Meridian Awards 2012

Background

The Department of Health advised healthcare professionals across the country on pandemic swine flu preparations including the prioritisation of patients, services and treatments.

Primary Care Trusts nationally were required to ensure there were ready accessibility to antiviral drugs in the event of a major outbreak.

The four Primary Care Trusts in the Avon region – Bristol, North Somerset, South Gloucestershire, and Bath and North East Somerset – have a joint emergency planning team to address the challenges of swine flu including the management of antiviral stock levels.

Among the team are public health directors, medical managers, resource planners and service commissioners. They meet regularly at a dedicated co-ordination centre in Bristol.

Challenge

One of the team’s key priorities is to identify sufficient collection points so that large numbers of people can access antiviral drugs quickly if required.

Under Department of Health guidance, each collection point should be able to provide to around 10,000 patients.

The local plan was developed with vital GIS support from Avon IM&T Consortium (AIMTC), a shared information management and technology service. It provides analytical support for healthcare across the Avon area whenever there is a joint or wider strategic need that the primary care trusts cannot manage individually.

The emergency planning team called for consortium help early because of a specific need to use GIS for pandemic swine flu preparations.

Solution

One of the first things the planning team had to do was identify the precise locations of collection points that could issue antiviral drugs if and when that was necessary given a change in the state of alert.

The emergency planning team had used local knowledge to produce a database of community pharmacies where drugs may be collected. We then used MapInfo Professional and the RouteFinder add-on module to analyse drive times to those locations. The local target is to ensure that a collection point is accessible to everyone in our 1.1 million population within a 20-minute drive time.

We took the geographic spread of collection points and performed travel time analysis using the NAVTEQ road network dataset. Drive time isochrones were generated using local road speed parameters in conjunction with the RouteFinder software.

With the RouteFinder software we were able to generate isochrones (drive zones) to identify how accessible the distribution points were from the road network. That allowed us to see where the gaps in the travel time target were.

We then took those existing community pharmacies identified as potential Antiviral Collection Points (ACPs) and calculated the population numbers they were serving. The population breakdown was based on UK Census Output Areas geographies but updated to show latest population figures extracted from the General Practice patient registration database.

The process involved creating voronoi polygons which enable an equal distribution of areas around the points, and we then calculated the population numbers that each of the sites would be providing for and then considered these results to determine any changes in ACP sites that were necessary.

It was a complex piece of analysis covering around 500 sq miles. We also looked at other factors concerning vulnerable groups, for example identifying pupil numbers at local schools.

As a direct result of the GIS analysis, the emergency planning team agreed the need and locations of several more centres to bolster capacity in the Avon region. Overall capability was increased to include community pharmacies, hospitals and other NHS sites.

Our work has influenced resource planning to ensure there is no gap in service across the four Primary Care Trust organisations. It has helped to make the case for more distribution points. This is a prime example of the strength of GIS. Without it, we would have had to put an Ordnance Survey map on the wall and stick pins in it and basically decide what to do by feeling our way. GIS analysis gave us a major advantage for this planning.

Note: AIMTC GIS suppliers are; CDR Group (software and training), Higher Mapping Solutions (RouteFinder) and Dotted Eyes (datasets through the NHS Digital Mapping Agreement).