# Post-TB care in the UK: a national survey of existing practice

## TL;DR

This study surveyed UK TB services to understand how post-TB care is currently being managed, finding that while many clinicians recognize the issue, care is inconsistent and limited by resources.

## Contribution

The paper presents the first national survey of post-TB care practices in the UK, highlighting gaps and challenges in current approaches.

## Key findings

- Most UK TB clinicians encounter post-TB morbidity, including lung disease and social vulnerabilities.
- High caseload services report more types of post-TB morbidity compared to low caseload services.
- Resource constraints like staffing and funding are major barriers to comprehensive post-TB care.

## Abstract

Tuberculosis (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.

We conducted a digital survey between February and May 2025 across National Health Service 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.

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.

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.