QSurveillance Practice Information Sheet
Purpose of document
This document invites EMIS LV practices to join the QSurveillance scheme which is a near real time surveillance scheme which will collects, analyses and reports on rates infectious diseases and vaccine uptake (MMR, flu vaccine and pneumococcal vaccine).
QSurveillance has the capability of providing timely data in the face of emerging public health problems (eg flu epidemic or gastroenteritis which could result from widespread flooding).It was used to provide critical information during the recent swine flu pandemic in 2009. QSurveillance can also respond to chemical incidents, concerns about safety of medication or report in extreme weather conditions (eg during a heat wave) to help estimate the scale of the problem and plan a response.
What data is extracted and analysed?
QSurveillance only extracts summary data which is aggregated by age and sex (ie counts of patients who have the conditions of interest in a given time period). No individual patient data is extracted. There is no risk to patient confidentiality. The reports are run at midnight each night and extracted onto a central server at EMIS and from there to a secure server based in Nottingham University.
QSurveillance summary data has also been designed so that it can rapidly assess the safety and effectiveness of new medications (for example, a newly developed flu vaccine developed rapidly during a pandemic or where there is an unexpected public health issue).
How are decisions about additional data be taken and implemented?
Professor Julia Hippisley-Cox acts as the clinical custodian of QSurveillance responsible to the practices, profession and thepublic for use and disposition of QSurveillance data. In the event of an unexpected urgent public health situation requiring increased surveillance, we will discuss the additional data items with the relevant government authority. For example, for infectious disease or chemical incidents, this will be the Health Protection Agency. For medication safety it will be the Department of Health or Medicine Health Regulatory Authority. Representatives of the University of Nottingham, BMA, EMIS and the National EMIS User Group will be consulted and Trent MREC where appropriate. The additional indicators will be added to the table on the website which lists all the current indicators. The patch system will be used to notify practices of the reason for the extraction (for example, the floods in the South West) and the additional data items needed. Practices can opt out at any point without giving a reason.
All analyses will be independently undertaken, scientifically reviewed where appropriate and publically available in accordance with our research governance framework.
Is there any risk to practice or patient confidentiality?
No patient level data or identifiable data is extracted and there is no risk to patient confidentiality. As an additional safeguard, we suppress counts where there are fewer than 5 patients in a age/sex cell.
No practices can or will be identified in published reports since only summary data are reported and the identify of practices contributing data to QSurveillance is not released to the Health Protection Agency. Reports at PCT level are only produced where there are at least 3 practices contributing data to the QSurveillance database.
We analyse and report on other data for infectious diseases at PCT level and summary reports will be sent to the Health Protection Agency for inclusion in their weekly or daily bulletins. http://www.hpa.org.uk/infections/topics_az/primary_care_surveillance/QResearch.htm
How is QSurveillance funded?
QSurveillance receives funding from the Health Protection Agency (HPA) in respect of the weekly and daily bulletin service.
Do practices receive any payments for taking part in QSurveillance?
Practices are not paid for taking part and do not need to pay to join. The data are not used to determine practice payments or measure performance.
What do I need to do to take part in QSurveillance?
If your practice is not taking part QSurveillance then you need to activate the system by doing the following:
Selecting ST and I (Information upload services).
The following menu will appear. Not all services are on all sites.
Highlight Q-Surveillance daily report” and select “A” to activate. The status will change to “Active”
By Selecting “V” to view details it will tell more information about the report and selecting “V” to view transmissions will tell you what reports have been run and sent.
If you decide at any stage that you no longer wish to take part in QSurveillance, then you can simply deactivate your system without having to give any reason. This will take immediate effect.
Who is running QSurveillance and who is the clinical custodian?
QSurveillance is run as a collaboration between the University of Nottingham, EMIS and ClinRisk (medical software company)..Professor Julia Hippisley-Cox (Professor of General Practice at the University of Nottingham and medical director of ClinRisk) is the clinical custodian of the summary data. The scheme is supported by the EMIS National User Group.
If you are a practice contributing to QSurveillance, or would like to contribute, and have any questions then please contact julia.hippisley-cox@nottingham.ac.uk
What indicators are included in QSurveillance?
The indicators which are currently included in QSurveillance are as follows and will evolve in response to developing needs for public health surveillance. This list will be revised accordingly.
Count of the number of patients registered with the practice by age and sex |
influenza and influenza like illness |
influenza plus antivirals |
Pneumonia +/- antibiotics |
At risk of flu +/- flu vaccination |
Flu vaccination
|
Total emergency hospital admission |
Total GP and nurse consultations |
Deaths |
Deaths from flu |
Wheeze or breathlessness |
Lower respiratory tract infection |
Upper respiratory tract infection |
Severe asthma |
Pneumococcal vaccine |
Myocardial infarction |
Chickenpox |
Conjunctivitis |
Allergic rhinitis |
Herpes zoster |
Pharyngitis/scarlet fever +/- antibiotics |
Cellulitis +/- antibiotics |
Vomiting |
Mumps |
Gastroenteritis |
diarrhoea +/- oral rehydration |
Impetigo |
Measles |
Rubella |
Pertussis |
heat stroke |
Measles MMR |