‘Pooled’ TB Testing Could Save the NHS Millions and Speed Up Diagnoses, Study Finds

A new study suggests that pooling tuberculosis tests — analysing samples in batches rather than individually — could significantly cut costs for the NHS while maintaining diagnostic accuracy, offering a potential breakthrough in the fight against the disease in the UK.

**Lead**

A groundbreaking study published this week has revealed that a ‘pooled’ testing strategy for tuberculosis (TB) could save the National Health Service (NHS) substantial sums of money and improve the speed of diagnosis for patients across the United Kingdom. Researchers found that by combining multiple patient samples into a single test batch, laboratories could reduce the use of expensive reagents and streamline workflows without compromising the reliability of results. The findings come as the UK grapples with persistent TB rates in certain urban and vulnerable populations, where delayed diagnosis often leads to worse outcomes and higher transmission.

**Contexto**

Tuberculosis remains a significant public health challenge in the UK, with over 4,000 new cases reported annually according to the UK Health Security Agency. While the overall incidence is low compared to many countries, the disease disproportionately affects homeless individuals, migrants from high-burden regions, and those with compromised immune systems. Traditional diagnostic methods, such as the Xpert MTB/RIF assay, are highly accurate but costly, with each individual test requiring expensive cartridges and specialised equipment. In resource-constrained settings within the NHS, this can lead to bottlenecks, particularly in high-volume laboratories serving areas with elevated TB prevalence.

The concept of pooled testing is not new. It has been successfully deployed during the COVID-19 pandemic to screen large populations efficiently. The principle is straightforward: if a batch of samples tests negative, all individuals are cleared; if a batch tests positive, each sample is retested individually to identify the infected person. The new study, conducted by researchers at several UK universities in collaboration with NHS laboratories, applied this same logic to TB diagnostics. By simulating real-world testing scenarios using archived patient samples, the team demonstrated that pooling up to five samples per test could reduce reagent costs by as much as 40% while retaining a sensitivity above 95%.

The research also highlighted significant time savings. In busy diagnostic centres, individual testing can create a backlog, forcing patients to wait days for results. Pooled testing allows laboratories to process more samples in a single run, potentially cutting turnaround times by half. This is particularly critical for TB, where early detection is essential to prevent severe lung damage and curb community spread. The study’s authors emphasised that the approach would be most effective in settings with a low prevalence of TB, where the likelihood of multiple positive samples in a single batch is minimal, thus avoiding excessive retesting.

**Analise**

For the NHS, which is under constant pressure to deliver value for money, the implications of this study are profound. The cost of TB diagnostics is not trivial. Each Xpert MTB/RIF cartridge costs approximately £15 to £20, and with thousands of tests performed annually across the country, the cumulative expense runs into millions of pounds. By adopting a pooled testing protocol, the NHS could redirect these savings towards other critical areas, such as contact tracing, patient support, and preventive therapy for latent TB infections. Moreover, faster diagnosis means that patients can begin treatment sooner, reducing the duration of infectiousness and lowering the risk of outbreaks in shelters, prisons, and other congregate settings.

However, the transition to pooled testing is not without challenges. Laboratory workflows would need to be reconfigured, and staff would require training to manage the new protocols. There is also the risk of a slight increase in false negatives due to sample dilution, although the study found this to be minimal when using optimised pooling ratios. Public health officials must weigh these operational hurdles against the clear financial and clinical benefits. The study’s findings are particularly timely given the recent rise in drug-resistant TB cases in parts of London and the West Midlands, where rapid and accurate diagnosis is paramount.

From a broader perspective, this research underscores a growing trend in global health: the adaptation of pandemic-era innovations to fight other infectious diseases. The success of pooled testing for COVID-19 has inspired similar investigations for HIV, hepatitis, and now TB. For the UK, which has committed to the World Health Organization’s goal of ending TB by 2035, such cost-effective strategies are not just desirable but necessary. The study provides a robust evidence base that could prompt the National Institute for Health and Care Excellence (NICE) to update its guidelines on TB diagnostics, potentially paving the way for a nationwide rollout.

**Fontes**

The information in this article is based on the study published in the journal *The Lancet Microbe* (September 2026 edition), as well as data from the UK Health Security Agency’s annual TB surveillance report and the National Institute for Health and Care Excellence’s current diagnostic guidelines. No direct interviews were conducted for this piece.