World TB Day Event: The London TB Plan 22 March 2012
Summary of event
Composition of audience:
The event was well attended with a variety of international and national stakeholders including clinical
leads, current and future London commissioners, public health experts and patient organisations. The
third sector and TB nurses were also well represented alongside leading experts in Tuberculosis,
National Knowledge Service and Respiratory Medicine.
Objectives for the event:
The London event aimed to provide an update and feedback to key stakeholders, who had supported
development of the London TB Case for Change and Model of Care. In doing so we addressed the
recommendations of the model by showcasing practical implementation to date across London. The
aim was for participants to be able to address what they needed to do locally in raising awareness,
working together better with colleagues and improving the profile of TB.
Key focus of the presentations:
The event was opened by Dr William Lynn, Consultant in Infectious Diseases at Ealing Hospital
London and the London TB Clinical Lead. He facilitated three informative sessions through the day to
highlight the London TB Plan and current good practice.
Session one set the scene by broadly addressing the current TB statistics. Dr Getahun spoke on
behalf of The World Health Organisation, reflecting on the global issues of TB and Dr Huiric updated
on TB in Europe from the perspective of the ECDC. Sarah Anderson focused on the current figures
for London and Dr Lynn outlined the issues highlighted in the case for change and recommendations
in the model of care for London. Speakers’ details:
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Dr Haileyesus Getahun, Head of WHO Stop TB Department’s TB/HIV and Community
Engagement Unit
Dr Emma Huitric, Tuberculosis Programme Officer, European Centre for Disease Prevention
and Control (ECDC)
Sarah Anderson, Regional Epidemiologist, Health Protection Agency (HPA), London Region
Dr William Lynn, Consultant in Infectious Diseases, Ealing Hospital
Session two focused in on two major aspects of the London model: the importance of latent TB
infection screening and the way that providers of TB services will need to work differently going
forward. Speakers included:
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Dr Chris Griffiths, GP, Hackney
Dr Onn Min Kon, Consultant Respiratory Physician MD FRCP, Imperial College Healthcare
NHS Trust
Dr Marc Lipman, Consultant in Respiratory Medicine, The Royal Free Hospital
The final session addressed the importance of cohort review, how third sector organisations support
TB control in London and finally, reflected on how we, as a city will know that collectively, our actions
are making a difference. The final speakers of the day were:
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Surinder Tamne, Senior TB Specialist Nurse, HPA
Mike Mandelbaum, Chief Executive, TB Alert
Prof Ibrahim Abubakar PHD, FFPH, FRCP (Edin) Head of TB Section, HPA, Professor and
Consultant of Infectious Disease Epidemiology
The event was also fortunate enough to have stands for participants to visit throughout the day
including TB Alert, ARCHIVE, TB Action Group, Embrace UK, TB Reach and London Health
Programmes.
Discussion topics:
Discussions following the sessions and presentations were wide ranging covering how the current
global financial situation and cutbacks in UK NHS funding might impact on, and lead to further
inequality in TB care. The importance of investing now to disinvest later was well received and that
the pan London, collaborative commissioning approach across the TB patient pathway to achieve
value was the way forward.
Participants endorsed the London TB model of care and asked for increased emphasis on the role of
TB patients which would be assisted by simplifying the language used in the documentation. This
would also be helpful in reaching out to the various community groups where the rates of TB are high.
In addition there is a need to understand borough TB profiles and local issues around TB which would
assist with the focus on primary care based case finding for active and latent TB. This could be
integrated with other health issues such as HIV supporting earlier diagnosis and being more cost
effective.
Feedback on the event was very positive.
Conclusions:
Feedback from participants was that they found the event very informative and that the event updated
and fed back to them on the development of the London TB model of care. Participants also strongly
supported the model of care pan London, collaborative approach.
Recommendations:
Main outputs of the event were to:
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Ensure implementation of the London TB model of care
Centralised commissioning was key
Investing now with a relatively small resource is important and that we need to look at
innovative ways of making this happen
Monitor to ensure that the plan is working
And most importantly act now and as individuals to stay on course.