Using PRIMIS+ to improve public health

Greenwich 2005

Julie Richardson, PRIMIS facilitator, has been helping practices in Greenwich PCT to use PRIMIS 'flu query sets to identify which patients are most at risk from influenza ('flu) and would benefit most from immunisation.

Practices have traditionally targeted patients who are over 65 years old for 'flu vaccination. This is an at risk group that is easily identifiable. However, Julie used the 'flu query sets developed by PRIMIS to raise the profile of at risk patients who are under 65 years old and to increase the uptake of immunisation among this group. This includes patients who have poor immunity or who suffer from conditions such as diabetes, chronic respiratory diseases, chronic renal disease, heart disease or chronic liver disease. These patients are more likely to suffer from complications as a result of contracting the 'flu virus. The Health Protection Agency recommended the use of PRIMIS 'flu query sets in order to make a national assessment of the effectiveness of immunisation campaigns for all at risk patients.

The PRIMIS 'flu query sets enable practices to identify patients of all ages who are at risk from 'flu and take a pro-active approach to planning a vaccination campaign. In addition, it is a simpler method for practices to use; it allows uniform reporting across practices and provides robust data for future planning which can be used at practice, PCT, regional and national levels.

In Greenwich PCT this proactive approach was timed so that practices could prepare the vaccination campaign before the 'flu season. At risk patients were identified in September 2004, a sufficient quantity of vaccine was ordered and vaccinations were offered to this group from October 2004 onwards. This approach was intended to maximise the impact of immunisation.

In addition to boosting the uptake of 'flu vaccination among all at risk patients, Julie found several other benefits in using the PRIMIS 'flu query sets. It improved the integrity of practice disease registers and gave an indication of each practice's capacity to run queries and return data. It highlighted the link between 'flu and other types of morbidity – and therefore the link between 'flu and consultation rates. The PCT received uniform, comparable data from all practices, providing a baseline for targeted planning to reduce the impact of 'flu in the future. In addition, patients benefited from the use of data to support preventative cohort care.

* Julie is still at Greenwich Teaching PCT, as Head of GP Support and Delivery.