TB on the Rise Again

Here is Cllr Chowdhury’s Question and the response from
Cllr Ali.

“Nine years ago, the level of TB in the borough was 119 per 100,000 members of the population. Because of the initiatives of the council, that number was reduced from 119 to under 47 per 100,000. That was in 2017.

Since then the decline has levelled and latterly begun to rise so that the current figure is above 49 per 100,000. Newham is now the sole outlier in London with a rate above the benchmark of 40 cases per 100,000.

I would like to ask:

How does the Cabinet Member for Health intend to get the TB rate to below 40 per 100,000 residents to remove Newham from the list of high incidence of TB?” 

Published Response

While rates of TB have come down in Newham, more recently there has been an increase in the proportion of those patients with significant complexity (both clinically and socially) which makes achieving cure through treatment completion very challenging.  There is an ongoing need to ensure that TB services are adequately staffed and with the appropriate skill mix and resources to meet the needs of their patients, and that we link with colleagues in services such in the NHS, primary care,  housing, social care and wider communities. 

Newham led the way in London with latent tuberculosis infection testing and treatment in primary care, and has reaped some of the benefits from this. Having been paused at the height of Covid first wave, the National Programme is now restarting. 

Nationally there has been consultation on a new TB Action plan for 2020-25 which will be launched soon, and at a London level our Director of Public Health is the public health representative on the London TB Control Board.

In Newham working at a local level tackle the challenges of TB is an important priority in the new Health and Wellbeing Strategy -50 steps to a Healthier Newham. A local partnership board is in place. The role of the board is to work across the system with colleagues from primary care, TB services, The Find and Treat service, public health and services such as housing and social care to understand the local priorities and develop actions to reduce levels further. The next action for the Newham partnership is to consider the new national action plan and shape accordingly for the Borough based on our needs to tackle local levels of TB.

Our Thoughts:

A little disingenuous? Cllr Ali suggests that the increase is in the rate of complex cases of TB, but doesn’t feel the need to back this up with any figures.  He also implies that the situation is compounded because the NHS lacks the key staff. He implies this without ever saying so categorically. He seems to have missed the point. 

He then goes on to say how Newham led the way in reducing TB, as indeed they did, (under the Wales regime). But he simply repeats what Cllr Chowdhury stated in her opening paragraph.

Is the reference to Covid there to imply that the Covid-pause caused the increase? If so, it is a suggestion that is demonstrably false, though next years’ figures may well show a further spike.

So, there is a new national TB action plan. It would be nice to know how that will affect the people of Newham. But on this, Cllr Ali is silent.

And how does Cllr Ali plan to reduce the number of cases of TB in the borough. He’s going to have more meetings.

Here is Cllr Chowdhury’s response.

The increase in numbers predates Covid! Therefore, I can’t see the link between Covid and an increase in TB.

Let me help the cabinet member. In the last five years nearly 21,000 high risk individuals chose not to attend screening appointments.

Another 1,755 individuals who tested positive for latent TB, chose not to take up the offer of treatment.

These 23,000 individuals are those most likely to develop symptomatic TB. 

My follow up question is:

Will the Cabinet Member, in consultation with the Newham CCG and the Health and Wellbeing Board, initiate a call-up programme, inviting all of those 23000 people back for screening or treatment, as appropriate, before Winter?

The Response of Cllr Ali.

We are not impressed Cllr Ali. Not impressed at all.

It’s time for less talk and more action.