We need a Workforce to fight TB
Written by Jessica Townsend
The views and opinions expressed are solely those of the author and do not necessarily represent the views of their employer.
For the first time in England nurses have voted for strike action, with the third round of strikes occurring in healthcare settings across the country this month. Nurses are striking in England for fair pay to help tackle the chronic staff shortages (there are 47,000 registered nurse vacancies in England) and to help with recruitment and retention. Why is this relevant to Tuberculosis (TB)? In England in 2020 the incidence of TB was 7.3 per 100,000, which is below the World Health Organisation (WHO) definition of a low incidence country of 10 per 100,000 (UKHSA, 2021). However, TB is a curable infectious disease that continues to cause significant ill health and even death in the UK. In 2021 The TB Action Plan for England 2021 to 2026 was adopted for reducing the incidence of TB in England with the aim of prevention, detection and control. It identifies five key priorities for achieving a reduction in the TB incidence and to help England meet the WHO elimination targets by 2035. Priority number five is the workforce, central to which are nurses.
I have worked on the frontline in the NHS for over ten years, as a TB Specialist Nurse for seven years and I voted to strike. TB Nurses work across England and we are integral to the fight against TB. Whilst the main focus of our role is to support our patients to successfully complete their treatment there are other elements which are also key to the prevention and control of TB: we are responsible for ensuring contact tracing is carried out; we help to ‘find’ patients who may struggle to attend clinic, or who go missing altogether; we notify patients to our national TB register which aids disease control strategies; and we treat patients who have latent TB - preventing it from becoming active and therefore being transmitted to others.
Active TB treatment is a minimum course of 6 months and longer for those with extensive disease or a drug resistant bacteria. In my experience successful treatment completion is not only reliant on the availability of the right medicines but is also affected by a person’s social situation such as a stable income, home and their ability to access healthcare. As a TB nurse I have helped patients with their housing and accommodation concerns and to access the benefits they are entitled to. We enable patients to attend their clinic appointments, support them not just with health complications relating to TB but also with other factors that might determine an individual’s ability to complete their treatment. This might include referring patients to mental health or addiction services, assisting with accessing support for asylum claims and ensuring the basics of housing and food. Identifying and tackling not only the health needs of patients but the social needs is essential as these play a huge role in our patients’ capacity to continue to engage with care.
Finally, TB nurses are key to raising awareness of TB and educating not just our patients and their close contacts but other health and social care professionals and the local communities we live and work in. Increasing the numbers of people who ‘Think TB’ will lead to earlier diagnoses and thus reduced community transmission.
I know the role of the TB nurse is vital in the fight against TB and it emphasizes how it will be won not just with new medicines and vaccines but also with interventions that address social needs and provision of person-centered holistic care. Nurses working for the NHS in England, including TB specialist nurses, have experienced 20% real terms pay cut since 2010. We are being asked to do more work with less staff and patient care is suffering. We voted to strike because a diverse, well-trained, appropriately remunerated workforce (which is made up of more than nurses) is vital if we are to eliminate TB and end the suffering it causes.
About the Author - Jessica Townsend
Jessica Townsend is an Executive Committee member of UKAPTB, co-leading on representing TB nurses across the UK. She is the Lead TB nurse at St Georges Hospital in London and is a Nurse Rep on the London TB Control Board.
Jessica has worked in the field of TB for 7 years, encompassing a variety of nursing roles in London hospitals, including working on the TB pathway for prisoners at HMP Wormwood Scrubs. She has also spent time working abroad in Nepal and Malawi.
She is “keen to bring the nursing voice to the table!” – a key role in the fight against TB.
