The Director of Public Health will provide the Commission with a verbal update.
Minutes:
The Director of Public
Health gave a verbal update of the latest position of health
protection, and it was noted that:
· TB had previously been mentioned as a topic of concern as rates are higher than would like in the city. There was a successful reduction of TB rates in the early 2000’s but there had been an upward trend, with Leicester now having the second highest rates in the country. New figures will be released next month, and it is suspected Leicester will be rated as having the highest rates of TB.
· Work has been ongoing across the public health team, the ICB and UK Health Security Agency (UKHSA) and a new strategy has been developed with a steering group Chaired by the Director of Public Health with a host of actions.
· University Hospitals Leicester have an amazing TB service, but it does not have the resources for managing the levels of TB in the city. A business case has been created to increase the capacity for the service.
· TB treatment is difficult and lengthy taking 6 months. Latent cases are particularly difficult to maintain treatment as patients feel healthy in themselves, yet the treatment can have side effects making them feel ill.
· Identifying and treating cases of latent TB screening is a main objective through GP practises, however funding is an issue. A case has been made to NHS England for doubling funding locally in order to reduce TB rates in the city.
· The Loughborough strain is more severe and contagious, and treatment can take up to 9 months but there are fewer cases.
· Mpox has become a global concern with a new (clade 1b) potentially more severe and contagious to affect younger people although data is not yet available. There have been cases in Europe but none in the UK to date. The UKHSA has outlined a plan should it come to the UK and is monitoring the situation.
Members were reassured that there is a strategy in place for controlling the rates of TB, but it was concerns were acknowledged in that Leicester was likely to have the highest rates in the country. In response to questions and comments from Members, it was noted that:
· Public Health are hopeful that the request for additional resources for latent TB testing would be successful.
· A joint letter from the Health and Wellbeing Board, the Deputy City Mayor for Social Care, Health and Community Safety and the ICB had been sent to the UK Health Security Agency to request additional funding. The business case had been put through urgently with the hope that an outcome would be achieved before the usual time span of 6-8 weeks.
· As part of the strategy implementation to address TB there had been lots of work with health partners around screening, data analysis, communications, and a particular focus on addressing the stigma that is often associated with TB to help break down barriers for screening or treatment.
· TB requires a resource intensive treatment, so it is important to ensure the local infrastructure has the capacity to support the most vulnerable to sustain the treatment.
· There were 200 cases of TB in the city last year, and one case of the Loughborough strain; so is not comparable to covid or flu numbers but concerning and higher than other areas in the country.
· TB is usually related to patterns of migration. Leicester has high numbers of refugees and asylum seekers, as well as individuals travelling to areas of high prevalence of TB so it is vital to make sure screening, particularly latent screening, occurs.
· The TB vaccination is not as effective as vaccinations for other conditions.
· It has not been a requirement for migrants to get a latent TB test, just an active one which is not always reliable. Nationally, there needs to be a more effective screening programme.
The Commission expressed the importance of seeking additional funding and hoped the city would be successful to tackle the current rates. It was further noted that Members suggested health checks at border controls would be most effective in bringing down rates and that lessons should be learnt from previous decades with clear messaging.
As part of discussions the Chair invited the youth representative to make comments and it was noted that there are different campaigns to encourage vaccination uptake for different vaccinations and these differ dependent on targeted population. There had been lots of work in schools and communities to target vaccination campaigns.
AGREED:
· The Commission noted the report.
· The TB strategy and action plan to be added to the work programme.