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Journal of Public Health Advance Access originally published online on December 7, 2006
Journal of Public Health 2007 29(1):75-82; doi:10.1093/pubmed/fdl078
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© The Author 2006, Published by Oxford University Press on behalf of Faculty of Public Health. All rights reserved.

Developing a national primary care-based early warning system for health protection—a surveillance tool for the future? Analysis of routinely collected data



Gillian Smith, Regional Epidemiologist1

Julia Hippisley-Cox, Professor of Clinical Epidemiology and General Practice2

Sally Harcourt, Health Protection Scientist - Primary Care Surveillance1

Mike Heaps, Project Manager/Systems Analyst2

Mike Painter, Public Health Physician3

Alex Porter, SQL Programmer/Analyst QRESEARCH2

Mike Pringle, Professor of General Practice2
1 Health Protection Agency West Midlands, 9th Floor Ladywood House, Birmingham B2 4DY, UK
2 Centre for Population Sciences, 13th Floor Tower Building, University Park, Nottingham NG7 2RD, UK
3 Health Protection Agency Centre for Infections, 61 Colindale Avenue, London, NW9 5EQ, UK

Address correspondence to Gillian E. Smith, E-mail: gillian.smith{at}hpa.org.uk

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.

Keywords: health protection, primary care


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