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Tuberculosis [NG33]

Measuring the use of this guidance

Recommendation: 1.1.1.3

Statutory, community and voluntary organisations and advocates working with the general public, and under‑served and high‑risk groups in particular, should share information on TB education and awareness training with all frontline staff. (They should get information on this from the local multidisciplinary TB team.)

What was measured: Proportion of healthcare providers that fully met the standard in providing training for healthcare staff in recognising the signs and symptoms of TB.
Data collection end: January 2014
58.3%
Number that met the criteria: 7 / 12
Area covered: Local
Source: Mehay A, Raj T, Altass L, Newton A, O'Moore E, Railton C, Tan H, Story A, and Frater A. (2017). An audit of tuberculosis health services in prisons and immigration removal centres. Journal of Public Health, 39, pp.387-394.


Recommendation: 1.1.4.1

Employees new to the NHS who will be working with patients or clinical specimens should not start work until they have completed a TB screen or health check, or documentary evidence is provided of such screening having taken place within the preceding 12 months.

What was measured: Proportion of healthcare providers that reported that custodial staff were screened prior to and during employment by employer occupational health departments.
Data collection end: January 2014
8.3%
Number that met the criteria: 1 / 12
Area covered: Local
Source: Mehay A, Raj T, Altass L, Newton A, O'Moore E, Railton C, Tan H, Story A, and Frater A. (2017). An audit of tuberculosis health services in prisons and immigration removal centres. Journal of Public Health, 39, pp.387-394.


Recommendation: 1.5.2.2

In prisons or immigration removal centres, everyone with X‑ray changes indicative of active TB, as well as those with symptoms who are awaiting X‑ray, should be isolated in an adequately ventilated individual room or cell. Prisoners and detainees should be retained on medical hold until they have: proven smear‑negative and had an X‑ray that does not suggest active TB or had a negative risk assessment for multidrug‑resistant TB and completed 2 weeks of the standard treatment regimen.

What was measured: Proportion of healthcare providers that reported that they isolated suspected or confirmed cases of TB.
Data collection end: January 2014
91.7%
Number that met the criteria: 11 / 12
Area covered: Local
Source: Mehay A, Raj T, Altass L, Newton A, O'Moore E, Railton C, Tan H, Story A, and Frater A. (2017). An audit of tuberculosis health services in prisons and immigration removal centres. Journal of Public Health, 39, pp.387-394.


Recommendation: 1.6.2.10

Healthcare professionals in prisons and immigration removal centres should ensure prisoners and detainees are screened for TB within 48 hours of arrival.

What was measured: Proportion of healthcare providers that screened new individuals for TB within the first 48 hours.
Data collection end: January 2014
66.7%
Number that met the criteria: 8 / 12
Area covered: Local
Source: Mehay A, Raj T, Altass L, Newton A, O'Moore E, Railton C, Tan H, Story A, and Frater A. (2017). An audit of tuberculosis health services in prisons and immigration removal centres. Journal of Public Health, 39, pp.387-394.


Recommendation: 1.6.2.12

Prison and immigration removal centre health staff should report all suspected and confirmed TB cases to the local multidisciplinary TB team within 1 working day.

What was measured: Proportion of healthcare providers that reported suspected or confirmed cases to the non-prison MDTB team within 24 hours.
Data collection end: January 2014
83.3%
Number that met the criteria: 10 / 12
Area covered: Local
Source: Mehay A, Raj T, Altass L, Newton A, O'Moore E, Railton C, Tan H, Story A, and Frater A. (2017). An audit of tuberculosis health services in prisons and immigration removal centres. Journal of Public Health, 39, pp.387-394.


Recommendation: 1.7.1.3

Offer directly observed therapy as part of enhanced case management in people who: do not adhere to treatment (or have not in the past) have been treated previously for TB have a history of homelessness, drug or alcohol misuse are currently in prison, or have been in the past 5 years have a major psychiatric, memory or cognitive disorder are in denial of the TB diagnosis have multidrug‑resistant TB request directly observed therapy after discussion with the clinical team are too ill to administer the treatment themselves. [2012, amended 2016]

What was measured: Proportion of TB cases who are currently homeless or have a history of homelessness and receive directly observed therapy.
Data collection end: December 2017
60.4%
Area covered: England
Source: Public Health England. Tuberculosis in England.

What was measured: Proportion of TB cases who currently misuse alcohol and receive directly observed therapy.
Data collection end: December 2017
68.4%
Area covered: England
Source: Public Health England. Tuberculosis in England.

What was measured: Proportion of TB cases who currently misuse drugs and receive directly observed therapy.
Data collection end: December 2017
54.6%
Area covered: England
Source: Public Health England. Tuberculosis in England.

What was measured: Proportion of TB cases who are currently homeless or have a history of homelessness and receive directly observed therapy.
Data collection end: December 2018
53.3%
Area covered: England
Source: Public Health England. Tuberculosis in England.

What was measured: Proportion of TB cases who currently misuse alcohol and receive directly observed therapy.
Data collection end: December 2018
61.9%
Area covered: England
Source: Public Health England. Tuberculosis in England.

What was measured: Proportion of TB cases who currently misuse drugs and receive directly observed therapy.
Data collection end: December 2018
48.5%
Area covered: England
Source: Public Health England. Tuberculosis in England.


Recommendation: 1.7.3.1

On arrival at a prison or immigration removal centre, healthcare professionals should ask all prisoners and detainees (including those being transferred from other establishments) if they are taking TB medication, to ensure continuity of treatment.

What was measured: Proportion of healthcare providers that asked individuals on entry to the prison if they have previously been taking TB medication.
Data collection end: January 2014
100%
Number that met the criteria: 12 / 12
Area covered: Local
Source: Mehay A, Raj T, Altass L, Newton A, O'Moore E, Railton C, Tan H, Story A, and Frater A. (2017). An audit of tuberculosis health services in prisons and immigration removal centres. Journal of Public Health, 39, pp.387-394.


Recommendation: 1.7.3.4

All prisoners having treatment for active TB should have directly observed therapy.

What was measured: Proportion of healthcare providers that reported all patients receiving treatment for TB were managed with directly observed therapy.
Data collection end: January 2014
100%
Number that met the criteria: 12 / 12
Area covered: Local
Source: Mehay A, Raj T, Altass L, Newton A, O'Moore E, Railton C, Tan H, Story A, and Frater A. (2017). An audit of tuberculosis health services in prisons and immigration removal centres. Journal of Public Health, 39, pp.387-394.

What was measured: Proportion of TB cases who are currently imprisoned or have a history of imprisonment and receive directly observed therapy.
Data collection end: December 2016
53.8%
Data collection end: December 2017
50.3%
Area covered: England
Source: Public Health England. Tuberculosis in England.

What was measured: Proportion of TB cases who are currently imprisoned or have a history of imprisonment and receive directly observed therapy.
Data collection end: December 2018
50.6%
Area covered: England
Source: Public Health England. Tuberculosis in England.


Recommendation: 1.7.3.5

Prison health services should have contingency, liaison and handover arrangements to ensure continuity of care before any prisoner on TB treatment is transferred between prisons or released. In addition, other agencies working with prisoners or detainees should also be involved in this planning.

What was measured: Proportion of healthcare providers that reported a form of contingency, liaison and handover plan for treatment of TB in case of transfers or release.
Data collection end: January 2014
83.3%
Number that met the criteria: 10 / 12
Area covered: Local
Source: Mehay A, Raj T, Altass L, Newton A, O'Moore E, Railton C, Tan H, Story A, and Frater A. (2017). An audit of tuberculosis health services in prisons and immigration removal centres. Journal of Public Health, 39, pp.387-394.


Recommendation: 1.8.10.1

Multidisciplinary TB teams, prisons, custody suites and immigration removal centre healthcare services should have named TB liaison leads to ensure they can communicate effectively with each other.

What was measured: Proportion of healthcare providers that cited a named TB liaison lead, whose main role was to provide communication with non-places of prescribed detention (PPD) multidisciplinary TB (MDTB) teams.
Data collection end: January 2014
83.3%
Number that met the criteria: 10 / 12
Area covered: Local
Source: Mehay A, Raj T, Altass L, Newton A, O'Moore E, Railton C, Tan H, Story A, and Frater A. (2017). An audit of tuberculosis health services in prisons and immigration removal centres. Journal of Public Health, 39, pp.387-394.


Recommendation: 1.8.10.2

Prison, custody suites and immigration removal centre healthcare services should develop a TB policy by working with the TB control board and multidisciplinary TB team and the local Public Health England health protection team.

What was measured: Proportion of healthcare providers that had a TB policy in place.
Data collection end: January 2014
66.7%
Number that met the criteria: 8 / 12
Area covered: Local
Source: Mehay A, Raj T, Altass L, Newton A, O'Moore E, Railton C, Tan H, Story A, and Frater A. (2017). An audit of tuberculosis health services in prisons and immigration removal centres. Journal of Public Health, 39, pp.387-394.


Recommendation: 1.8.10.3

Multidisciplinary TB teams, in conjunction with prisons, custody suites and immigration removal centre healthcare services, should agree a care pathway for TB. This is to ensure that any suspected or confirmed cases are reported to, and managed by, the multidisciplinary TB team.

What was measured: Proportion of healthcare providers that had a TB pathway in place.
Data collection end: January 2014
58.3%
Number that met the criteria: 7 / 12
Area covered: Local
Source: Mehay A, Raj T, Altass L, Newton A, O'Moore E, Railton C, Tan H, Story A, and Frater A. (2017). An audit of tuberculosis health services in prisons and immigration removal centres. Journal of Public Health, 39, pp.387-394.



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