Feasibility of Point-of-Care testing for influenza within a national primary care sentinel surveillance network in England: protocol for a mixed methods study

Background: Point-of-care testing (POCT) for influenza promises to provide real-time information to influence clinical decisionmaking and improve patient outcomes. Public Health England has published a toolkit to assist implementation of these tests inthe UK National Health Service.Objective: A feasibility study will be undertaken to assess the implementation of influenza POCT in primary care as part of asentinel surveillance network.Methods: we will conduct a mixed methods study to compare the sampling rates in practices using POCT and current virologyswabbing practices not using POCT, and to understand the issues and barriers to implementation of influenza POCT in primarycare workflows. The study will take place between March and May 2019. It will be nested in general practices that are part ofthe English national sentinel surveillance network run by the Royal College of General Practitioners Research and SurveillanceCentre. The primary outcome is the number of valid influenza swabs taken and tested by the practices involved in the study usingthe new POCT.Results: a total of 6 practices were recruited, and data collection commenced on March 11, 2019. Moreover, 312 swab sampleshad been collected at the time of submission of the protocol, which was 32.5% (312/960) of the expected sample size. In addition,68 samples were positive for influenza, which was 20.1% (68/338) of the expected sample size.Conclusions: to the best of our knowledge, this is the first time an evaluation study has been undertaken on POCT for influenzain general practice in the United Kingdom. This proposed study promises to shed light on the feasibility of implementation ofPOCT in primary care and on the views of practitioners about the use of influenza POCT in primary care, including its impacton primary care workflow