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Hi Jackie, CXR and IGRA/ TB Quantiferon for all those who have been in high risk country for more than 3 months in last 5 years - we do not mantoux until CXR and TB bloods negative If positive refer to TB team Mantoux for all staff without BCG scar or documented BCG/ Heaf/ Mantoux history - if negative give BCG vaccine If positive CXR, TB bloods and refer to TB team - we will refer before results if Mantoux reading is more than 10mm With current supply issues, we run booked clinics, which have a 50% DNA rate, so we overbook to ensure we make the best use of limited supply. Please contact me directly if you want to discuss further, Hope this helps Tracy Huguenel Clinical Lead Nurse Manager Occupational Health and Wellbeing Queen's Hospital 01708 503437 Internal Ext 3937 Email: [log in to unmask] Follow us on Twitter @BHRUT_HWBHub -----Original Message----- From: [log in to unmask] [mailto:[log in to unmask]] On Behalf Of Jackie Thomas Sent: 07 July 2016 21:29 To: [log in to unmask] Subject: [OCC-HEALTH] TB Have posted this on the OH forum but still just in case anybody else knows the answer: I know this was discussed earlier on this year but has anyone made any sense of it or am I dim? https://www.nice.org.uk/guidan…/ng33/chapter/recommendations Offer a Mantoux test to new NHS employees who are not new entrants from high-incidence countries and have not had BCG vaccination (for example, they are without a BCG scar, other documentation or a reliable history). If the Mantoux test is positive, offer an interferon-gamma release assay. If this is positive, assess them for active TB if this assessment is negative, offer them treatment for latent TB. (SO AM I RIGHT EITHER WAY IF THE MANTOUX IS POSITIVE AND THE IGRA IS POSITIVE OR NEGATIVE WE HAVE TO REFER THEM ON TO THE TB PEOPLE?) Offer a Mantoux test to new NHS employees who are from a high-incidence country. If the Mantoux test is positive (5 mm or larger, regardless of BCG history), assess for active TB if this assessment is negative, offer them treatment for latent TB infection If Mantoux testing is unavailable, offer an interferon-gamma release assay. If the interferon-gamma release assay is positive, assess for active TB and If this assessment is negative, offer them treatment for latent TB infection . (AGAIN WE HAVE TO REFER THEM ONTO THE TB PEOPLE). Please correct me if i am wrong or have interpreted it incorrectly, if anyone has a dummies guide to the new guidence i would greatly appreciate it. ******************************** Please remove this footer before replying. OCC-HEALTH ARCHIVES: http://www.jiscmail.ac.uk/lists/occ-health.html CONFERENCES AND STUDY DAYS: http://www.jiscmail.ac.uk/cgi-bin/filearea.cgi?LMGT1=OCC-HEALTH For compliancy information regarding our email usage, please visit http://www.bhrhospitals.nhs.uk/email-compliancy-information.htm Please only print this email if you really need to. ******************************** Please remove this footer before replying. OCC-HEALTH ARCHIVES: http://www.jiscmail.ac.uk/lists/occ-health.html CONFERENCES AND STUDY DAYS: http://www.jiscmail.ac.uk/cgi-bin/filearea.cgi?LMGT1=OCC-HEALTH