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Post-TB care in the UK: a national survey of existing practice
Ailva O'Reilly1,2,3, Christopher Andrew Martin1,2,3,4, Sharon Elizabeth Cox5,6
1Division of Public Health and Epidemiology, School of Medical Sciences, University of Leicester College of Life Sciences, Leicester, UK.
Background:
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.
Methods:
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.
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.
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