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Early warning and NHS Direct: a role in community surveillance?
Maureen Baker1, Gillian E Smith, Duncan Cooper
1Royal College of General Practitioners, 14 Princes Gate, Hyde Park, London SW7 1PU, UK.
Journal of Public Health Medicine
|January 30, 2004
Summary
Daily analysis of NHS Direct data can detect early symptoms of illness, including those from biological or chemical threats. This community surveillance system provides an early warning for public health responses.
Area of Science:
- Public Health Surveillance
- Epidemiology
- Emergency Preparedness
Background:
- NHS Direct is a national nurse-led telephone helpline in England and Wales.
- Utilizes caller symptom data for community surveillance.
- Unique in its use of daily electronic data for national surveillance.
Purpose of the Study:
- To assess the potential of NHS Direct data for early detection of disease outbreaks.
- To identify increases in symptoms indicative of deliberate biological or chemical agent releases.
- To evaluate the system's capability for national-scale community surveillance.
Main Methods:
- Description of the NHS Direct surveillance system and call data from Dec 2001-July 2002.
- Construction of confidence limits for 10 key algorithms.
- Development of control charts for 5 algorithms in urban areas.
Main Results:
- Achieved daily reporting from NHS Direct sites across England and Wales.
- Detected significant activity in specific algorithms nationally and regionally.
- Observed a sustained national increase in fever-related calls in January 2002.
Conclusions:
- Early-stage analysis shows potential for detecting community symptoms related to deliberate releases or outbreaks.
- NHS Direct surveillance can serve as an 'early warning' system.
- Integration with public health response, including diagnostics, is crucial for effective early warning.
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