	30
West Midlands	24,756 (14,343 to 41,647)	0.52 (0.30 to 0.87)	35
Yorkshire and Humber	16,720 (9,012 to 29,921)	0.37 (0.20 to 0.67)	39

Data source: Modelling based on Sentinel Surveillance of Bloodborne Virus Testing. For further information, see information on data sources and Hepatitis B in England national report.

The modelling methodology used to calculate these estimates has been published in the Journal of Viral Hepatitis. It is important to note that there is less confidence in the regional estimates compared to the national estimate and, as the estimates are based on data from the Sentinel Surveillance of Blood Borne Viruses (SSBBV), the accuracy of regional estimates may be influenced by the coverage of SSBBV in that region.

New laboratory-confirmed diagnoses of HBV

Figure 1. Number of new laboratory reports of hepatitis B (acute and chronic), residents of North West UKHSA region, 2015 to 2024

Data source: Second Generation Surveillance System (SGSS). For further information, see information on data sources.

In 2022, a new bloodborne virus (BBV) testing programme was introduced in selected emergency department (ED) sites in areas of high HIV diagnosed prevalence across England. This ‘opt-out’ programme may have led to increases in new diagnoses, however since the start of the ED opt-out programme, only approximately 11% of new hepatitis B diagnoses nationally where testing location is known have been made in ED.

There were 1736 new laboratory reports of hepatitis B (both acute and chronic) in North West residents in 2024. This represented a 53% increase compared to 2023 and the highest number of reports in the previous 9 years. The increase in testing through emergency departments and improvements to laboratory reporting is likely to have increased the number of new laboratory reports in 2024.

Figure 2. New laboratory reports of hepatitis B (acute and chronic) rate per 100,000 population [note 1], residents of North West UKHSA region and England, 2015 to 2024

Data sources: SGSS and Office for National Statistics (ONS) mid-year population estimates (MYE). For further information, see information on data sources.

Note 1: the error bands represent 95% confidence intervals.

In 2024 the rate of laboratory reports of hepatitis B (both acute and chronic) in the North West was 22.4 per 100 000 population, similar to the England rate (21.4).

Since 2015, the North West rate has remained below the England rate with the exception of 2019 when there was a notable increase in reports to a level similar to the national level. The North West rate has increased since 2022, a trend mirrored in the England-level data and which may reflect changes in healthcare seeking behaviours and access following the COVID-19 pandemic.

Table 2. Number of new laboratory reports of hepatitis B (acute and chronic) by UKHSA region of residence, 2015 to 2024

Area	2015	2016	2017	2018	2019	2020	2021	2022	2023	2024
East Midlands	281	407	574	590	535	339	426	556	675	675
East of England	636	674	616	513	616	495	511	650	721	809
London	5,581	6,666	4,875	2,851	3,302	2,531	2,703	3,830	5,291	5,359
North East	155	192	228	199	206	112	144	205	271	275
North West	780	761	715	830	1,123	750	794	771	1,137	1,736
South East	712	684	830	726	966	533	734	978	1,072	1,077
South West	385	431	569	445	371	348	547	697	590	656
West Midlands	858	889	890	850	868	557	627	860	1,188	1,081
Yorkshire and Humber	864	699	683	755	764	451	548	731	804	886
England [note 2]	10,252	11,406	9,991	7,829	8,806	6,149	7,107	9,427	11,910	12,566

Data source: SGSS. For further information, see information on data sources.

Note 2: sum of all regional cases may not equal the number of England cases as some cases may not have been able to be assigned to a region.

In 2024, UKHSA received 1,736 laboratory reports of hepatitis B (acute and chronic) in North West residents, which was 13.8% of all reports received in England.

Table 3. Rate per 100,000 population of new laboratory reports of hepatitis B (acute and chronic) by UKHSA region of residence, 2015 to 2024

Area	2015	2016	2017	2018	2019	2020	2021	2022	2023	2024
East Midlands	6.0	8.6	12.0	12.3	11.0	7.0	8.7	11.3	13.5	13.3
East of England	10.0	10.5	9.5	7.9	9.4	7.5	7.7	9.7	10.6	11.8
London	64.4	76.2	55.5	32.3	37.1	28.5	30.7	43.2	58.8	59.0
North East	5.9	7.3	8.7	7.6	7.8	4.2	5.4	7.6	9.9	10.0
North West	10.9	10.5	9.8	11.3	15.3	10.2	10.7	10.2	14.9	22.4
South East	8.2	7.8	9.4	8.2	10.8	6.0	8.1	10.7	11.6	11.5
South West	7.0	7.8	10.2	7.9	6.6	6.1	9.6	12.1	10.1	11.1
West Midlands	14.9	15.3	15.2	14.4	14.7	9.4	10.5	14.3	19.5	17.5
Yorkshire and Humber	16.1	12.9	12.6	13.9	14.0	8.2	10.0	13.2	14.3	15.6
England	18.7	20.6	18.0	14.0	15.7	10.9	12.6	16.5	20.6	21.4

Data sources: SGSS and ONS MYE. For further information, see information on data sources.

The rate of laboratory reports of hepatitis B (acute and chronic) in the North West in 2024 was 22.4 per 100,000 population, similar to the England rate (21.4) and the second highest regional rate after London (59.0). Since 2015, the North West rate has remained below the England rate with the exception of 2019 when there was a notable increase to a level similar to the national level.

Figure 3. Age group and sex of new laboratory reports of hepatitis B (acute and chronic) [note 3], residents of North West UKHSA region, 2024

Data source: SGSS. For further information, see information on data sources.

Note 3: cases reported in children under one year old have been removed. 7 Hepatitis B cases in North West region in 2024 had no age and/or sex data and have not been included in this age-sex pyramid.

Among those where age and sex were reported (1,729 of 1,736), males accounted for more (64%) laboratory reports of hepatitis B in North West residents in 2024 compared to females. The most affected groups were males aged 35 to 44 (322), 25 to 34 (243) and 45 to 54 (214).

Figure 4. Ethnicity distribution of new laboratory reports of new diagnoses of HBV [note 4], residents of North West UKHSA region, 2015 to 2024

Data source: SGSS. For further information, see information on data sources.

Note 4: this figure excludes cases of unknown ethnicity.

A similar proportion of new hepatitis B diagnoses in North West residents in 2024 were reported across the White British (27.16%), Black or Black British (27.04%) and Asian or Asian British (26.79%) ethnic groups. The proportion of new diagnoses in the White British ethnic group increased by 9% between 2023 and 2024 while the proportion in the Asian and Asian British ethnic group declined by 15% between 2022 and 2024.

Table 4. Number of new laboratory reports of hepatitis B (acute and chronic) by upper tier local authority of residence [note 5], North West UKHSA region, 2015 to 2024

Upper tier local authority	2015	2016	2017	2018	2019	2020	2021	2022	2023	2024
Blackburn with Darwen	7	6	1	7	5	8	4	4	6	4
Blackpool	9	0	3	4	23	14	25	22	33	35
Bolton	30	34	43	36	39	30	29	28	50	53
Bury	22	28	17	17	31	12	12	19	14	24
Cheshire East	23	21	16	22	20	16	25	27	35	36
Cheshire West and Chester	12	16	11	12	23	13	16	24	25	32
Cumberland	2	5	4	6	5	2	5	6	6	5
Halton	2	4	4	3	9	4	1	6	15	15
Knowsley	3	3	6	3	9	7	3	0	18	23
Lancashire	44	16	19	65	68	50	159	93	77	84
Liverpool	3	12	4	20	225	112	59	7	232	499
Manchester	251	241	285	324	267	203	215	234	284	427
Oldham	48	57	50	67	68	29	38	44	33	74
Rochdale	41	35	25	34	30	26	28	26	28	50
Salford	45	48	50	59	74	48	50	64	67	96
Sefton	4	9	8	4	25	20	7	3	32	36
St. Helens	9	8	5	6	14	20	6	8	6	18
Stockport	19	21	21	24	26	19	10	29	34	50
Tameside	22	19	21	24	18	19	16	22	34	43
Trafford	21	35	24	22	21	22	28	45	36	46
Warrington	8	6	21	12	21	10	14	23	32	25
Westmorland and Furness	4	0	0	8	7	2	4	2	3	0
Wigan	23	21	22	36	62	37	22	21	24	41
Wirral	10	5	15	15	32	22	15	14	12	20

Data source: SGSS. For further information, see information on data sources.

Note 5: this table excludes cases where upper tier local authority was unknown.

The highest number of laboratory reports of hepatitis B (acute and chronic) in 2024 was reported from Liverpool (499), followed by Manchester (427). Manchester has consistently reported the highest number of new hepatitis B laboratory diagnoses in the North West since 2015 whereas the number from Liverpool over the same period have fluctuated due to changes in laboratory reporting. The lowest number of reports in 2024 were from Westmorland and Furness (0), Blackburn with Darwen (4) and Cumberland (5). In order to compare hepatitis B diagnoses between local authorities it is important to take into account differences in the size of the resident population in each area.

Table 5. Rate per 100,000 population of new laboratory reports of hepatitis B (acute and chronic) by upper tier local authority of residence [note 6], North West UKHSA region, 2015 to 2024

Upper tier local authority	2015	2016	2017	2018	2019	2020	2021	2022	2023	2024
Blackburn with Darwen	4.7	4.0	0.7	4.6	3.2	5.2	2.6	2.6	3.8	2.5
Blackpool	6.3	0.0	2.1	2.8	16.2	9.9	17.7	15.5	23.1	24.3
Bolton	10.5	11.8	14.8	12.3	13.2	10.1	9.8	9.3	16.4	17.1
Bury	11.6	14.7	8.9	8.8	16.0	6.2	6.2	9.7	7.1	12.1
Cheshire East	6.1	5.5	4.2	5.7	5.1	4.1	6.2	6.6	8.4	8.5
Cheshire West and Chester	3.5	4.7	3.2	3.4	6.5	3.7	4.5	6.6	6.8	8.6
Cumberland	0.7	1.8	1.5	2.2	1.8	0.7	1.8	2.2	2.2	1.8
Halton	1.6	3.2	3.1	2.3	7.0	3.1	0.8	4.6	11.5	11.4
Knowsley	2.0	2.0	4.0	2.0	5.9	4.6	1.9	0.0	11.3	14.1
Lancashire	3.7	1.3	1.6	5.4	5.6	4.1	12.9	7.4	6.0	6.5
Liverpool	0.6	2.5	0.8	4.1	46.4	23.2	12.2	1.4	46.1	98.0
Manchester	48.0	45.2	53.1	59.9	48.9	37.1	39.0	41.1	48.9	72.4
Oldham	20.6	24.3	21.1	27.9	28.1	12.0	15.7	18.0	13.3	29.4
Rochdale	19.1	16.2	11.4	15.5	13.5	11.7	12.5	11.4	12.1	21.2
Salford	18.2	19.1	19.6	22.8	28.1	18.0	18.5	22.9	23.3	32.6
Sefton	1.5	3.3	2.9	1.4	9.0	7.2	2.5	1.1	11.3	12.6
St. Helens	5.0	4.5	2.8	3.3	7.7	11.0	3.3	4.3	3.2	9.5
Stockport	6.6	7.2	7.2	8.2	8.9	6.5	3.4	9.8	11.3	16.5
Tameside	9.8	8.4	9.3	10.5	7.8	8.2	6.9	9.4	14.4	17.9
Trafford	9.0	15.0	10.2	9.3	8.9	9.3	11.9	19.0	15.1	19.1
Warrington	3.8	2.8	9.9	5.7	9.9	4.7	6.6	10.9	15.0	11.6
Westmorland and Furness	1.8	0.0	0.0	3.5	3.1	0.9	1.8	0.9	1.3	0.0
Wigan	7.2	6.5	6.8	11.1	19.0	11.3	6.7	6.3	7.1	11.9
Wirral	3.1	1.6	4.7	4.7	10.0	6.9	4.7	4.3	3.7	6.1

Data sources: SGSS and ONS MYE. For further information, see information on data sources.

Note 6: this table excludes cases where upper tier local authority was unknown.

The upper tier local authority with the highest rate of laboratory reports of hepatitis B (acute and chronic) per 100, 000 population in the North West in 2024 was Liverpool (98.0). The fluctuating trend observed in Liverpool over the last 10 years is largely due to changes in laboratory reporting. The rate in Manchester was also considerably higher than for the other upper tier local authorities in 2024 (72.4) which represented a 48% increase in the rate compared to 2023 (48.9). Other upper tier local authorities in the upper quartile of rates in 2024 were Salford (32.6), Oldham (29.4), Blackpool (24.3) and Rochdale (21.2). 

The upper tier local authorities with the lowest rate of laboratory reports of hepatitis B (acute and chronic) per 100, 000 population in the North West in 2024 were Westmorland and Furness (0.0), Cumberland (1.8) and Blackburn with Darwen (2.5). Wirral (6.1), Lancashire (6.5) and Cheshire East (8.5) were also in the lower quartile of rates in 2024.

Figure 5. Test location of new laboratory reports of hepatitis B (acute and chronic), residents of North West UKHSA region, 2024

Data sources: SGSS. For further information, see information on data sources.

Most new laboratory diagnoses of hepatitis B in North West residents in 2024 originated from hospital settings (55.6%), followed by general practice (19.5%), emergency departments (13.2%) and sexual health clinics (8.1%). Emergency department testing accounted for fewer than 1.5% of all diagnoses between 2018 and 2023 and then increased by 11.8% in 2024, following the introduction of opt-out testing. The percentage of diagnoses originating in hospital settings declined by 10.8% compared to 2023, while those made in general practice remained stable.

Acute or probable acute diagnoses of HBV

Figure 6. Estimated incidence of acute or probable acute hepatitis B per 100,000 population by UKHSA region [note 7], 2024

Data sources: SGSS, UKHSA Case and Incident Management System (CIMS) and ONS MYE. For further information, see information on data sources.

Note 7: UKHSA transitioned to a new case management system for notifiable diseases in 2024 which has impacted the identification of people with acute hepatitis B and likely resulted in underreporting.

The estimated incidence rate of acute or probable acute hepatitis B infection in North West residents in 2024 was 0.59 per 100,000 population. This was higher than the England average incidence rate of 0.47 and the third highest after London (0.80) and the West Midlands (0.60).

Figure 7. Estimated incidence of acute or probable acute hepatitis B per 100,000 population [note 8], North West UKHSA region and England, 2015 to 2024

Data sources: SGSS, CIMS and ONS MYE. For further information, see information on data sources.

Note 8: UKHSA transitioned to a new case management system for notifiable diseases in 2024 which has impacted the identification of people with acute hepatitis B and likely resulted in underreporting.

The trend in the estimated incidence rate of acute or probable acute hepatitis B infection in the North West has been at a similar level, and shown a similar trajectory, to the wider trend in England. There was a decreasing trend from 2015 to 2020, then since 2020 there has been an increase which continued in 2024 to 0.59 per 100,000 population in the North West.

HBV testing in the wider population

Figure 8. Number of individuals tested for HBsAg by year (excluding antenatal testing) and proportion positive in sentinel laboratories [note 9] in North West UKHSA region, 2015 to 2024

Data source: Sentinel Surveillance of Bloodborne Virus Testing. For further information, see information on data sources.

Note 9: the error band represents 95% confidence intervals.

Note 10: Between 2023 and 2024, there was underreporting of hepatitis testing data from a sentinel laboratory which undertakes a large proportion of testing for drug treatment services, making it difficult to monitor trends in drug treatment services over this period.

From 2022 to 2024, the opt-out ED BBV testing programme was scaled-up, leading to increased numbers of tests being conducted in these sentinel surveillance sites.

There were 104,669 individuals tested for HBsAg (hepatitis B surface antigen) in sentinel laboratories in the North West in 2024, of which 0.97% tested positive. The proportion of positive test results remained largely stable from 2015 to 2022 but increased sharply in 2023 from 1.05 to 1.68% before declining to 0.97% in 2024.

Figure 9. Number of individuals tested for HBsAg by year (excluding antenatal testing) and proportion positive, through GP surgeries in sentinel laboratories [note 9] in North West UKHSA region, 2015 to 2024

Data source: Sentinel Surveillance of Bloodborne Virus Testing. For further information, see information on data sources.

Note 9: the error band represents 95% confidence intervals.

In 2024, 10,420 individuals were tested for HBsAg through GP surgeries in sentinel laboratories in the North West, of which 1.28% tested positive. The proportion of positive test results remained stable between 2021 and 2023 but increased slightly in 2024 from 1.12% to 1.28%. There was an overall declining trend in test positivity between 2015 and 2024 (1.36% to 1.28%) with fluctuations in 2020 and 2021 likely due to changes in access to healthcare during the COVID-19 pandemic, when fewer tests were being performed.

Testing and diagnoses in sexual health services (SHS)

Figure 10. Number of individuals tested for HBsAg by year (excluding antenatal testing) and proportion positive, through sexual health services in sentinel laboratories [note 9] in North West UKHSA region, 2015 to 2024

Data source: Sentinel Surveillance of Bloodborne Virus Testing. For further information, see information on data sources.

Note 9: the error band represents 95% confidence intervals.

In 2024, 9,396 individuals were tested for HBsAg through sexual health services in sentinel laboratories in the North West, of which around 0.96% tested positive. Positivity remained stable between 2015 and 2019 (0.83% to 0.71%), declined in 2020 and 2021, likely linked to the COVID-19 pandemic, and increased steadily to 0.96% in 2024.

Testing and diagnoses in people who inject drugs and/or attend drug services

Figure 11. Number of individuals tested for HBsAg by year and proportion positive, through drug services in sentinel laboratories [note 9] [note 10] in North West UKHSA region, 2015 to 2024

Data source: Sentinel Surveillance of Bloodborne Virus Testing. For further information, see information on data sources.

Note 9: the error band represents 95% confidence intervals.

Note 10: Between 2023 and 2024, there was underreporting of hepatitis testing data from a sentinel laboratory which undertakes a large proportion of testing for drug treatment services, making it difficult to monitor trends in drug treatment services over this period.

The number of individuals tested for HBsAg through drug services in sentinel laboratories in the North West appeared to decline sharply between 2022 and 2024. This can be explained by underreporting of hepatitis testing data from a sentinel laboratory which undertakes a large proportion of testing for drug treatment services. (see Note 10)

Testing and diagnoses in people attending emergency departments

Figure 12. Number of individuals tested for HBsAg by year and proportion positive, through emergency departments in sentinel laboratories [note 9] in North West UKHSA region, 2015 to 2024

Data source: Sentinel Surveillance of Bloodborne Virus Testing. For further information, see information on data sources.

Note 9: the error band represents 95% confidence intervals.

The number of individuals tested for HBsAg through emergency departments in sentinel laboratories in the North West increased gradually between 2015 and 2023 from 647 to 2919. In 2024, testing increased sharply to over 13 times the number tested in 2023 (38,944) due to an expansion of ‘opt-out’ testing; the proportion of those tests which were positive declined from 0.79% to 0.26%. Overall, between 2015 and 2024, the proportion of positive tests declined from 1.7% to 0.26%.

Coverage of maternal hepatitis B surface antigen (HBsAg) testing

Figure 13. Coverage of hepatitis B antenatal screening by NHS region - Screening Standard IDPS-S02, NHS North West region, financial years 2021/2022 to 2023/2024

Data source: Infectious Disease in Pregnancy Screening (IDPS) (for further information, see information on data sources)

NHS regions may not be the same as UKHSA regions. The NHSE region being used for this plot is North West.

Coverage of hepatitis B antenatal screening in the NHS North West region remained high in FY 2023 to 2024 at 99.8%.

Monitoring HBV-related morbidity

Hospital admissions with HBV

Figure 14. Number of hospital admissions [note 11] and admission rate per 100,000 population [note 12] for individuals with a diagnosis code for acute or chronic hepatitis B [note 13], residents of North West UKHSA region [note 14], 2015 to 2024

Data source: Hospital Episode Statistics (HES), NHS England. Produced by the UK Health Security Agency. Copyright © 2025, re-used with the permission of the NHS England. All rights reserved. For further information, see information on data sources.

Note 11: data has been suppressed in accordance with NHS disclosure control guidance for sub-national breakdowns. Numbers between 1 and 7 (inclusive) are suppressed and (where applicable) represented in the figure by asterisks (*). All other numbers are rounded to the nearest 5. Zeroes are unchanged. Due to data quality issues around HES identifiers, data has been omitted for 2017 and 2018 (grey box).

Note 12: rates have been calculated using ONS mid-year population estimates.

Note 13: hepatitis B is defined by ‘International Statistical Classification of Diseases and Related Health Problems 10th Revision’ (ICD-10) codes B16.0, B16.1, B16.2, B16.9, B18.0 and B18.1.

Note 14: there is a high proportion of data missingness in the HES data for the geographies of residence for people admitted to hospital with acute and chronic hepatitis B (approximately 25% for 2024 admissions). This means that the regional admission counts and rates are likely an underestimate of the true number.

The hospital admission rate per 100,000 people for those with a diagnosis code of acute or chronic hepatitis B increased in the North West from 11.96 in 2022 to 15.51 per 100,000 population in 2024. This mirrored the national trend, although the admission rate was lower in the North West than in England in 2024 (19.95 per 100,000).

Figure 15. Number of hospital admissions [note 15] for individuals with a diagnosis code for hepatitis B-related end-stage liver disease (HBV-related ESLD) or hepatitis B-related hepatocellular carcinoma (HBV-related HCC) [note 16] [note 17], residents of North West UKHSA region [note 18], 2015 to 2024

Data source: Hospital Episode Statistics (HES), NHS England. Produced by the UK Health Security Agency. Copyright © 2025, re-used with the permission of the NHS England. All rights reserved. For further information, see information on data sources.

Note 15: data has been suppressed in accordance with NHS disclosure control guidance for sub-national breakdowns. Numbers between 1 and 7 (inclusive) are suppressed and (where applicable) represented in the figure by asterisks (*). All other numbers are rounded to the nearest 5. Zeroes are unchanged. Due to data quality issues around HES identifiers, data has been omitted for 2017 and 2018 (grey box).

Note 16: end-stage liver disease (ESLD) is defined by ICD-10 codes for ascites (R18), bleeding oesophageal varices (I85.0 and I98.3), hepato-renal syndrome (K76.7), hepatic encephalopathy (K72.9) or hepatic failure (K72.0, K72.1 and K70.4). Hepatocellular carcinoma (HCC) is defined by ICD-10 code for hepatocellular carcinoma (C22.0).

Note 17: the methodology used to calculate hepatitis B-related ESLD and HCC admissions has been updated for this report, as the previous method of only using HES data may under report hepatitis B as it relies on a diagnosis of hepatitis B being recorded in HES. The updated methodology, which follows the ‘upper bound’ methodology outlined in Hepatitis B in England 2025 report, links HES data to laboratory diagnoses of hepatitis B from SGSS and SSBBV from any year.

Note 18: there is a high proportion of data missingness in the HES data for the geographies of residence for people admitted to hospital with ESLD and/or HCC (approximately 23% for ESLD admissions in 2024 and approximately 26% for HCC admissions in 2024). This means that the regional admission counts are likely an underestimate of the true number.

Hepatitis B-related morbidity can be estimated by monitoring the incidence of hepatitis B-related end-stage liver disease (HBV-related ESLD) and/or hepatitis B-related hepatocellular carcinoma (HBV-related HCC).

The number of hospital admissions for individuals with HBV-related ESLD in the North West steadily increased between 2022 and 2024 to 110 admissions (a 36% increase), the highest recorded in the previous 9 years. Hospital admissions for individuals with HBV-related HCC increased over the same period but more gradually from 25 in 2022 to 35 in 2024.

Monitoring HBV-related mortality

Figure 16. Rate of deaths with ESLD [note 19] or HCC in those with HBV mentioned on their death certificate [note 20] by UKHSA region, 2020 to 2024

Data sources: ONS Mortality and ONS MYE. For further information, see information on data sources.

Note 19: ESLD is defined by codes or text entries for ascites, bleeding oesophageal varices, hepato-renal syndrome, hepatic encephalopathy or hepatic failure. Patients were identified via ICD-10 codes and text searching.

Note 20: the methodology used to calculate hepatitis B-related mortality has been updated for this report, as the previous method of only counting deaths where ESLD and/or HCC and hepatitis B were reported in ONS death registrations may lead to underreporting. The updated methodology, which follows the ‘upper estimate’ methodology outlined in Hepatitis B in England 2025 report, links ONS deaths registrations data to HES hospital admissions data and laboratory diagnoses of hepatitis B from SGSS and SSBBV from any year to yield a maximum number of deaths attributable to hepatitis B-related ESLD and/or HCC.

The rate of deaths with end-stage liver disease and hepatocellular carcinoma among residents of the North West from 2020 to 2024 was 0.416 per 100,000 population. This was the second highest regional rate after London (0.688 per 100,000 population) and higher than for England overall (0.333 per 100,00 population).

Prevention of infection by immunisation

Coverage of hepatitis B vaccine 3 doses (HepB3) in universal programme

Figure 17. Routine hepatitis B vaccine coverage of 3 doses of the hexavalent vaccine at 12 months, North West UKHSA region and England, financial years 2019/2020 to 2024/2025

Data source: NHS Childhood Vaccination Coverage Statistics (COVER). For further information, see information on data sources.

Coverage of the routine hepatitis B (hexavalent) vaccine at 12 months in North West residents declined between financial years 2022/2023 and 2024/2025 from 91.78% to 90.53%. There was a smaller decline in coverage in England overall throughout the same period (91.80% to 91.30%).

Figure 18. Routine hepatitis B vaccine coverage of 3 doses of the hexavalent vaccine at 24 months, North West UKHSA region and England, financial years 2020/2021 to 2024/2025

Data source: NHS COVER. For further information, see information on data sources.

There was a decline in coverage of the routine hepatitis B (hexavalent) vaccine at 24 months in North West residents between financial years 2021 to 2022 and 2024 to 2025, from 94.01% to 92.19%. Overall coverage in England remained relatively stable over this period (93.04% in 2021 to 2022 to 92.50% in 2024 to 2025). Coverage in the North West was similar to in England in FY 2024 to 2025 (92.19% and 92.50% respectively).

Coverage of hepatitis B vaccine 3 doses (HepB3) in selective programme

Table 6. Children born to mothers positive for hepatitis B vaccinated against hepatitis B by their first birthday by upper tier local authority: vaccine coverage (5 doses routine and selective combined [note 21]) and eligible population, North West UKHSA region, FY 2024 to 2025

Local authority	Eligible population	Number vaccinated	Percentage covered (%)
Blackburn with Darwen	6	6	100.00%
Blackpool	0	0	Not applicable
Bolton	16	15	93.80%
Bury	8	8	100.00%
Cheshire East	8	8	100.00%
Cheshire West and Chester	[note 22]	[note 22]	70% to 100%
Cumbria	[note 22]	[note 22]	70% to 100%
Halton	5	5	100.00%
Knowsley	[note 22]	[note 22]	70% to 100%
Lancashire	18	17	94.40%
Liverpool	20	16	80.00%
Manchester	44	44	100.00%
Oldham	14	14	100.00%
Rochdale	7	7	100.00%
Salford	14	14	100.00%
Sefton	[note 22]	[note 22]	70% to 100%
St. Helens	[note 22]	[note 22]	70% to 100%
Stockport	7	7	100.00%
Tameside	13	13	100.00%
Trafford	6	6	100.00%
Warrington	[note 22]	[note 22]	70% to 100%
Wigan	9	9	100.00%
Wirral	0	0	Not applicable

Data source: NHS COVER. For further information, see information on data sources.

Note 21: babies received 2 monovalent vaccines (at birth and at 4 weeks), and 3 doses of hexavalent vaccines (at 8, 12 and 16 weeks).

Note 22: denotes that data is suppressed due to potential disclosure issues associated with small numbers.

In financial year 2024 to 2025, the proportion of children at high risk of maternal transmission vaccinated against hepatitis B by their first birthday in UTLAs in the North West was 100% in 12/23 UTLAs. Approximate coverage could only be reported for 6 UTLAs as data was suppressed due to potential disclosure issues associated with small numbers. Where coverage could be reported, it was lowest in Liverpool at 80.0%. It is challenging to draw further conclusions due to issues interpreting statistics based on small numbers.

Table 7. Children born to mothers positive for hepatitis B vaccinated against hepatitis B by their second birthday by upper tier local authority: vaccine coverage (6 doses routine and selective combined [note 23]) and eligible population, North West UKHSA region, FY 2024 to 2025

Local authority	Eligible population	Number vaccinated	Percentage covered (%)
Blackburn with Darwen	5	5	100.00%
Blackpool	[note 24]	[note 24]	70% to 100%
Bolton	15	15	100.00%
Bury	9	9	100.00%
Cheshire East	[note 24]	[note 24]	70% to 100%
Cheshire West and Chester	5	5	100.00%
Cumbria	[note 24]	[note 24]	70% to 100%
Halton	5	5	100.00%
Knowsley	[note 24]	[note 24]	70% to 100%
Lancashire	16	12	75.00%
Liverpool	15	14	93.30%
Manchester	36	35	97.20%
Oldham	11	9	81.80%
Rochdale	13	13	100.00%
Salford	12	11	91.70%
Sefton	[note 24]	[note 24]	70% to 100%
St. Helens	6	6	100.00%
Stockport	9	8	88.90%
Tameside	8	7	87.50%
Trafford	[note 24]	[note 24]	70% to 100%
Warrington	[note 24]	[note 24]	70% to 100%
Wigan	5	5	100.00%
Wirral	[note 24]	[note 24]	70% to 100%

Data source: NHS COVER. For further information, see information on data sources.

Note 23: babies received 3 monovalent vaccines (at birth, 4 weeks and 12 months), and 3 doses of hexavalent vaccines (at 8, 12 and 16 weeks).

Note 24: denotes that data is suppressed due to potential disclosure issues associated with small numbers.

In financial year 2024 to 2025, the proportion of children at high risk of maternal transmission vaccinated against hepatitis B by their second birthday in UTLAs in the North West was 100% in 8 out of 23 UTLAs. Approximate coverage could only be reported for 8 UTLAs as data was suppressed due to potential disclosure issues associated with small numbers. Where coverage could be reported, it was lowest in Lancashire at 75.0%. It is challenging to draw further conclusions due to issues interpreting statistics based on small numbers.

Vaccine uptake in people who inject drugs

Figure 19. Reported level of hepatitis B vaccine uptake among people who inject drugs (PWID), North West UKHSA region, 2014 to 2023

Data source: Unlinked Anonymous Monitoring (UAM) survey. For further information, see information on data sources.

The proportion of people who inject drugs (PWID) who reported hepatitis B vaccination in the North West in 2023 was 61.8%, a small increase compared to 2022 (59.1%). The proportion who reported vaccination in 2023 was similar to the England figure of 62.2%. There has been a declining trend in the reported level of hepatitis B vaccine uptake among PWID in the North West and in England overall since 2017.

Prevention of infection by harm reduction

Figure 20. Reported level of direct sharing of needles and/or syringes among people who inject drugs (PWID) in the preceding 4 weeks, North West UKHSA region and England, 2014 to 2023

Data source: UAM survey. For further information, see information on data sources.

The reported level of direct needle and/or syringe sharing amongst people who inject drugs (PWID) in the North West in 2023 was 24.3%, similar to the reported level for England of 25.2%. There has been an increasing trend in reported direct needle and/or syringe sharing in the North West and overall in England since 2014.

Figure 21. Reported level of direct and indirect sharing of injecting equipment among people who inject drugs (PWID) in the preceding 4 weeks, North West UKHSA region and England, 2014 to 2023

Data source: UAM survey. For further information, see information on data sources.

The reported level of direct and indirect sharing of injecting equipment amongst PWID in the North West in 2023 was 43.5%, a decline compared to 2022 (47.6%) and similar to the overall England level of 43.9%. There has been an overall gradual upward trend in the proportion of PWID reporting direct and indirect sharing of injecting equipment in the North West and in England between 2014 and 2023, albeit with some fluctuation from year to year.

Information on data sources

Second Generation Surveillance System (SGSS)

Brief description

SGSS captures routine laboratory surveillance data on infectious diseases and antimicrobial resistance from laboratories within England. Along with a number of other organisms, hepatitis B is notifiable under the Health Protection (Notifications) Regulations (2010).

Technical notes

Data extracted from Sentinel Surveillance of blood borne virus testing (SSBBV) and SGSS will vary for several reasons and should not be compared: the 2 systems have collected data over different historical periods, with data reported to SGSS and predecessor systems since 1995, whereas SSBBV has been running since 2002. Data reported to SSBBV reflects the timeframe from when the laboratory joined the surveillance system, with laboratories joining more recently having less data available than laboratories who have been reporting since 2002. Furthermore, whilst SGSS collects national level data, SSBBV collects data from a subset of laboratories. There are 35 laboratories which report to SSBBV with an estimated 45% coverage testing in the GP registered population in England.

Data completeness for ethnicity within this dataset declines over time, due to changes in methodology. ONOMAP, an ethnicity estimator which classifies ethnicity based on name is no longer used. Ethnicity is assigned using data reported through the test request form and through linkage to healthcare datasets and represents ethnicity that is assigned rather than estimated. Data will improve over time as additional information is reported, older records are more likely to be more complete.

Laboratory reports of new diagnoses of HBV include positive test results for HBV surface antigen (HBsAg) and are submitted to UKHSA or predecessor organisations via SGSS/CoSurv.

Data includes laboratory reports for both acute and chronic hepatitis B infections and therefore cannot be used to estimate incidence.

Data is assigned to local authority and UKHSA region by patient postcode where present, if patient postcode is unknown, data is assigned to local authority and UKHSA region of registered general practice; where both patient postcode and registered general practice are unknown data is assigned to local authority and UKHSA region of laboratory.

Dates are assigned based on earliest positive specimen date.

Patient identifiable data submitted by NHS laboratories is variable, particularly from sexual health and drug and alcohol services, which limits the ability to deduplicate.

Laboratory reports for children under one year of age are excluded from the analyses to rule out detecting maternal antibody.

Rates per 100,000 have been calculated using mid-year population estimates supplied by the Office for National Statistics (ONS).

Caveat: SGSS data in this report may differ from data shown in the Hepatitis B in England report and from data reported in other surveillance outputs at a different point in time. This is due to the SGSS dataset being a live system and a number of cleaning, deduplication, remapping and other operational processes being routinely applied to the data to improve data quality.

HPZone/CIMS

Brief description

HPZone was a case and outbreak management system used by the health protection teams (HPTs) in UKHSA until mid-2024, when it was replaced by a new Case and Incident Management System (CIMS). Details related to cases of hepatitis A, B, C and E are stored on this system in addition to details of other infections reported to the HPTs. 

HPZone and CIMS are secure systems. Where acute hepatitis B cases are reported, HPTS used HPZone historically and CIMS currently to capture data about these cases and relevant risk factors to inform public health action. As a result of the transition from HPZone to CIMS in mid-2024, there is a known issue that has likely impacted the identification of people with acute hepatitis B and likely resulted in the underreporting of cases. 

Hepatitis B case definitions using SGSS and HPZone/CIMS data

The definition for acute hepatitis B is ‘HBsAg positive and anti-HBc IgM positive and abnormal liver function tests with a pattern consistent with acute viral hepatitis’. As information on liver function is not usually available to UKHSA, for the purpose of this analysis the following case definitions were used:

• cases classified as acute viral hepatitis B by the local UKHSA region or the laboratory and/or with a documented positive anti-HBc IgM were classified as acute cases
• cases classified as acute viral hepatitis B by the local UKHSA region but without an anti-HBc IgM test result or not classified but a positive anti-HBc IgM reported were assumed to be probable acute hepatitis B cases
• cases initially classified as acute by the local UKHSA region but with contradictory laboratory evidence were reclassified as chronic infections
• cases classified as chronic infections or those not classified where anti-HBc IgM was negative or equivocal or missing were assumed to be chronic infections

The case definitions were derived using the following methodology: cases reported to UKHSA regions via HPZone/CIMS were extracted from 1 January 2015 to 31 December 2024 and matched using identifiers to SGSS data. The SGSS data was used to determine final classification of any cases reported from the UKHSA region via HPZone/CIMS. A final reconciled data set including cases classified as acute or probable acute was used for this report. 

Technical notes

UKHSA transitioned to a new case management system for notifiable diseases in 2024 which has impacted the identification of people with acute hepatitis B and likely resulted in underreporting.

Sentinel Surveillance of bloodborne viruses (BBVs)

Brief description

The sentinel surveillance study of hepatitis, HIV and HTLV began in 2002 and provides information on testing, individual risk exposures and clinical symptoms. The study collects information on blood borne virus testing carried out in participating sentinel laboratories regardless of result. In 2022 there were 24 participating laboratories and at the time this report was produced there were 28 participating laboratories, some of the new laboratories have provided legacy data if they were able to. 

Technical notes

See first technical note for SGSS

Excludes dried blood spot, oral fluid, reference testing and testing from hospitals referring all samples. Data is de-duplicated subject to availability of date of birth, Soundex and first initial.

Individuals under one year old are excluded from the analysis. 

Regional and England data is aggregated data for all organisations who provided complete data for all 4 quarters. Data is assigned to UKHSA region by the location of the requesting testing site.

Infectious Diseases in Pregnancy Screening (IDPS)

Brief description

NHSE’s IDPS Programme has commissioned the Integrated Screening Outcomes Surveillance Service (ISOSS). ISOSS monitors pregnancies where the mother is screen positive or is already known to have hepatitis B. Monitoring is also conducted for HIV, syphilis as well as continuing monitoring cases of congenital rubella syndrome

Technical notes

Published data can be found at Antenatal screening standards: data report 2020 to 2021.

Hospital Episode Statistics (HES)

Brief description

HES is a database containing details of all admissions, A&E attendances and outpatient appointments at NHS hospitals in England. This data is used to calculate the number of individuals per year that have a hospital admission related to hepatitis B associated end stage liver disease (ESLD) or hepatocellular carcinoma (HCC). It is also used to calculate incidence of HBV related ESLD and HCC. 

Technical notes

Hospital Episode Statistics (HES), NHS England. Produced by the UK Health Security Agency. Copyright © 2025, re-used with the permission of the NHS England. All rights reserved. 

Data is based on Hospital Episode Statistics as at October 2025. 

Patients who have had more than one hospital episode with a diagnosis of HBV in any one year and who have moved residence within that year have been grouped into the UKHSA region of their latest hospital episode in that year. 

Hepatocellular carcinoma (HCC) is defined by ICD-10 code for hepatocellular carcinoma (C22.0). End-stage liver disease (ESLD) is defined by ICD-10 codes for ascites (R18), bleeding oesophageal varices (I85.0 and I98.3), hepato-renal syndrome (K76.7), hepatic encephalopathy (K72.9) or hepatic failure (K72.0, K72.1 and K70.4). 

Data for 2017 and 2018 has been omitted. This is due an interrupt in the supply of identifiers in the HES year April 2017 to March 2018 making it impossible to distinguish repeat hospital episodes for the same person within the same year, and thus determine the number of prevalent cases of HBV and HBV-related HCC/ESLD in 2017 and 2018.

Office for National Statistics (ONS) Mortality data

Brief description

Data from the Mortality and Birth Information System is used to calculate the number of deaths from end stage liver disease (ESLD) or hepatocellular carcinoma (HCC) with hepatitis B mentioned on the death certificate. 

Technical notes

Published data about deaths can be found on the ONS website. 

Data on the number of deaths from ESLD and HCC in this report was identified by searching the ONS Mortality dataset using a combination of 2 methodologies described below, deaths that met either of these criteria were included in this report: 

• searching for all causes of mortality using the following ICD-10 codes - ‘C220’, ‘R18’, ‘K767’, ‘K729’, ‘K720’, ‘K721’, ‘K704’, ‘I850’, ‘I983’
• searching all free-text variables for the following terms - “hepatocellular c%”, “primary liver c%”, “hcc”, “ascites”, “encephal%”, “liver failure”, “hepatorenal syndrome”, “hepatic failure”, “hepatic coma”, “bleeding o%”, “ruptured oesoph%”, “haemorrhage from oesoph%”, where ICD-10 codes ‘B160’, ‘B161’, ‘B162’, ‘B169’, ‘B181’, ‘B180’ were also reported on the death certificate

There has been no additional clinical review stage, as may be conducted on other UKHSA reporting for ESLD/HCC mortality, and therefore numbers may vary slightly from other reports.

Cover of Vaccination Evaluated Rapidly (COVER)

Brief description

The COVER programme is a quarterly data collection that started in 1987 with the aim of providing timely data. COVER data is extracted from Child Health Information Systems at the local authority level for children aged one, 2 and 5 years of age. Babies born to mothers with hepatitis B have been offered the hepatitis B vaccine from birth since the late 1980s. During autumn 2017 hepatitis B became part of the routine childhood immunisation schedule for all babies in a 6-in-1 vaccine.

Technical notes

Data from the Universal Programme:

• in FY 2019 to 2020, all children in the 12 month cohort were eligible for the DtaP/IPV/Hib/HepB (6-in-1) vaccination, which replaced the 5-in-1 vaccination
• this is the first year coverage is fully reported against the 6-in-1 vaccine for the 12 month cohort
• the DTaP/IPV/Hib (5-in-1) vaccine was replaced by the DTaP/IPV/Hib/HepB (6-in-1) vaccine in August 2017; therefore the 24 month age cohort in FY 2019 to 2020 (born in FY 2017 to 2018), will have received either the 5-in-1 or the 6-in-1 vaccination, depending on when in the year they were vaccinated
• from FY 2020 to 2021 onwards, all children in the 12 month cohort and 24 month cohort were eligible for the DtaP/IPV/Hib/HepB (6-in-1) vaccination, which replaced the 5-in-1 vaccination in 2017
• the DTaP/IPV/Hib (5-in-1) vaccine was replaced by the DTaP/IPV/Hib/HepB (6-in-1) vaccine in August 2017; therefore the 5 year age cohort in FY 2022 to 2023 (born in FY 2017 to 2018), will have received either the 5-in-1 or the 6-in-1 vaccination, depending on when in the year they were vaccinated
• all babies born on or after 1 January 2020 received their first dose of PCV at 12 weeks of age
• prior to this, PCV primary at 12 months was 2 doses administered at 8 and 16 weeks - FY 2021 to 2022 is the first year that coverage reported is based on the single dose primary course

Data from the Selective Programme:

• the ‘eligible population’ is the total number of children reaching their first birthday during the specified evaluation period with maternal Hep B positive status
• the ‘number of children vaccinated’ by their first birthday is total number of children from the eligible population receiving 2 monovalent HepB vaccines (at birth and one month) and 3 doses of hexavalent vaccine (at 8, 12 and 16 weeks) before their 1st birthday
• the ‘number of children vaccinated’ by their second birthday is total number of children from the eligible population receiving 3 monovalent HepB vaccines at birth, 4 weeks and 12 months, and 3 doses of hexavalent vaccine (at 8, 12 and 16 weeks) before their 2nd birthday
• small number suppression is carried out on data in this table, adhering to the following methodology; suppress all data (that is, eligible population, number vaccinated and coverage) where the eligible population is 1 or 2, and where the eligible population is greater than 2 and the number of children vaccinated is 0 or 1, suppress the number of children vaccinated and the coverage

Due to small number suppression, some local authorities had to be combined, therefore:

• Leicestershire also contains data for Rutland
• Hackney also contains data for City of London
• Cornwall also contains data for Isles of Scilly

More information can be found at Childhood Vaccination Coverage Statistics, England, 2022 to 2023.

Unlinked Anonymous Monitoring (UAM) Survey

Brief description

The voluntary UAM survey recruits people who have ever injected psychoactive drugs through specialist services (such as needle and syringe programmes and addiction treatment centres) across England, Wales and Northern Ireland. Those who agree to take part complete a questionnaire and provide a biological specimen that is tested anonymously for HIV, hepatitis B and hepatitis C.

Technical notes

Regional level data from the UAM survey should be interpreted cautiously as the survey recruits participants through a nationally reflective sample of the services provided to people who inject drugs. 

Published regional-level data and more information can be found at People who inject drugs: HIV and viral hepatitis monitoring.

Acknowledgements

We would like to thank the following: 

• local laboratories for supplying the hepatitis data 
• the UKHSA Blood Safety, Hepatitis, STI and HIV Division for collection, analysis and distribution of data 
• the UKHSA Epidemiology Data Science unit (part of the Regions Data Science team) for producing the charts and figures contained in this report
• the Office for National Statistics (ONS carried out the original collection and collation of the data but bears no responsibility for their future analysis or interpretation) 
• the Hospital Episode Statistics (HES), NHS England, produced by UKHSA

About Field Services

Field Services is a Division within UKHSA that provides a national service comprising geographically dispersed multi-disciplinary teams integrating expertise in Field Epidemiology, Public Health Microbiology, Rapid Investigation, Real-time Syndromic Surveillance, and Field Epidemiology Training to strengthen the surveillance, epidemiological intelligence and response functions of UKHSA.

You can contact your local Field Services team at fes.northwest@ukhsa.gov.uk

If you have any comments or feedback regarding this report or the Field Services, please contact FS.Central@ukhsa.gov.uk