Effective management of tuberculosis is vital not just for the individual concerned, but also in the wider interests of public health. Inappropriate management increases the risk of morbidity and mortality in the index case, increases the risk of producing drug resistant organisms, and increases the risk of spread of the disease to others.
National guidelines are in place (formerly the BTS Guidelines, now the NICE Guideline) to assist in optimal management. However, as with all Guidelines not every eventuality can be covered and their interpretation and application to the individual case requires the exercise of professional judgment, based on knowledge and experience.
Even the most experienced healthcare professional involved in Tuberculosis will encounter circumstances where very difficult decisions must be made. At the other end of the spectrum of experience, many doctors practice in parts of the country where there is relatively little TB and may have difficulty acquiring the experience base necessary for the best management of those cases for which they do find themselves responsible.
Since optimal management of TB may have consequences for the morbidity and even mortality of others and not just for the original patient, the argument for a move towards a Multi-Disciplinary Team (MDT) model for TB care would seem to be a compelling one.
Discussions between BTS and the Department of Health in mid-2007 led to the proposal that the Department would provide funds to enable the Society to establish a multi-disciplinary TB Advice Network.
A copy of the proposal is available
here.
Further information on this project is available through the links provided below: