2.0 2.5 3.0
200
0.0 0.5 1.0 1.5
150 100 50 0 30 34 38 42 46 50 2 ISO week n H1N1 n H1N2 n H3 n OtherA n B n RSV n COVID-19
Fig 1. Example of a report generated from RSC data, showing RSV, influenza and SARS-CoV-2 virology swab surveillance (by strain).
symptomatic patients, each offered by representative subsets of practices. While the focus of the RSC is influenza and other acute respiratory infections, it contributes to focused reports. These have included assessing shingles vaccine effectiveness; and following a cluster of diphtheria cases the RSC’s serosurveillance demonstrated that community immunity remains adequate. The RSC’s Weekly Return reports the weekly incidence of 37 monitored conditions (see Fig 1). These data provide valuable information that support national health policy decisions and public health priorities.
Every year, approximately 300 RSC practices volunteer to take part in virology and serology sampling. Between October 2020 and October 2021, the network collected over 8,000 virology swabs and 24,000 serology samples which were tested at UKHSA reference laboratories in Colindale and Manchester. Blood samples are used to formally measure vaccine effectiveness and provide information about background levels of population immunity to infectious diseases. Virology swabs help the RSC to identify which viruses are circulating. Of particular interest are influenza, respiratory syncytial virus (RSV), and SARS-CoV-2. In the past, sampling took place during the winter season. However, since 2020, this has
continued all-year round. This information is critical for National Health Service (NHS) planning and provides the World Health Organization (WHO) key data for bi-annual global vaccine strain selection meetings.
The RSC detected the first UK case of COVID-19 not associated with foreign travel, and rapidly reported COVID- 19’s epidemiology and associated mortality. Early in the pandemic, our
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VIROLOGY SURVEILLANCE Jul24 Aug24 Sep24 Oct24 Nov24 Dec24 Jan25 Feb25 Apr25 Jul24 May25 Jun25
serosurveillance demonstrated the population was largely unexposed to SARS-CoV-2 and required vaccination. Research was shared at the highest policy levels, including with the Joint Committee on Vaccination and Immunisation (JCVI). It is this programme that resulted in the sample being collected that resulted in the first detection of the H1N2 strain of influenza in a human in the UK.
Surveillance sampling The mechanism used to gather the surveillance samples has been through the provision of sampling kits directly to the participating practices (see Fig 2). The GP is required to complete a paper form capturing the participating patient’s details and to then package the sample, the completed form and the protective packing into a pre-paid container for posting to the performing laboratory. This process is not only time consuming for the GPs but also requires a workflow that does not align with the routine requesting / resulting workflow that they are now used to. In addition, the completed request needs to be manually entered into the performing laboratory’s own information system. The RCGP RSC is now introducing a workflow that it is calling ‘LabLinks’ to improve the process. Historically the only laboratories the network has been involved in have been the performing laboratories. This has resulted in a point-to-point relationship between the GP practice and the laboratory. A critical part of the workflow – in addition to the creation of the request – is the return of a result to the originating GP. Although this is not viewed as a diagnostic result it still has clinical value to the GP. The current mechanism
for the return of results to the referring GP is either via a results portal that requires the GP to connect to, or via a paper result. The mechanism within LabLinks is to transmit a result in the same format as the existing routine results a GP receives. This has the added benefit of recording the result within the patient record.
Fig 2. Sample kit provide by RSC.
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Dr Shahbaz Ali, Managing Partner at Woodstock Bower Group Practice, Rotherham, explains how participation in the RSC scheme benefits his practice: “Engaging with the RSC Virology initiative equips our GP surgery with
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Number of positive swabs
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