A van with a plan: TB screening in Kent’s vulnerable communities

With cases of tuberculosis (TB) detected in Kent’s rough sleeping community, the Find and Treat Service supported our specialist TB nurses to reach those at risk of infection this summer.

Sue* had been an alcoholic for several years before giving up the booze seven months ago. She had just relapsed when TB specialist nurses Helen Nash, Becky Pitt and Tara Wiltshire from the Find and Treat Outreach Team find her outside the job centre in Margate.

“We look after people in their homes, car parks and in prisons.

"We are a tiny team but in a recent national review, we have some of the best treatment outcomes across the country.”

Sue is in and out of temporary accommodation. The team had been searching for eligible people to visit the mobile screening clinic at Margate Football Club.

Helen sits down beside her, puts a hand on her shoulder, and listens. “I was doing so well, but I am just back on the alcohol,” Sue sighed. “I am struggling again. I smoke too. I cough sometimes.”

“Have you heard of TB?” Helen asked, gently. “We have a van where you can get tested really quickly.”

Later that morning, Sue has boarded a bus to the football ground and is there having an x-ray and blood tests to rule out any infectious diseases.

Find and Treat is a specialist outreach team that works alongside NHS and voluntary services to tackle tuberculosis among vulnerable people, like Sue.

The mobile screening unit, contained in a purpose-built van, has an on-board remote x-ray machine and can offer instant results. Our specialist nurses worked in partnership with the service to bring the van to both Canterbury and Margate this summer for the specialist screening events.

The events are led by the UK Health Security Agency and paid for by Kent and Medway Integrated Care Board (ICB). They are also supported by Kent County Council.

“We look after people in their homes, car parks and in prisons,” said Sarah Murphy, Clinical Lead TB Specialist Nurse for Kent Community Health NHS Foundation Trust. “We are a tiny team but in a recent national review, we have some of the best treatment outcomes across the country.”

TB is a bacterial infection that mainly affects the lungs but can impact any part of the body, including the glands, bones and nervous system. If detected, it is treatable with antibiotics.

Sarah continued: “We have tried routine ways of screening but this community struggles to access healthcare. This approach is proactive and we’ve seen great success.”

Our TB nurses headed out in the morning to food banks, job centres, churches and regular hot spots of rough sleepers to encourage people to visit the van.

“I smoke cannabis,” said Matt* who is receiving treatment for addiction and heard about our testing event through friends. “I used to be addicted to all sorts of things. I worry about my chest so I will get this test done. Better safe than sorry.”

Matt’s x-ray is over in minutes and he’s happy that his chest looks healthy and clear. “I’ve had my MOT and now I know I am okay.” he said.

Twenty three patients were screened at the event in Margate, thankfully with no cases of TB detected. At the previous event in Canterbury, one active case of TB and four latent cases were diagnosed.

Specialist Nurse Becky Pitt said: “Most of our clients in the rough sleeping community are grateful that someone is looking out for them when we talk about TB testing.”

For lead nurse Sarah, the benefits of this programme are clear. Sarah said: “To find even one case of TB stops the spread and infection to other people. Today, we’ve also picked up a case of pneumonia and been able to get antibiotics from the GP.

“If someone attending leaves knowing the signs and symptoms of TB and where to contact our team, then this is a big step forward.”

* names have been changed

Typical symptoms of TB:

• a persistent cough that lasts more than three weeks and usually brings up phlegm, which may be bloody
• weight loss
• night sweats
• high temperature (fever)
• tiredness and fatigue
• loss of appetite
• new swellings that haven’t gone away after a few weeks.

You should see a GP if you have a cough that lasts more than three weeks or if you cough up blood. If TB has spread, other symptoms may appear in different parts of the body.

Find out more by visiting: www.nhs.uk/conditions/tuberculosis-tb