title: Developing a national primary care-based early warning system for health protection--a surveillance tool for the future? Analysis of routinely collected data.
abstract: The increasing threat of infections with pandemic potential such as influenza has focussed attention on the information needed to inform those managing a pandemic. The Health Protection Agency, Nottingham University and EMIS have developed a new national health protection surveillance system using QRESEARCH, an established primary care-derived database, to provide timely and local information on trends in community illness and prescribing. This article describes the first year of the surveillance project. Data on consultations and prescribing were extracted from routinely generated computerized consultation records between November 2004 and December 2005. Weekly consultation and prescribing rates for a range of conditions including influenza-like illness and prescription of anti-viral drugs for influenza and vomiting were developed as 'key indicators'. These indicators were presented in a weekly bulletin showing data to strategic health authority level for use by those working in public health. The particular value of this scheme is the ability to produce timely data on illness to local level and to link prescribing to morbidity. The data were used 'real time' to reassure about lack of illness following the Buncefield Fuel Depot incident. This scheme is being further developed to provide daily local influenza-related information needed in an influenza pandemic.
authors.affiliation: Health Protection Agency West Midlands, 9th Floor Ladywood House, Birmingham B2 4DY, UK. gillian.smith@hpa.org.uk
authors.forename: Gillian
authors.initials: G
authors.lastname: Smith
authors.forename: Julia
authors.initials: J
authors.lastname: Hippisley-Cox
authors.forename: Sally
authors.initials: S
authors.lastname: Harcourt
authors.forename: Mike
authors.initials: M
authors.lastname: Heaps
authors.forename: Mike
authors.initials: M
authors.lastname: Painter
authors.forename: Alex
authors.initials: A
authors.lastname: Porter
authors.forename: Mike
authors.initials: M
authors.lastname: Pringle
mesh_terms: D000555:Ambulatory Care Information Systems; D016208:Databases, Factual; D004196:Disease Outbreaks / Q000517:prevention & control*; D004739:England / Q000453:epidemiology; D005194:Family Practice / Q000706:statistics & numerical data*; D006801:Humans; D007251:Influenza, Human / Q000453:epidemiology* / Q000517:prevention & control; D016347:Medical Records Systems, Computerized; D008501:Medical Records, Problem-Oriented; D009313:National Health Programs / Q000458:organization & administration*; D010865:Pilot Projects; D011320:Primary Health Care / Q000706:statistics & numerical data*; D040442:Public Health Informatics; D018571:Sentinel Surveillance; D017062:Small-Area Analysis; D014852:Wales / Q000453:epidemiology