Public Health England proposes national TB screening

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TB web As the number of tuberculosis (TB) cases rises in certain areas of England, public health officials propose a new targeted screening programme in primary care across the country.

Public Health England (PHE) has concluded that the only way to “reverse the tide” of predicted rises in TB incidence is a national programme that sees GPs screening high-risk patients for the disease.

The plans were outlined in a comment article in The Lancet, with PHE criticising the co-ordination of the current proactive screening programme, which could leave the highest-risk areas struggling to fund TB screenings.

Dr Dominik Zenner, head of the TB screening unit at PHE, said having a “national programme would lead to a co-ordinated approach” to ensure “the areas with the greatest need can also prioritise the screening”.

The PHE proposals would set “an agreed algorithm and a central pot [of money]” to allow screening programmes to be funded where most needed. A pilot study, run by PHE, has already shown that the new programme could prove cost-effective in primary care at £20,818 for each case prevented.

PHE plans to present the proposals to the National Screening Committee “very soon”, with the timing of the programme depending on when the national strategy is launched.

The General Practitioners Committee welcomed the new proposals, with Dr Richard Vautrey, its deputy chair, agreeing on the need for “more investment into this area of work”.

Rates of TB, which are predicted to climb, are high among immigrants despite their being screened for the disease before entering the UK. Immigrants make up 75% of TB cases nationally, with half of these developing the disease during the first five years in the UK.

The GPC has raised concerns that the Government’s proposals to “limit the access of migrants to NHS care may make the problem of detecting and treating TB worse,” despite the improved PHE plans.