Tuberculosis (TB) is an infectious airborne disease that is well-known for affecting the lungs, but can affect any part of the body, including the skin, kidneys or brain.
TB is a serious problem for London. Between 1999 and 2009, the number of TB cases in the capital increased by 50%. As a result, London now has the highest TB rate of any capital city in Western Europe.
TB is curable and relatively inexpensive to treat if identified early. If left untreated, or treatment is not completed, it is more likely to become complex or drug resistant, requiring more intensive and expensive treatment. The cost of treating an uncomplicated case of TB can be as low as £2,000 but can exceed £50,000 for complex or drug resistant cases. More than 12% of the cases in London are considered complex – almost 400 people.
Failure to complete treatment can make the problem worse. The standard treatment for uncomplicated TB is a course of two antibiotics for six months or more. Unfortunately only 83% of people complete treatment in London – those who don’t increase their risk of developing drug resistant TB and infecting their friends and families.
In response to these challenges, we have worked with a wide range of TB experts from across the city to develop the draft London TB Plan. The overall aim of the plan is to reduce the TB rate in London by 50% over the next 10 ten years.
The London TB Plan is made up of three parts:
- The TB case for change sets out in detail why action is urgently needed
- The proposed TB model of care describes a range of recommendations intended to improve the early detection of TB, improve the effectiveness of treatment and reduce the risk of transmission
- The outline implementation plan explains how the proposals will be put into practice. It will be published once the model of care has been revised in response to feedback received during the engagement period
We have sought the views of a wide range of stakeholders including GPs, patients, third sector and community organisations, public health and wider health and social services. A summary of the eight week engagement period to shape the final model is available along with presentations given during two public stakeholder events.
This feedback has been incorporated into both the case for change and the proposed model of care. We aim to implement the model from April 2012. A final stakeholder event will take place to coincide with World TB Day in March 2012. The event will be an opportunity to provide an update and feedback to key stakeholders, who have supported development of the London TB Plan along with showcasing current good practice.