Evaluation of patient experience: latent tuberculosis (LTBI) in Newham

In October 2016, Newham CCG commissioned our team to learn about the patient experience and feedback on the Latent Tuberculosis Infection screening service (LTBI) in Newham.
Skeletal view of the lungs

Summary

Latent TBI is commonly described as ‘sleeping’ TB bacteria which can wake up and become active TB. Identifying and treating Latent TB will reduce the risk of if activating. Newham is offering screening to 16-35 years old, who were born or lived in a high-risk country. The objectives of the project were to understand the intricacies of test decline,  of test uptake and improve the patient experience with the LTBI screening service.

Key findings

  • GP practices that invite patients by phone to take the test, are more likely to have the patient take up the test, compared to practices that send letters or SMS only.
  • Although patients at-risk are pre-identified on EMIS in each GP practice, there is not necessarily a reminder on EMIS that helps GP ‘remember’ if a patient is at risk.
  • Patients think that TB or Latent TB test does not apply to them, due to patient’s lack of awareness of what TB is. For example, one patient thinks that TB is a sexual disease, and therefore, people decline to take the test due to the stigma attached to this sexual disease. Other patients say that people who are frequent travellers or heavy smokers can develop TB, and therefore, the test does not apply to them.
  • Many patients think that TB has no cure or medicine, which may cause anxiety to get tested for TB.

Recommendations

  • To commission and to develop a community engagement scheme to raise awareness of TB and Latent TB among at-risk communities, working closely with the voluntary sector, including mothers’ groups and children’s centres.

  • To commission a dedicated TB community development worker, based in GP practices to engage with at-risk patients, and to ensure their uptake of test.

  • To ensure that the LTBI test is being offered to existing and new GP patients as part of a general GP check-up.

  • To ensure that information disseminated to individuals and communities about TB and Latent TB is reassuring and to include information that covers the following: what is TB and Latent TB, how it can be passed onto others, risks, and that the disease is curable and that treatment is available.

  • To consider commissioning and developing a peer support scheme to raise awareness of TB among communities

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