A service evaluation of the NHS England funded latent Tuberculosis (LTBI) testing and treatment for migrants in the South East of England
PHE ePoster Library. Gedi A. Apr 10, 2019; 257529; 15460
Ayaan Gedi
Ayaan Gedi
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Abstract A total of four clinical commissioning groups participated in the study. A retrospective data base review was undertaken using multiple data sources. A cross sectional survey was sent to stakeholders working in the LTBI programme and programme leads were invited for semi- structured interviews. The results were analysed using thematic content analysis.Data was collected from local LTBI programmes, laboratories and the national TB office. A total of 2391 patients accepted the LTBI test. Of these 13.4% (n=321) tested positive and 93.1% (n=299) of the patients were referred for treatment 63.8% (n=191) accepted LTBI treatment. Large data discrepancies and missing data were identified. The cross sectional survey was sent to 51 participants with a response rate of 45%. The greatest local challenges were laboratory arrangements and staffing and workforce. Data systems were greatest challenge for participants.Five in-depth interviews were undertaken across four CCG LTBI screening programmes. Project managers and administrative support was identified as being important to the workforce. Participants reported variation in laboratory and courier services reported by participants including turnaround time for results and days and times available. Participants reported the data collection template was not fit for purpose and that repetitive data was collected and reported.This service evaluation demonstrates variation in the LTBI pathway models across the South East with screening delivered in both primary and secondary care. There was unequal access to screening services and issues gaining patient consent to be referred to LTBI services. Perceptions from pre-entry screening remains the biggest barrier to testing. Patient engagement is needed to promote successful screening. Data management was consistently reported by participants to be one of the biggest challenges. This evaluation recognises the achievements and good practice of the South East LTBI teams and helps identify solutions to improve the screening service for the future.
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