JMIR Publications

ABSTRACT

Background:

The Oxford-Royal College of General Practitioners (RCGP) Research and Surveillance Centre (RSC) and Public Health England (PHE) are commencing their 54th season of collaboration at a time when coronavirus 2019 infections (COVID-19) are likely to be co-circulating with usual winter infections.

Objective:

To conduct surveillance of influenza, other monitored respiratory conditions, and report vaccine uptake and effectiveness using nationally representative surveillance data extracted from primary care computerised medical records (CMR) systems. Practices also collect virology and serology specimens and participate in trials and other interventional research.

Methods:

The RCGP RSC network comprises over 1,700 general practices in England and Wales. We extract pseudonymised data twice weekly and are migrating to daily extracts. 1. We collect pseudonymised routine coded clinical data for the surveillance of monitored as well as unexpected conditions; vaccine exposure and adverse events of interest (AEIs), and approved research study outcomes. 2. We provide dashboards to give practices feedback about levels of care and data quality, compared to other network practices. We focus on collecting data about influenza-like-illness (ILI), upper and lower respiratory infections (URTI and LRTI) and suspected coronavirus 2019 disease (COVID-19). 3. Approximately 300 practices, will participate in the 2020/21 in virology and serology surveillance, this will include responsive surveillance and long term follow up of previous COVID-19 infections. 4. Member practices can recruit volunteer patients to trials, including early interventions to improve COVID-19 outcomes and point of care testing. 5. The legal basis for our surveillance with PHE is Regulation 3 of The Health Service (Control of Patient Information) Regulations 2002; other studies require appropriate ethical approval.

Results:

The RCGP RSC network has tripled in size, there were previously 100 virology and 500 practices overall, we now have 322 and 1,724 respectively. The Oxford RCGP Clinical Informatics Digital Hub (ORCHID) secure networks enable the daily analysis of the extended network, currently 1,076 practices are uploaded. We are implementing a central swab distribution system to patients self-swabbing at home, in addition to in-practice sampling. We have migrated to use the systematised nomenclature of medicine clinical terms (SNOMED CT). Throughout spring and summer the network has continued to collect specimens in preparedness for the winter, or any second wave of COVID-19 cases. We have collected 5,404 swabs and detected 623 cases of COVID-19 through extended virological sampling and 19,341 samples collected for serology. This shows our preparedness for the winter season.

Conclusions:

The COVID-19 has been associated with a groundswell of general practices joining our network. It has also created a permissive environment in which we have developed the capacity and capability of the national primary care surveillance systems and our unique public health institute, Royal College and University collaboration.