The service is a collaboration between LTHT and Ä¢¹½tvÊÓƵ Community Healthcare (LCH), working closely with Bevan Healthcare and UKHSA.
We offer latent TB screening and treatment for contacts of those with TB, new entrants to the UK from countries with a high incidence of TB, those with no fixed abode, those commencing immunosuppressing therapies, and those identified by NHS occupational health screening.
We offer diagnosis and treatment for people with active TB, with personalised support including home visits and direct observed therapy.
We are part of the West Yorkshire TB Clinical Network, and offer tertiary advise as the regional centre for multi-drug resistant TB.
We offer diagnosis and treatment for those with non-tuberculous mycobacterium pulmonary disease.
Outpatient services
The Ä¢¹½tvÊÓƵ Tuberculosis Clinic is held weekly on Thursday mornings at Ä¢¹½tvÊÓƵ Chest Clinic at the Ä¢¹½tvÊÓƵ General Infirmary.
We offer an integrated service including diagnosis and treatment of active Tuberculosis and Latent Tuberculosis Infection, and screening for people who have been in contact with tuberculosis.
We aim to provide holistic care for patients and their families, with support in the clinic from the specialist TB Health Visitor team, and adult and paediatric services running together so parents, children, and other family members needing contact screening can usually be seen in the same visit. TB drugs are supplied directly within the clinic by a specialist pharmacist.
New patients with suspected pulmonary TB are usually seen within one week of referral, and extra pulmonary TB within 2 weeks.
Home support
The TB Health visitor team provide on-going support to patients and their families. They can help with concerns about medication including support for completing the course (with Directly Observed Therapy when necessary) and possible side effects. Their contact telephone number is available for any concerns, and messages may be left out of hours: 0113 3922148
In Patient service
The majority of TB patients can be successfully treated as outpatients, but when hospital admission is necessary care is provided in the Respiratory Medicine or Infectious Diseases wards at St James’s University Hospital. Four Negative pressure isolation rooms are available for drug resistant TB or others who may be highly infectious.
Diagnostic services
Bronchoscopy, Endobronchial Ultrasound (EBUS), CT and ultrasound guided biopsy facilities are available for diagnostic sampling
Full laboratory services including microscopy, culture for tuberculosis, interferon gamma release assays (QuantiFERON TB Gold and T.Spot TB), rapid molecular testing for mycobacteria and for drug resistance, and piloting whole genome sequencing. Sensitivity testing is carried out in the reference laboratory in Newcastle.
Specialist services
TB – HIV co-infection
Children with TB
Directly Observed Therapy
Multi Drug resistant TB –
- Members of our team are on the British Thoracic Society MDR TB advice service panel
- Access to new drugs for MDR TB including bedaquiline and delaminid
Multidisciplinary team
There is a weekly meeting for the whole team including microbiology, pharmacy and public health when all new TB cases and any complex or difficult cases are discussed and plans agreed.
New entrant screening
Ä¢¹½tvÊÓƵ has pioneered the development of a screening programme for new arrivals from high TB incidence countries.
TB numbers in Ä¢¹½tvÊÓƵ have been falling since this service was started in 2008. Our programme has been adopted as a model for the 2015 National Strategy for Tuberculosis adopted by NHS England and Public Health England. Initial screening is carried out in a community based clinic by the TB Health Visitor team, and those requiring further investigation or treatment are referred to the TB clinic. The screening service continues to develop with the implementation of the National Strategy.
Training
As a specialist service in a teaching hospital, the Ä¢¹½tvÊÓƵ TB service provides training and experience to higher specialist trainees in Respiratory Medicine, Infectious Diseases, Microbiology and Paediatrics, as well as junior trainees in public health. We regularly contribute to the teaching of medical and nursing students.
Audit and Clinical Governance
We aim to provide an outstanding service and are continually looking to improve. We undertake quarterly cohort review (with our colleagues in the neighbouring Bradford TB service), regular audits of aspects of the service, and annual mortality review.
The Team
- Dr Deborah Ellames – Consultant Respiratory Physician
- Dr Lekshmi Mohan Das – Consultant Respiratory Physician
- Dr Fiona McGill – Consultant in Medical Microbiology and Infectious Diseases
- Dr Charlotte Hall – Consultant in Infectious Diseases
- Dr Sean O’Riordan – Consultant Paediatrician
- Dr Toby Capstick – Consultant Pharmacist
- Deborah Gascoyne-Binzi – Principal Clinical Scientist
- Victoria Legg – Clinical Lead for TB, LCH
- Kate Quyn – Specialist TB nurse
- Emma Storey – Specialist TB nurse
- Lingani Masole – TB nurse
- Kelsey Coelho-Jones – TB nurse
- Alison Wright – Registered nursing associate
- Michelle Donnigan – Clinical assistant