HSJ Awards 2018: Community or Primary Care Services Redesign (London and the South)

Newham Clinical Commissioning Group – Latent Tuberculosis Infection Screening and Treatment Programme

For many years, the east London borough of Newham has had the capital’s highest rates of tuberculosis – rates higher even than those in some developing countries.

One third of Newham’s young, ethnically diverse population was born overseas, many from countries with high levels of TB, but there has traditionally been a low level of understanding about the condition.

That includes knowledge about latent TB, in which an individual has been infected with the bacteria but does not have an active infection. In around one in 10 of these cases, the individual will develop active tuberculous in the future – which is contagious.

And so in 2014, the CCG launched its latent tuberculosis infection screening and treatment programme. It targets people aged between 16 and 35 who have arrived in the UK in the past five years from one of the countries on a pre-defined high risk list.

Anyone who registers at a GP practice and meets the criteria is screened for LTBI. If the result is positive, the patient has a consultation with the GP and is offered treatment via one of 16 CCG-accredited community pharmacies.

The GP sends an electronic prescription for a three month programme to the chosen pharmacy and, importantly, the pharmacist then dispenses the treatment mostly and monitors progress. The programme is unique in being entirely based in primary care, which is said to mean greater choice for patients as well as reduced costs.

Since the LBTI programme launched, rates of TB in Newham have been steadily falling – from 78.0 per 100,000 in 2014 to 48.1 in 2017.

Read a detailed case study about this project at HSJ Solutions