Tuberculosis - RNOH/GIRFT review: national report

1 Foreword

Tuberculosis (TB) remains a major global health problem, despite being both preventable and curable. The World Health Organisation (WHO) ranks TB as the leading cause of death from an infectious disease worldwide. In recent years Scotland too has seen a worrying increase in the number of TB cases, resulting in increased patient morbidity and additional pressure on TB-specific and wider health services. Despite having made significant previous progress on reducing TB incidence in Scotland, the sustained increase in case numbers since 2022 mean that we are no longer on-track towards TB elimination.

Through a collaborative approach involving NHS Health Boards, Public Health Scotland, TB clinicians and other healthcare professionals, we have sought to better understand the current situation in Scotland. This includes identifying the ongoing challenges faced by Health Boards and highlighting areas where we can improve clinical practice. In this way we seek to reduce unwarranted variation in care and ensure that all patients receive the highest standard of treatment.

As part of this process, we commissioned a “Getting It Right First Time” review of TB services across Scotland, the findings of which are contained within this report. In addition to the important recommendations from the GIRFT team which aim to further improve services, there are also numerous examples of excellent clinical care and innovation, highlighting the dedication and diligence of our Scottish TB and wider health workforce. I extend my personal thanks to this workforce, and particularly to those who participated in this important review.

It is also clear, however, that there are areas of variation in TB service provision within Scotland and the review highlights the actions we need to take to deliver a more consistent, effective, and patient-centred approach to TB diagnosis and treatment, with an ever-present focus on reducing such health inequalities in Scotland.

As we move forward, I encourage all those involved in the commissioning and delivery of TB services in Scotland to play their part in considering and implementing the recommendations within this review. By continuing to strive to improve our care, and by working together, we can combat this important threat to population health with the ultimate goal of TB elimination in Scotland.

Professor Nicola Steedman

Deputy Chief Medical Officer