Post-TB care in the UK: a national survey of existing practice
File(s)
Published version
Author(s)
O'Reilly, Ailva
Martin, Christopher Andrew
Cox, Sharon Elizabeth
Haldar, Pranabashis
Zenner, Dominik
Type
Journal Article
Abstract
Background
TB survivors experience high mortality and long-term morbidity, contributing substantially to the
global TB burden. In the UK, where TB incidence is rising, the scale of post-TB health needs is
unknown and current guidelines do not recommend follow-up. We conducted the first nationwide
survey of UK TB services to assess approaches to post-TB care.
Methods
We conducted a digital survey between February and May 2025 across NHS TB services in all four
nations, targeting specialist clinicians. The questionnaire captured data on types of post-TB
morbidity encountered and current practice. We analysed descriptively and stratified by caseload.
Results
We received responses from 113 of 135 TB services (84%). Most respondents were lead clinicians
(81%), and nearly all (96%) had encountered post-TB morbidity in their patient populations,
including lung disease (82%), social vulnerabilities (79%), and financial issues (66%). High caseload
services (≥30 cases/year) reported more types of morbidity (mean 4.2 vs 2.9; p<0.001). While end of
treatment symptom screening and chest X-rays are routine (>95%), fewer than half of services
perform assessments for broader post-TB sequelae and comorbidities, or provide direct ongoing
medical care (41%). Most services cited staffing (78%), clinic capacity (70%), and funding (59%) as
challenges to post-TB care.
Conclusions
A high proportion of UK TB clinicians recognise post-TB morbidity among their patient groups. TB
services are introducing elements of post-TB care, but provision is heterogenous and often informal,
with multiple resource-related challenges. Robust UK-specific data, stakeholder engagement, and
clear guidance are needed to support post-TB care pathways.
TB survivors experience high mortality and long-term morbidity, contributing substantially to the
global TB burden. In the UK, where TB incidence is rising, the scale of post-TB health needs is
unknown and current guidelines do not recommend follow-up. We conducted the first nationwide
survey of UK TB services to assess approaches to post-TB care.
Methods
We conducted a digital survey between February and May 2025 across NHS TB services in all four
nations, targeting specialist clinicians. The questionnaire captured data on types of post-TB
morbidity encountered and current practice. We analysed descriptively and stratified by caseload.
Results
We received responses from 113 of 135 TB services (84%). Most respondents were lead clinicians
(81%), and nearly all (96%) had encountered post-TB morbidity in their patient populations,
including lung disease (82%), social vulnerabilities (79%), and financial issues (66%). High caseload
services (≥30 cases/year) reported more types of morbidity (mean 4.2 vs 2.9; p<0.001). While end of
treatment symptom screening and chest X-rays are routine (>95%), fewer than half of services
perform assessments for broader post-TB sequelae and comorbidities, or provide direct ongoing
medical care (41%). Most services cited staffing (78%), clinic capacity (70%), and funding (59%) as
challenges to post-TB care.
Conclusions
A high proportion of UK TB clinicians recognise post-TB morbidity among their patient groups. TB
services are introducing elements of post-TB care, but provision is heterogenous and often informal,
with multiple resource-related challenges. Robust UK-specific data, stakeholder engagement, and
clear guidance are needed to support post-TB care pathways.
Date Issued
2026-02-26
Date Acceptance
2026-01-31
Citation
BMJ Open Respiratory Research, 2026, 13 (1)
ISSN
2052-4439
Publisher
BMJ Publishing Group
Journal / Book Title
BMJ Open Respiratory Research
Volume
13
Issue
1
Copyright Statement
© Author(s) (or their employer(s)) 2026. Re-use permitted under CC BY. Published by BMJ Group.
License URL
Identifier
10.1136/bmjresp-2025-004021
Publication Status
Published
Article Number
004021
Date Publish Online
2026-02-26