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Tuberculosis

Checked: 17-07-2024 by Vicky Ryan Next Review: 16-07-2026

Overview

There are CKS guidelines on Tuberculosis.

Tuberculosis is a notifiable disease and if suspected then PHE should be informed. Do not wait for confirmation of diagnosis.

Referral Guidance

Suspected TB

UHBW - the TB clinic at UHBW is available via eRS as a RAS service. Referrals should be marked urgent and patients will be seen as soon as possible.

NBT - refer on eRS via Specialty – Infectious Diseases, Clinic type – Tuberculosis.

Tuberculosis (TB) services in BNSSG are provided by a partnership of UHBW, NBT and the Sirona Community TB nursing team.

Clinics operate at the BRI and Southmead Hospital supported by the Community Sirona TB nursing team.

Patients who are HIV positive should be referred to the Southmead Hospital team who provide integrated care with the HIV service.

Patients thought to have possible active TB should be referred urgently via eRS as above.

Acutely unwell suspected cases can be discussed with either the Infectious Disease registrar at Southmead (via switchboard) or the respiratory registrar at BRI ( via switchboard).

If you are referring a patient with a productive cough, please arrange an urgent CXR and 3 sputum samples for acid fast bacilli at the time of referral, so that results are available when the patient is triaged.

We aim to see all patients with active TB within 2 weeks.

If you wish to obtain some general advice regarding a potential referral please contact the TB nursing team. If you are concerned the patient has active pulmonary TB then diagnostics and advice can be given in the community.

If you are referring a patient with latent TB they should be referred routinely via eRS. If you are referring a TB contact, please contact the TB nursing team in the first instance, who can advise if they need screening in the community or a hospital referral.

TB nurses can be contacted on 0117 954 3066 or email on sirona.tbnurse@nhs.net

Screening and immunisation

TB screening in primary care (Pathway 2) 2020

TB screening for new entrants aged 0 - 16 (Pathway 3) 2018

BCG immunisation in children

Red Flags

Consider urgent admission for patients with suspected CNS TB, neurological symptoms, or those who are systemically unwell.

Community TB Nurse Service - Sirona

The team are responsible for providing outreach and support to people with active or latent tuberculosis (TB) in BNSSG. The team are responsible for identifying and arranging screening for people who’ve been exposed to TB.

What is the service?

The service supports patients to complete treatment for tuberculosis
Promoting community and professional awareness of TB, and supporting people through the process of diagnosis
The team works closely with the TB medical teams at the BRI and Southmead Hospital

Who is this service for?

The service is for people who are undergoing treatment or investigations for tuberculosis
It is for professionals and organisations requiring information about TB
People who are referred to the service by the hospital doctor who has diagnosed TB or suspected TB, or who is investigating the person for possible TB
GPs/Primary Care staff wishing to discuss management of a case or suspected case

If you are a clinician or GP and wish to refer to this service, please contact the team on 0117 9543066 (24 hour answerphone), or email: sirona.tbnurse@nhs.net

Efforts are made to ensure the accuracy and agreement of these guidelines, including any content uploaded, referred to or linked to from the system. However, BNSSG ICB cannot guarantee this. This guidance does not override the individual responsibility of healthcare professionals to make decisions appropriate to the circumstances of the individual patient, in consultation with the patient and/or guardian or carer, in accordance with the mental capacity act, and informed by the summary of product characteristics of any drugs they are considering. Practitioners are required to perform their duties in accordance with the law and their regulators and nothing in this guidance should be interpreted in a way that would be inconsistent with compliance with those duties.

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