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Potential added value of the new emergency care dataset to ED-based public health surveillance in England: an initial concept analysis
  1. Roger Morbey1,
  2. Helen Hughes1,
  3. Gillian Smith1,
  4. Kirsty Challen2,
  5. Thomas C Hughes3,
  6. Alex J Elliot1
  1. 1 Real-time Syndromic Surveillance, Public Health England, Birmingham, UK
  2. 2 Lancashire Teaching Hospitals NHS Foundation Trust, Chorley, Lancashire, UK
  3. 3 John Radcliffe Hospital, Oxford, Oxfordshire, UK
  1. Correspondence to Roger Morbey, Real-time Syndromic Surveillance, Public Health England, Birmingham B3 2PW, UK; roger.morbey{at}


Introduction For the London Olympic and Paralympic Games in 2012, a sentinel ED syndromic surveillance system was established to enhance public health surveillance by obtaining data from a selected network of EDs, focusing on London. In 2017, a new national standard Emergency Care Dataset was introduced, which enabled Public Health England (PHE) to initiate the expansion of their sentinel system to national coverage. Prior to this initiative, we estimated the added value, and potential additional resource use, of an expansion of the sentinel surveillance system.

Methods The detection capabilities of the sentinel and national systems were compared using the aberration detection methods currently used by PHE. Different scenarios were used to measure the impact on health at a local, subnational and national level, including improvements to sensitivity and timeliness, along with changes in specificity.

Results The biggest added value was found to be for detecting local impacts, with an increase in sensitivity of over 80%. There were also improvements found at a national level with outbreaks being detected earlier and smaller impacts being detectable. However, the increased number of local sites will also increase the number of false alarms likely to be generated.

Conclusion We have quantified the added value of national ED syndromic surveillance systems, showing how they will enable detection of more localised events. Furthermore, national systems add value in enabling timelier public health interventions. Finally, we have highlighted areas where extra resource may be required to manage improvements in detection coverage.

  • emergency department
  • epidemiology
  • infectious diseases

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  • Contributors RM conceived the study and analysed the data. AJE and GS advised on the public health implications of the research. HH provided advice on the functioning of the sentinel and national Emergency Department Syndromic Surveillance System, including coverage estimates and the implementation of ECDS. KC, TCH and GES advised on the choice of scenarios used for the analysis. KC and TCH also advised on the implementation of the Emergency Care Data Set and the impact on emergency departments. RAM drafted the manuscript and all authors provided critical revision and final approval for submission.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Disclaimer The views expressed are those of the author(s) and not necessarily those of the NHS, the NIHR, the Department of Health or Public Health England.

  • Competing interests TCH was employed by the Department of Health/Royal College of Emergency Medicine during the conduct of the study to develop/implement the Emergency Care Data Set.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Patient consent for publication Not required.