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Delivering tertiary tuberculosis care virtually
  1. Louise Turnbull1,
  2. Christine Bell2,
  3. Stefanie Davies3,
  4. Fran Child4
  1. 1 Paediatric Respiratory Department, Royal Manchester Children's Hospital, Manchester, UK
  2. 2 Tuberculosis Team, Manchester Royal Infirmary, Manchester, UK
  3. 3 Epidemiology and Information Analyst, North West Field Service, Public Health England North Region, Manchester, UK
  4. 4 Paediatric Respiratory Medicine, , Manchester, UK
  1. Correspondence to Dr Louise Turnbull, Paediatric Respiratory Department, Royal Manchester Children's Hospital, Manchester M13 9WL, UK; louise.turnbull{at}


Objective To assess the impact of a virtual multidisciplinary team (MDT) review panel in reducing travel for children with a rare disease (tuberculosis (TB)) without compromising clinical outcomes.

Design Retrospective review of patients discussed in a virtual MDT panel. Independent pre-intervention and post-intervention data from Public Health England.

Setting Paediatric departments across North West England.

Patients Children aged <16 years with suspected TB infection/disease.

Intervention Weekly, virtual MDT discussion between district paediatricians and a tertiary TB team.

Main outcome measure Care closer to home, time from presentation to treatment.

Results 45% (37 of 82) children received care closer to home. Median time from presentation to treatment reduced by 28% (from 18 to 13 days). 21% more children were diagnosed before developing symptoms (76% of children presented with symptoms pre-intervention, 55% post-intervention). 5 children incorrectly labelled with latent TB infection were treated for TB disease.

Conclusions A clinical network supported by virtual MDT reviews can improve treatment for children with rare diseases while providing care close to home.

  • health services research
  • qualitative research
  • information technology

Data availability statement

Data are available upon reasonable request. Data available if required.

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Data availability statement

Data are available upon reasonable request. Data available if required.

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  • Contributors All authors contributed to the data collection. SD provided the cohort review data from Public Health England. LT and FC wrote the article with input from CB.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.