COVID-19: Next steps in primary care surveillance

coronavirus and girl wearing mask

13 March 2020

Professor Simon de Lusignan, Director, RCGP Research and Surveillance Centre 

Since the outbreak of COVID-19 in Wuhan, China, RCGP Research and Surveillance Centre (RSC) has been commissioned by Public Health England (PHE) to incorporate the monitoring of COVID-19 into its virology surveillance scheme. The College is also working with other national bodies to closely monitor and plan to deal with any potential outcome that may develop in the UK. A vital part of that work will be to monitor the number of suspected COVID-19 cases in the community in a timely way.

What does this involve?

Ideally all general practices will contribute to surveillance of COVID-19. This largely involves coding confirmed cases, suspected cases, and recording as “excluded” those who have negative tests.

Most, if not all, this data will be collected over the phone or from medical records, and not involve direct patient contact.

Practices should manage suspected cases according to PHE guidance. Generally this involves signposting to NHS 111.

How? – coding guidance

In early February, new terms were added to all general practice computerised medical record (CMR) systems so that data relevant to COVID-19 can be recorded. Practices are asked to use these to code in the practice’s CMR system:  

  • Confirmed cases where there is hard evidence of infection, for example, a positive test or discharge summary
  • Exposure to another case with COVID-19
  • Suspected cases perhaps where a patient has travelled to an area of high risk
  • Patients referred for COVID-19 testing
  • Record where COVID-19 has been excluded, for example, negative test results. 

The new terms available are listed in the table below – their names were set before 2019-nCoV (Wuhan) was renamed COVID-19.

Category

Code

Definite case

Confirmed 2019-nCoV (Wuhan) infection 

Possible case

Exposure to 2019-nCoV (Wuhan) infection                

Suspected 2019-nCoV (Wuhan) infection                  

Tested for 2019-nCoV (Wuhan) infection            

Not a case

Excluded 2019-nCoV (Wuhan) infection

 Who needs to know about this?

It is vital that all staff involved in triaging patients and all who are involved in entering data into computerised medical record systems are informed of this and that they are encouraged to code accurately. (Click here and scroll down to view coding prompt cards for staff)

Tracking COVID-19

RCGP RSC now has an observatory to track COVID-19, which can be assessed on online.

Is coding really that important?

Yes! Many GPs and primary care teams may not realise that important relevant data can be easily coded. Coded information is far easier to extract and to process than free text and it is coded information which will feed into the RCGP RSC observatory (see below). There is the potential during any pandemic to monitor the effectiveness of measures designed to control transmission.

How to get involved?

The RCGP RSC offers many research opportunities and benefits with tangible impact on the health of the public, for example, it was the RSC network that spotted the swine flu pandemic in 2009.

Member practices can be involved in research projects, which include funding for practice time. We offer 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 MedicalDirectorRSC@rcgp.org.uk.

If you would like further information please email us at: practiceenquiries@phc.ox.ac.uk.

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