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Advocacy, guidance and publications

Tuberculosis: information for prison and immigration removal centre staff

Gudiance from Public Health England providing advice for non-healthcare staff who work in UK prisons and immigration removal centres on identifying and handling TB cases.

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Psychosocial counselling and treatment adherence support for people affected by tuberculosis

This pioneering new psychosocial support guide addresses critical gaps in TB care and control by focusing on overcoming the psychological, social and economic factors that prevent people from accessing diagnosis, adhering to care plans and successfully completing treatment.

The guide was developed by TB Alert with support from an international reference group comprising TB survivors, members of multilateral organisations, TB activists, academia, researchers and representatives of civil society organizations working with various TB key populations.

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Tackling TB: Local Government’s Public Health Role

Local government leadership to champion TB is crucial to achieve better TB control. This document is aimed at Councillors and officers in local government to help them meet local government responsibilities to ensure that the wider social determinants of TB are addressed and that people are supported to be diagnosed early and complete their treatment. Many of the actions needed to eliminate TB require strengthened and integrated local services as TB does not exist in isolation from other health and social concerns.

The document includes sections on:

  • what is TB, TB in England and globally
  • TB diagnosis, treatment and drug resistance
  • social risk factors for TB
  • TB prevention, pre-entry screening and LTBI testing and treatment of new entrants
  • what can local authorities do to tackle TB?
  • data on the burden of TB by upper tier local authority

Actions local government can take to control TB are outlined below:

  • ensure a joined-up, multi-agency approach to TB patient care and support
  • encourage local health and social service commissioners to prioritise the delivery of appropriate clinical and public health services for TB
  • promote local leadership of TB at all levels
  • encourage NHS commissioners, local authorities, housing departments and hostel accommodation providers to agree a process for housing homeless TB patients
  • support where possible an individual’s social needs
  • invite a local TB nurse to raise awareness of TB among local authority staff
  • ensure information about TB is cascaded into key local authority teams
  • facilitate appropriate access to information and advice on TB
  • promote registration with GPs for new migrants, vulnerable or marginalised people
  • work, via the DPH, with CCGs and NHS England to ensure that screening, immunisation and treatment services reach out to diverse populations
  • consider how third sector organisations can help improve access to TB services and patient support
  • include TB in the local authority’s Joint Strategic Needs Assessment (JSNA)
  • encourage multi-agency working on TB via the health and wellbeing board (HWB) and health protection board
  • consider undertaking a scrutiny committee review of TB

The document has a number of key messages around local authority involvement in the TB agenda. These include local leadership, access to advice and information on TB for local government staff and that local councillors and officers understand TB and support the actions outlined in this document.

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Latent TB toolkit

Access, testing and treatment: A toolkit for new entrant latent tuberculosis programmes by Public Health England, NHS England and TB Alert. The toolkit provides guidance for planners and providers on how to maximise the uptake of latent TB testing and treatment and make programmes patient-focused to ensure maximum retention of patients along the pathway. For each of the three stages of Access, Testing and Treatment, it identifies issues and challenges which need to be considered, strategies for addressing them, and resources to support the process. It also provides guidance on using social marketing and behaviour change theory to understand and more effectively reach people within eligible communities.

The toolkit includes a PDF of the 56 page toolkit and introductory PowerPoint presentation which are available for download together as a zip file.

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Tackling TB in Under-Served Populations

A resource for TB Control Boards and their partners, published by PHE in partnership with TB Alert and NHS England. The resource provides a framework and practical examples to help build collaborative TB services to work with traditionally under-served groups: homeless people; people who misuse drugs and/or alcohol; people in contact with the criminal justice system; migrants from high-incidence countries – particularly refugees, asylum seekers and those in immigration detention – and some people living with mental health problems.

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NICE Quality Standard QS141 Tuberculosis

This quality standard covers preventing, identifying and managing latent and active tuberculosis (TB) in children, young people and adults. It describes high-quality care in six priority areas for improvement:

  • Statement 1: People aged 16 to 35 years who have arrived in the country within the past 5 years, from countries with a high incidence of tuberculosis (TB), are tested for latent TB infection when they register with a GP.
  • Statement 2: Adults aged under 65 years who are diagnosed with HIV, are tested for latent tuberculosis (TB) infection.
  • Statement 3: People who are referred to a tuberculosis (TB) service, who meet specific criteria, have rapid diagnostic nucleic acid amplification tests (NAATs).
  • Statement 4: People who have imaging features suggestive of active pulmonary tuberculosis (TB) are assessed by the next working day.
  • Statement 5: People with active tuberculosis (TB) from under-served groups are offered directly observed therapy.
  • Statement 6: People with active pulmonary tuberculosis (TB) who are homeless are offered accommodation for the duration of their treatment.

The standard does not cover areas of national policy, such as the UK Bacillus Calmette-Guérin (BCG) immunisation programme.

More information about the NICE Quality Standards

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Support of vulnerable patients throughout TB treatment

A paper on the needs of vulnerable patients during their TB treatment, highlighting the importance of social support to ensure that TB treatment for vulnerable patients is sustained and effective. The paper includes an overview of current guidance and legislation, case studies and examples of existing models of community support; and recommendations for ensuring a coordinated, whole system approach to successful TB treatment.

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TB curriculum for Key Stage 3

This Key Stage 3 curriculum supports teaching about TB.

The resource pack includes:

  • assembly ideas
  • lesson plans covering TB for every subject in the current school curriculum
  • TB fact sheets for teachers and students.

The pack will help students gain an understanding of the social, medical and historical role of TB, as part of their Key Stage 3 study.

It will also help raise awareness of TB, and help students and teachers learn to recognise the symptoms of TB and what action to take if they believe they or someone they know may have TB.

The resource pack was developed by TB Alert in conjunction with Brent Council.

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