Public health directors’ plea for 111 data to track coronavirus

NHSE has been collecting postcode data on the suspected spread of the virus based on callers who ring NHS111 to report covid-19 symptoms. But so far this crucial information has not been shared with councils, leading to growing frustration among local public health leaders.

Dominic Harrison, public health director for Blackburn with Darwen Borough Council, told LGC the deaths and confirmed cases data councils are basing their planning on is two to three weeks behind the infection.

This is because it can take several days for an infected person to pass on the virus, then five and a half days on average for someone to show symptoms, followed by perhaps 10 days before a person is admitted to hospital and coronavirus confirmed.

“At the moment the [local] modelling is difficult because the data inputs are poor. One thing that would help is sharing the postcode data that NHS 111 is now collecting,” he said.

While the NHS 111 data was based on symptoms rather than confirmed test results, it would give an overall map of where the virus seemed to be spreading. This information would be “enormously helpful” to councils, Professor Harrison said.

‘Critical bit of the jigsaw’

A key role for directors of public health is to gather data to inform local planning for a surge. Knowing that five out of 10 people on a given street had rung up NHS 111 with symptoms would help services to direct local resources.

This data could also be used as a powerful tool for encouraging people on that street to practice social distancing measures, he said: “NHS 111 has that data but is unable to publish or share it with local authority directors of public health. It would give us insight into what is happening and be enormously helpful in modelling the pandemic.

“That is the critical bit of the jigsaw — data.”

Jeanelle de Gruchy, Association of Directors of Public Health president, criticised the lack of data sharing by NHSE and government departments.

“Many senior public sector leaders recognise the incredible, expert, hard work being done by our members, and know that we’re a key ‘go to’ local expert and leader. Unfortunately, this hasn’t always been the case,” she wrote in a recent blog post. 

“What has upset some of our members the most, despite leading so much of this work, is being left time and time again off key communications or guidance development by NHS England and some government departments. It’s not good enough — and it slows down our response at a time when we can least afford it.”

Lessons from swine flu 

The concern about data sharing has emerged as the relationship between directors of public health and the Department of Health and Social Care appears to have become strained.

One director of public health, who wished to remain anonymous, told LGC previous crises like the 2009 swine flu pandemic had highlighted the need for close cooperation between local and national government.

While some departments, such as the Ministry of Housing and Local Government, had taken this on board, others were operating in a silo, the source said: “MHCLG has learnt the lessons of the past and is sharing data really well. But [DHSC] has disappeared into its own little world. There’s not much dialogue between the Department of Health and local areas.”

LGC has contacted both NHSE and DHSC for comment.