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Elliot, Alex J., Hughes, Helen E., Harcourt, Sally E., Smith, Sue, Loveridge, Paul, Morbey, Roger A., Bains, Amardeep, Edeghere, Obaghe, Jones, Natalia R. 
ORCID: https://orcid.org/0000-0003-4025-2985, Todkill, Daniel and Smith, Gillian E.
(2024)
From fax to secure file transfer protocol: The 25-year evolution of real-time syndromic surveillance in England.
Journal of Medical Internet Research, 26.
ISSN 1439-4456
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Abstract
The purpose of syndromic surveillance is to provide early warning of public health incidents, real-time situational awareness during incidents and emergencies, and reassurance of the lack of impact on the population, particularly during mass gatherings. The United Kingdom Health Security Agency (UKHSA) currently coordinates a real-time syndromic surveillance service that encompasses 6 national syndromic surveillance systems reporting on daily health care usage across England. Each working day, UKHSA analyzes syndromic data from over 200,000 daily patient encounters with the National Health Service, monitoring over 140 unique syndromic indicators, risk assessing over 50 daily statistical exceedances, and taking and recommending public health action on these daily. This English syndromic surveillance service had its origins as a small exploratory pilot in a single region of England in 1999 involving a new pilot telehealth service, initially reporting only on “cold or flu” calls. This pilot showed the value of syndromic surveillance in England, providing advanced warning of the start of seasonal influenza activity over existing laboratory-based surveillance systems. Since this initial pilot, a program of real-time syndromic surveillance has evolved from the single-system, -region, -indicator pilot (using manual data transfer methods) to an all-hazard, multisystem, automated national service. The suite of systems now monitors a wide range of syndromes, from acute respiratory illness to diarrhea to cardiac conditions, and is widely used in routine public health surveillance and for monitoring seasonal respiratory disease and incidents such as the COVID-19 pandemic. Here, we describe the 25-year evolution of the English syndromic surveillance system, focusing on the expansion and improvements in data sources and data management, the technological and digital enablers, and novel methods of data analytics and visualization.
| Item Type: | Article |
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| Additional Information: | Funding Information: We thank the current syndromic data providers, that are NHS 111 and National Health Service (NHS) England; out-of-hours providers submitting data to the general practitioner out-of-hours system; emergency department clinicians and NHS Trusts and NHS England supporting Emergency Department Syndromic Surveillance System; and participating The Phoenix Partnership and the Oxford-Royal College of General Practitioner Clinical Informatics Digital Hub practices supporting general practitioner in-hours, ambulance trusts, and the Association of the Ambulance Chief Executives. We also thank the wider United Kingdom Health Security Agency (UKHSA) Real-Time Syndromic Surveillance Team for their technical expertise in delivering the daily syndromic service. We acknowledge Maureen Baker, Brian McCloskey, Sue Ibbotson, Rod Griffiths, Mary O\u2019Mahony, and Duncan Cooper for historical support of the English national syndromic surveillance service and their contribution to a wider piece of work documenting the history of syndromic surveillance in England. AJE, RAM, NRJ, and GES are affiliated with the National Institute for Health and Care Research Health Protection Research Unit (NIHR HPRU) in Emergency Preparedness and Response at King\u2019s College London in partnership with UKHSA. AJE, GES, and HEH are affiliated with the NIHR HPRU in Gastrointestinal Infections at the University of Liverpool in partnership with UKHSA. The views expressed in this article are those of the authors and not necessarily those of the NIHR, UKHSA, or the Department of Health and Social Care. Publisher Copyright: ©Alex J Elliot, Helen E Hughes, Sally E Harcourt, Sue Smith, Paul Loveridge, Roger A Morbey, Amardeep Bains, Obaghe Edeghere, Natalia R Jones, Daniel Todkill, Gillian E Smith. |
| Uncontrolled Keywords: | bioterrorism,epidemiology,mass gathering,pandemics,population surveillance,public health surveillance,sentinel surveillance,health informatics ,/dk/atira/pure/subjectarea/asjc/2700/2718 |
| Faculty \ School: | Faculty of Science > School of Environmental Sciences |
| Related URLs: | |
| Depositing User: | LivePure Connector |
| Date Deposited: | 16 Jan 2025 01:10 |
| Last Modified: | 18 Jan 2025 01:08 |
| URI: | https://ueaeprints.uea.ac.uk/id/eprint/98230 |
| DOI: | 10.2196/58704 |
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