Agenda item

The Chairman invited Dr. Laura Fabunmi, a Consultant in Public Health Medicine from Harrow and Barnet Public Health to introduce the report, which set out the rates of Tuberculosis in Barnet. 

The report outlined some of the challenges in tackling TB, who is affected by the disease and what is planned at national and local levels to identify people with TB and to provide the required treatment. Dr. Fabunmi informed the Committee that rates of TB in Barnet have dropped in the three-year average data, from 30.0/100,000 (2010-12) to 23.2 / 100,000 (2012-14). Although this is lower than the London average of 30.1 / 100,000 (2013), there are still hot-spots within the Borough, notably in Colindale and Oakleigh Wards.  Dr. Fabunmi noted however that the statistics for the Borough were based on a very small number of people, approximately 25 – 30 cases.  She informed the Committee that the rate of infection in non-UK born people is approximately 10 times greater than those who are U.K born.

The Committee noted the following responsibilities of the Public Health team in relation to dealing with the issue of TB:

·         Commissioning delivery and co-ordination of sessions and agree provider responsibilities

·         Sourcing promotional material from TB Alert for information packs

·         Organise staff awareness sessions for council staff

·         Encouraging GP uptake of Royal College of General Practitioners online training for TB

·         Organising TB seminar on World TB Day

Responding to a question from a Member, Dr. Fabunmi informed the Committee that, as is the case in London and the UK, the majority of TB cases in Barnet arise due to the reactivation of latent infection and so the main challenge to reducing TB in Barnet is the identification and treatment of those with latent TB.  The Committee noted that approximately 80% of people who develop active TB do so as a result of the reactivation of latent TB rather than through transmission from someone with the active disease. She stressed the importance of prompt identification of active cases of disease, supporting patients to successfully complete treatment and preventing new cases of disease.

The Committee were informed that Harrow and Barnet Public Health would be running the second phase of the project in relation to TB and that voluntary groups would be able to bid for money to fund work on the disease.

A Member noted that whilst the rate of TB was low in Britain, it was comparatively high compared to the rest of Europe and expressed concern at people delaying treatment.  Dr. Fabunmi commented that the delay in treatment was likely to be in part down to Latent TB, the stigma attached to the disease or the association with witchcraft in some cultures. 

Responding to a question from a Member, Dr. Fabunmi advised that control of TB came under Public Health England, who have a national strategy and that whilst Harrow and Barnet Public Health led on the work locally, they had to work along with health providers. 

A Member commented that the Local Authority’s strategy had the correct goals, but that the recent campaign had not generated much interest.  Dr. Fabunmi commented that the approach of reaching out to community groups had been successful in Harrow because TB was recognised more widely as an issue.  As the campaign had not been as successful in Barnet as in Harrow, a Member requested that the campaign is repeated in Barnet.

Responding to a question from a Committee member, Dr. Fabunmi noted that immunisation was now given through neo-natal BCGS.

RESOLVED that

1.    The Health Overview and Scrutiny Committee notes the report and the steps taken by the public health team and other partners to reduce incidence of TB in Barnet.

2.    The committee notes the recommendations accepted by the Health and Well Being Board on 30^th July 2015.