DoH ‘unable' to address unlicensed Mantoux test

Nurses may not ever be able to prescribe Mantoux tests without a doctor's signature after the DoH has admitted it is unable to change the situation.

Last March NICE issued new guidance on diagnosing and treating TB in response to its rapid increase in the UK, particularly in London.

It followed the government’s switch from HEAF tests to Mantoux tests, which use a tuberculin that is unlicensed in the UK, in late 2005.

Conflicting advice from the DoH caused confusion over whether independent nurse prescribers could administer the tests, but it was eventually agreed that nurses were unable to issue a Mantoux test without a patient specific directive.

Anne Baird, a nurse practitioner in Sheffield, said her practice did quite a few TB tests because it covered a large student population. Despite having three qualified nurse prescribers, they had to get a doctor’s signature for every patient.

‘In practice its complicated and silly because the doctor hasn’t even seen the patient,’ she said.

‘It seems odd that now TB is becoming a much bigger problem and NICE has issued guidance, we are not allowing nurses to deal with the problem effectively. Instead of making it easier, we’re making it more restrictive.’

A DoH spokeswoman said the product was unlicensed and as far as she was aware the manufacturer had not yet applied for a license. The government could not force them to apply, she added.

Independent Nurse questioned the Danish manufacturer, Statens Serum Institute, on its intentions to apply for a UK license but it failed to respond before IN went to press.

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