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NICE public health guidance
Issued: March 2012
PH37

Identifying and managing tuberculosis among hard-to-reach groups

View the summary and implementation tools

This is an extract from the guidance. The complete guidance is available at guidance.nice.org.uk/ph37

Introduction: scope and purpose of this guidance

What is this guidance about?

This guidance aims to improve the way tuberculosis (TB) among hard-to-reach groups is identified and managed. It sets out how commissioners and services can achieve this. The recommendations cover:

  • strategic oversight and commissioning of TB prevention and control activities

  • local needs assessment

  • cohort review

  • commissioning multidisciplinary TB support for hard-to-reach groups

  • raising and sustaining awareness of TB among health professionals and those working with hard-to-reach groups

  • raising and sustaining awareness of TB among hard-to-reach groups

  • identifying active pulmonary TB among those using homeless or substance misuse services

  • identifying and managing active TB in prisons or immigration removal centres: organisational factors

  • identifying active TB in prisons or immigration removal centres

  • managing active TB in prisons or immigration removal centres

  • identifying and managing active and latent TB: vulnerable migrants

  • identifying and managing latent TB: substance misusers and prison populations

  • contact investigations

  • rapid-access TB services

  • enhanced case management

  • accommodation during treatment.

Who is this guidance for?

The guidance is for commissioners and providers of TB services and other statutory and voluntary organisations that work with hard-to-reach groups.

Why is this guidance being produced?

The Department of Health (DH) asked the National Institute for Health and Clinical Excellence (NICE) to produce this guidance.

The guidance should be implemented alongside other guidance and regulations (for more details see sections on implementation and related NICE guidance respectively).

How was this guidance developed?

The recommendations are based on the best available evidence. They were developed by the Programme Development Group (PDG).

Members of the PDG are listed in appendix A.

The guidance was developed using the NICE public health programme process. See appendix B for details.

Supporting documents used to prepare this document are listed in appendix E.

What evidence is the guidance based on?

The evidence that the PDG considered included: three reviews of the evidence, economic modelling, the testimony of expert witnesses, stakeholder comments and fieldwork. Further detail on the evidence is given in the considerations section (3.25–3.39) and appendices B and C.

In some cases, the evidence was insufficient and the PDG has made recommendations for future research.

Status of this guidance

The guidance complements but does not replace, other NICE guidance on tuberculosis (for further details, see section 7).