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Experts predict big rise in TB cases and slam government’s failing TB Action Plan

22 March 2007

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Nine out of ten TB specialists believe the number of tuberculosis (TB) cases in the UK is set to rise over the next five years, and there is a failure to implement the government’s much-fanfared TB Action Plan, according to results of a new survey by the British Thoracic Society (BTS), published today (online survey among 54 of a total 184 TB leads across the UK, 7–14 March 2007).
The TB experts’ prediction is supported by new figures, published today by the Health Protection Agency, which show yet further increase in the number of TB cases in this country, which have risen year on year for the last decade.
Professor John Macfarlane, chairman of the BTS, said: “This Victorian disease is on the march. Doctors up and down the country are warning us that TB is in danger of staging a serious comeback.”
The results of the BTS’s survey among TB leads show worrying gaps in the implementation of the government’s TB Action Plan since its publication in 2004, including lack of TB resources and trained staff, and failures to meet referral times.

  • 77% of TB leads reported no change in provision of resources to implement the recommendations of the government’s TB Action Plan; almost 10% witnessed a decline in resources and 15% predict further decreases in resources.
  • Despite it being a central aim of the TB Action Plan that “suspected cases of pulmonary TB are seen by a TB team within two weeks of first presentation to healthcare”, over a fifth (21%) of TB leads stated this is not the case.
  • Despite the recommendation in the TB Action Plan that there should be “local TB clinical networks at population levels, with a designated local TB co-ordinator mandated to work across organisational boundaries”, 46% of respondents reported that they still do not have a local multidisciplinary TB network in their area.
  • Almost half of TB leads (43%) do not have access to a designated microbiologist who deals with TB.

TB specialist nurses seems to be worst affected. NICE guidelines state that TB specialist nurses are essential for the management of patients, yet almost a third (30%) of respondents to the survey claimed TB specialist nurse positions remain under threat or review. This is supported by further research from Britain’s national TB charity, TB Alert, which shows five out of 11 high-incidence areas in the UK do not meet the recommended 1:50 TB nurse to patient ratio.

Paul Sommerfeld, chair of TB Alert, said: “TB numbers are still rising despite optimistic predictions in the 2004 TB Action Plan of a drop within three years. It is deeply troubling that, at the same time, resources for TB services are drying up. It should be clear that the London guideline of one specialist TB nurse per 40 TB cases must apply to all high-incidence TB areas. It is unacceptable that barely a third of such areas meet this standard.”