{
  "abstract": "Accurate planning of TB workforce and services requires recognition of all activity contributing to TB care. The 2024 GIRFT Respiratory Medicine report emphasises the need to align workforce models with the full scope of service delivery, stating: ‘Many TB services lack visibility of the true workload undertaken by nurses and consultants outside of formal clinics.’ A substantial volume of service provision is performed outside standard clinics, yet this activity is often undocumented in formal service metrics. Additionally, workload generated outside of ‘active TB treatment’ is excluded from local and national reporting systems.We aimed to capture the ‘hidden’ work carried out by our TB service. Using TB referral data, we retrospectively compared categories of new referrals made to the service and numbers started on active and latent TB treatment from 1st April 2024 to 31st March 2025. Coding data which captured new and follow up appointments recorded on electronic patient records (EPRs) was also reviewed.In total, 1252 referrals were made to the TB service. Reasons for referral were available for Q2-Q4 (n=1014): symptomatic or abnormal result (46%) immunosuppression screening (26%), contact screening (20%), occupational health & other (8%). During this period, 147 patients were started on active and 203 on latent TB treatment. Additionally, a subset of referral work was found to take place during MDTs & email correspondence which is not reported as clinical activity on the EPR.A total of 7060 TB attendances were coded (figure 1). E95.8 and E95.9 (TB attendances) were found to be the most commonly used codes by clinicians at e-checkout during clinics. There was a 34% increase in total clinic coding from April-Sep 2024 [n=3020] to October-March 2025 [n= 4040], this reflected roll out of enhanced recording and coding of clinical activity.Hidden TB workload can be identified using multiple sources and is essential to deliver a safe, sustainable service. A live data reporting system nested within our clinical work flows will allow continuous monitoring of referrals, comparison with regional and national trends, and provide accurate data for quality improvement and audit to enable real-time responses to changes in patterns locally.Abstract M48 Figure 1Increase in number of TB attendances coded on electronic patient records from 1st April 2024 to 31st March 2025",
  "authors": [
    {
      "affiliations": [
        "Imperial College NHS healthcare Trust, London, UK"
      ],
      "name": "MO Azouaghe"
    },
    {
      "affiliations": [
        "Imperial College NHS healthcare Trust, London, UK"
      ],
      "name": "A Hoxha"
    },
    {
      "affiliations": [
        "Imperial College NHS healthcare Trust, London, UK"
      ],
      "name": "H Durkan"
    },
    {
      "affiliations": [
        "Imperial College NHS healthcare Trust, London, UK"
      ],
      "name": "TB Whyte"
    },
    {
      "affiliations": [
        "Imperial College NHS healthcare Trust, London, UK"
      ],
      "name": "P Sparkes"
    },
    {
      "affiliations": [
        "Imperial College NHS healthcare Trust, London, UK"
      ],
      "name": "M Coleman"
    },
    {
      "affiliations": [
        "Imperial College NHS healthcare Trust, London, UK"
      ],
      "name": "J Meghji"
    },
    {
      "affiliations": [
        "Imperial College NHS healthcare Trust, London, UK"
      ],
      "name": "M Park"
    },
    {
      "affiliations": [
        "Imperial College NHS healthcare Trust, London, UK"
      ],
      "name": "OM Kon"
    },
    {
      "affiliations": [
        "Imperial College NHS healthcare Trust, London, UK"
      ],
      "name": "L Martin"
    }
  ],
  "title": "M48 Revealing the hidden workload of TB services: using electronic patient records to support workforce planning",
  "uid": "a757f0a9-d20e-532c-8419-897409db17b9"
}