1. Promoting Excellence in Family Medicine RCGP Weekly Returns Service data extraction D. M. Fleming Director, Research and Surveillance Centre Nottingham meeting Sept 22 2011

2. Promoting Excellence in Family Medicine RCGP: WRS 1967-2007 Epidemiological information system from primary care describing incidence in real time and incidence accumulated over annual periods Established in 1967 initially based on clerical recording system using age-sex registers and diagnostic indexes Expanded into an electronic recording system between the period of MSGP4 in 1990/91 and1997. Recording captured all read coded morbidity entries with the attached episode type Until 2007 all data were processed on the basis of weekly tabular summaries from each practice collected using automated programs

3. Promoting Excellence in Family Medicine RCGP: WRS Since 2007 Tabular summary extraction continues unchanged New extraction routine introduced whereby patient specific longitudinal data are collected A slightly enhanced data set is collected ( includes vaccines selected prescriptions and lab results etc) with all patient links preserved. As new information is entered on the gp record a new extract is taken from the patient EMR covering the relevant entries since 1 Jan 2003. Each extract contains patient specific information but the patient cannot be identified. Each new extract replaces the one held on the existing database. Routine analyses now include selective linked data Database available for longitudinal investigation

4. Promoting Excellence in Family Medicine Problems for Discussion Ethical considerations Linkage to other data sources not possible ( eg by use of NHS number) Volume of data transfer (an additive routine first visualised was not workable) Software differences Practices changing software supplier Complexity of analytical routines