This briefing summarises NICE's recommendations for local authorities and partner organisations on identifying and managing tuberculosis (TB) in vulnerable people who may find it difficult to access services for diagnosis and treatment in traditional healthcare settings. This includes adults, young people and children from any ethnic background, regardless of migration status, whose social circumstances, language, culture or lifestyle (or those of their parents or carers) make it difficult to:

  • recognise the clinical onset of TB

  • access diagnostic and treatment services

  • self-administer treatment (or in the case of children and young people have treatment administered by a parent or carer)

  • attend regular appointments for follow-up.

In practice, people who experience these difficulties when accessing or completing treatment for TB using mainstream NHS services are more likely to include:

  • prisoners

  • vulnerable migrants

  • people who are homeless, or who live in insecure, poor or temporary housing

  • people who misuse alcohol or other substances.

This briefing is relevant to local authorities, particularly health and wellbeing boards, those commissioning services for vulnerable groups, and staff managing and delivering those services.

This briefing is endorsed by Public Health England.

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