Innovative care pathways including case finding and linkage to care are crucial to achieve the World Health Organization targets for the elimination of viral hepatitis. In England there were over 23.4 million attendances at Emergency departments (EDs) in 2016-17 representing a significant opportunity to engage for case finding. EDs may be the only healthcare access point for some marginalised groups including recent migrants, homeless, or people who inject drugs. Seroprevalence studies have been used in the USA to guide public health interventions where large scale, integrated ED testing and linkage programs are increasingly common. Since 2008 routine opt-out testing for HIV in UK ED settings has been recommended for those in high prevalence areas (>0.2%). This article is protected by copyright. All rights reserved.