COVID-19: Adaptive clinical trials, extended public health surveillance, and updated coding guidelines

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17 April 2020

The RCGP Research and Surveillance Centre (RSC), in collaboration with Public Health England (PHE), has been monitoring the number of suspected COVID-19 cases in the community. The RCGP RSC is also running the PRINCIPLE study to determine the efficacy of hydroxychloroquine to treat COVID-19 amongst high risk patients in primary care.

The RSC is working with over 900 GP practices, with over 400 practices signing up in the last few weeks. This capacity will need to be further extended in the coming months to support the need for more COVID-19 testing and to power the research trial.

We encourage all GP practices to sign up to the RSC network to monitor COVID-19 and to partake in the PRINCIPLE study. To register your interest please email:

The PRINCIPLE Trial: Hydroxychloroquine to treat COVID-19 among high risk patients in primary care

The RCGP RSC is calling on more practices to provide suspected COVID-19 cases to power the PRINCIPLE study. While RSC’s network of practices continues to be instrumental in delivering the key national hydroxychloroquine trial, the study needs to test more patients to deliver its findings.

We need 3000 COVID-19 suspected cases for the study. Lockdown is reducing community spread, with new COVID-19 cases dropping by a third. This means we need three times the number of practices to provide the suspected cases need for the study to deliver its findings as quickly as possible.

The study has been running for three weeks, with practice involvement continuing to grow. The trial has been designed to be adaptable and evaluate potential treatments as they are identified. Recruiting as many suspected cases as possible will help in the trial’s adaptability.

We encourage all GP practices, whether an existing RSC surveillance practice or a practice wishing to contribute to this important study, to sign up.

If your practice is interested in in taking part in this important study, please email:

 For more information visit:

PRINCIPLE trial - The study is run by the RCGP RSC, led by the Oxford Primary Care Clinical Trials Unit. For a week by week breakdown please look at the COVID-19 observatory 

Extended virology surveillance: COVID-19 self-swabbing now available

The RCGP RSC and Public Health England (PHE) are working with Saving Lives, a charity distributing self-tests, to provide self-test kits to practices.

In these practices, patients with influenza-like illness (ILI) and lower respiratory tract infection (LRTI) symptoms can have a swab posted to their home for self-testing. This is convenient for patients and reduces the risk of infection for practice staff. Patients send their swabs directly to PHE labs for testing, and patients and practices are advised of the outcome. This essential work is helping to efficiently identify patients with COVID-19 and monitor the spread of the disease. The surveillance will also help in monitoring patients recovering from COVID-19, tracking the long-term changes in their immunological response.

Respiratory disease incidence

Respiratory disease incidence is falling rapidly with the country under lockdown. The RSC’s weekly report showed last week’s respiratory disease levels down to about a third compared to usual; by Friday (reporting up to Wednesday) they had dropped even lower. A key extract from Friday’s interim special pandemic special issue report is below.

Want to join the RCGP RSC in COVID-19 surveillance?

Since the outbreak of COVID-19, the RCGP Research and Surveillance Centre has extended its collaboration of more than 50 years with Public Health England to incorporate COVID-19 into its surveillance. A vital part of this work will be to monitor the number of suspected COVID-19 cases in the community in a timely way.

Being a member of the RCGP RSC give practices an opportunity to collaborate across primary care to create an observatory of testing and confirmed cases in the network of 4 million patients. The COVID-19 observatory provides a near real-time update on the cases across the network and the activity within primary care nationally and locally.

In addition to taking part in the current pandemic surveillance, member practices can be involved in research projects, which include funding for practice time. The RCGP RSC offers learning and development opportunities, such as eligibility for RCGP Research Ready accreditation and quality improvement using our practice dashboards

To become part of a bottom-up professionally led network of like-minded practices, please download and complete our data request form [Word] and send it to If you would like further information, please email:



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