Primary Care Evaluation of COVID-19 Infection Surveillance in Our Network (PRECISION Study)

Problem

The COVID-19 pandemic has led to significant changes in how healthcare is delivered within UK General Practice, with a significant shift towards more remote (phone/video) consultations to reduce the risk of spreading COVID-19 infection. Clinicians must now weigh up the risk of seeing patients face-to-face and potentially spreading COVID-19 infection, against the risk of not seeing patients and missing important diagnoses.

Access to locally-relevant real-time COVID-19 surveillance reports may help inform decisions, both at a practice and patient-level, about how care is delivered to patients. Practices in England have access to surveillance reports but these are limited by a non-standardised approach to coding, concern from academics of poor coding quality, and the need for practice staff to proactively generate the reports. The perceived usefulness of surveillance reports to primary care professions is an important evidence gap.

This project aims to refine and develop weekly practice-level and CCG-level surveillance reports about COVID-19 and respiratory tract infections, and to explore clinician and practice manager views about their usefulness and potential impact.

Approach

Longitudinal semi-structured interviews with up to 20 clinicians and practice managers from 10 GP practices in the Bristol area. Three phases are planned: (i) development and refinement of reports in partnership OneCare (a GP-led organisation with access to CCG-level and practice level data) and clinicians/practice managers (complete), shared weekly with participating practices from March 2021; (ii) initial interviews (March/April 2021) and (iii) follow-up interviews to detect changes in perceptions over time (May/June 2021). Reports will include CCG-level and practice-level data about COVID-19 (e.g. confirmed cases, hospital admissions, deaths, proportion of patients vaccinated within vaccination categories) and trends in other respiratory tract infections. Interviews will be based on topic guides and grounded by referring to a surveillance report from the interviewee’s practice. Data will be analysed using thematic analysis.

Findings

Reports are currently being refined and finalised for weekly distribution from March 2021. Initial interviews will take place in March and follow-up interviews in May/June 2021.

Consequences

This project will create strong evidence regarding the perceived value of real-time locally relevant COVID-19 surveillance reporting in the primary care community. If the reports are deemed useful, we will quickly provide the DH&SC, NHS England and CCGs nationally with a report showing: (i) how to set up a standardised coding system for COVID-19 infection; and (ii) how practices have used the information, themed with practical, implementable examples. The project will assess the likely value of reporting for future pandemics and seasonal infectious diseases.