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Changing patterns of mycobacterial disease
P57 The London TB Metrics: are targets achievable in a local district hospital clinic?
  1. L S C Lok,
  2. L Ridge,
  3. J Barrett,
  4. D J F Mack,
  5. D D Creer
  1. Barnet and Chase Farm Hospitals NHS Trust, Barnet, UK

Abstract

Introduction and objectives Tuberculosis (TB) has re-emerged as an important public health problem in the UK. Subsequent to the publication of ‘Stopping Tuberculosis in England: An Action Plan from the Chief Medical Officer’ in 2004, the London TB Metrics was produced, against which the performance of local TB services can be measured. This audit recorded relevant aspects of diagnosis and management of all adult TB patients in a local district hospital TB clinic, and compared them against the Metric targets.

Methods Eight of the nine Metric indices were selected (neonatal BCG vaccination coverage excluded). Data were collected on all adult patients seen in an outpatient TB clinic in 2008 and compared against targets set in the London TB Metrics.

Results 73 adults (35 males, 38 females) were diagnosed, of which 38 (49.4%) were pulmonary cases. 69 patients (94.5%) were offered an HIV test; 63 patients attended for testing, with two patients testing positive for HIV. Abstract P57 Table 1 summarises results achieved.

Abstract P57 Table 1

Comparison of results achieved against targets set in the London TB Metrics

Discussion We have audited performance of a local TB clinic against targets set in the London TB Metrics. Achieving a microbiological diagnosis in 65% is difficult as patients are often already on treatment before referred into the service. Changes were instituted in laboratory workflow patterns to improve sputum smear result availability within one working day, increasing to 93.8% in the first 2 months of 2010.

Conclusion The London TB Metrics targets are achievable (seven of eight targets met) and provide an audit tool that may facilitate improvements in the standard of TB care.

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