The visa checklist has a line about a TB certificate, and a search for clinics nearby brings up a private GP on Green Lanes. It is a sensible place to look, and we would rather answer it in the first paragraph than at the end of a phone call. We cannot issue that certificate. What we can do is narrower, and for some people more useful.
The UK visa TB test has to be done at a clinic approved by the UK Home Office, and Clinique Alpa is not a Home Office approved TB clinic. The question underneath is usually twofold: do I need the test at all, and if my chest is worrying me, who should see me.
Chest pain, signs of a stroke, severe breathlessness, heavy bleeding, a severe allergic reaction or symptoms of sepsis need 999 or A&E immediately. For urgent advice that cannot wait, call NHS 111.
Who needs a UK visa TB test?
GOV.UK sets the rules, and they are worth reading in full on the TB tests for visa applicants page. In outline, a test is needed if you are coming to the UK for 6 months or more and have lived in one of the listed countries for 6 months or more. Certain family and returning resident routes need a test too. The list of countries, and the people who do not need a test, are set out there. I would check it against your own route rather than rely on a summary, including this one.
Where is the test done, and what does it involve?
The test must be done at a clinic approved by the UK Home Office. It is a chest X ray, and sometimes a sputum sample as well. A clear result gives a certificate that is valid for 6 months from the date of the X ray, so the timing of the X ray against the application date matters.
A letter from a private GP cannot stand in for that certificate, and I would not want anyone to pay for one in the hope that it might. The same applies to visa medicals for Canada, Australia, New Zealand and the United States, which are accepted only from doctors on those countries' own approved lists, known as panel physicians. Clinique Alpa doctors are not panel physicians and cannot do those examinations. There is more on that in visa medicals for Canada, Australia or the US.
What happens if I am worried about TB or a cough?
Some people come to us not for a certificate but because the visa process has made them notice something. A cough that has hung on since the winter. A relative who was treated for TB. Night sweats that were easy to ignore until someone asked about them. That is a proper reason to see a doctor, and it is one we can help with.
The history
I ask how long the cough has been there, whether it brings up phlegm, and whether there has ever been blood in it. I ask about fevers, night sweats, appetite, tiredness and weight, and I would rather weigh you than guess. Then the context: where you have lived and when, whether anyone close to you has been diagnosed with TB, any previous TB or treatment for it, and whether another condition or treatment might lower your resistance to infection. I also ask what has been done already, such as an earlier chest X ray and what it showed, because an old result can save time or change the plan.
The examination
I check temperature, pulse and oxygen levels, listen carefully to the chest, and feel for swollen glands in the neck. Much of the time the findings point somewhere ordinary, such as a cough that has lingered after a viral infection, asthma or reflux. The work is in being sure of that rather than assuming it.
The worry behind the worry
For some people the fear is less about the cough than about what a TB result might mean for the application. That is a reasonable fear, and it helps to separate it from the clinical question. My part is the clinical question: whether there is anything here that needs investigating for your own health. The honest answer to that is worth having whatever the visa timetable says.
What happens next
If anything suggests TB, or the history alone makes it worth excluding, I refer on for investigation, and a referral letter after a consultation is included in the consultation fee. With your consent, a summary goes to your NHS GP, because this is private healthcare alongside the NHS, never a replacement for it. If the picture is reassuring, I say so, and I tell you what would change that and when to come back.
Records and letters
If you have been seen here, you can ask for copies of your records. Where a letter about your health is clinically appropriate after assessment, we can write one; our medical letters page explains the types and fees. None of this replaces the TB certificate, and the approved clinic decides what it needs from you.
When should a cough be seen sooner?
- Coughing up blood, even a small amount.
- Breathlessness that is getting worse; if it is severe, call 999.
- A cough that has lasted more than 3 weeks.
- Fevers or drenching night sweats, with weight loss you were not trying for.
- New symptoms after close contact with someone diagnosed with TB.
Any of these deserves a doctor promptly, whether or not a visa is involved. Your NHS GP or NHS 111 can help, and so can we.
What can Clinique Alpa do, and what can it not?
We can see you for a 30 minute face to face consultation at 466 Green Lanes, Palmers Green, for £100. That is time to take the history properly and examine you. We can refer on where needed, share a summary with your NHS GP with your consent, provide copies of your records, and write letters where clinically appropriate after assessment. The clinic is open Monday to Friday 09:00 to 20:00 and Sunday 09:30 to 17:30, and closed on Saturday.
We cannot do the visa TB test or issue its certificate, because we are not a Home Office approved TB clinic. We cannot perform panel physician medicals for other countries. No doctor here can influence a visa decision; that rests with the Home Office. If you are reading this for a relative overseas, the GOV.UK page above is the right starting point for them. For other travel paperwork, there is more in visa and travel medical certificates.
Written by Dr Mitesh Parmar, MBBS MRCGP, Principal GP and Clinical Director at Clinique Alpa, 466 Green Lanes, Palmers Green, London N13 5PA. This article is general information, not personal medical advice. In an emergency call 999. For NHS advice call 111 or visit nhs.uk.