TB staff crisis looms

A patient being treated for tuberculosis

A "desperate shortage" of staff is hampering efforts to tackle TB, experts have warned.

A report from a specialist committee, presented to the winter meeting of the British Thoracic Society in London on Wednesday, shows just one in six of areas with a high incidence of tuberculosis can meet the minimum requirement for numbers of staff.

Tuberculosis levels are now at a 13-year high, rising from 5,085 in 1987 to 6,797 in 2001.

Outbreaks of TB, such as those in Leicester and Newport, have also raised the profile of the disease.

Recent outbreaks of TB have shown that we cannot be complacent about this disease - it has leapt back out of the history books and we must beat it

Dr John Harvey, BTS

Experts say there should be one full-time nurse for every 50 cases of TB, and one per 40 patients in London where there is a higher incidence of the disease.

Such a high ratio of staff to patients is needed, they say, because in addition to monitoring and treating patients, people who have been in contact with the patient with TB have to be tracked down.

The Joint Tuberculosis Committee of the BTS, which carried out the audit of staffing levels found that there had been no improvement in staffing levels since 1998 - despite a 12% increase in the rate of TB over these years.

Only seven of the 43 districts surveyed provided sufficient nurse support for patients with TB, the audit report said.

In 1998, just six of 42 and none of the areas in London met the minimum standards.

'Action needed'

Professor Peter Ormerod, a senior member of the BTS joint committee on tuberculosis, and Professor of Respiratory Medicine at Blackburn Royal Infirmary, said: "These data demonstrate the continuing under-provision of essential front line staff to treat tuberculosis in the community.

"The rise in TB has continued unabated since 1987 and we desperately need to address this staff shortage to deliver the care and service we need to halt the spread of tuberculosis across the UK."

Dr John Harvey, of the BTS, said: "Recent outbreaks of TB have shown that we can not be complacent about this disease - it has leapt back out of the history books and we must beat it.

"It is vitally important that we continue to invest into contact tracing and treating tuberculosis both to ensure that patients get the care they deserve and to prevent TB spreading from person to person across the UK."

He said the government must wake up to the "very real threat" the recent and continuing rise of tuberculosis poses to the country and take urgent action to stem this rise.

Professor Harvey said: "We urge the government to increase staffing levels to at least these minimum requirements to provide adequate care for patients with TB across the UK."

Staff 'crucial'

Paul Sommerfeld of the charity TB Alert said the staff shortage had been evident for some time.

"Staffing is absolutely crucial. With TB, you are dependent on good detection and good treatment.

"The BCG vaccination is just one part of the armoury. Tracing contacts is crucial. You can't do that without staff."