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“the continuous analysis, interpretation and
feedback of systematically collected data,
generally using methods distinguished by
their practicality, uniformity and rapidity
rather than by accuracy or completeness”
(Eylenbosch and Noah, 1988).
“NHS South Central – Improving health and alleviating the causes of poor health
for the benefit of patients, the public and taxpayer alike in Oxfordshire,
Buckinghamshire, Berkshire, Hampshire and the Isle of Wight”
“Action-oriented epidemiology”
“NHS South Central – Improving health and alleviating the causes of poor health
for the benefit of patients, the public and taxpayer alike in Oxfordshire,
Buckinghamshire, Berkshire, Hampshire and the Isle of Wight”
Source: BMJ 2003;326:274-276
“NHS South Central – Improving health and alleviating the causes of poor health
for the benefit of patients, the public and taxpayer alike in Oxfordshire,
Buckinghamshire, Berkshire, Hampshire and the Isle of Wight”
• Clinical safety and competence
• Environmental hazards
• Unexpected adverse events (drugs &
devices)
• Outbreaks
• Secular trends
• Impact of population level interventions
“NHS South Central – Improving health and alleviating the causes of poor health
for the benefit of patients, the public and taxpayer alike in Oxfordshire,
Buckinghamshire, Berkshire, Hampshire and the Isle of Wight”
Actual or potential surveillance systems or data sources that could feed surveillance
systems
•
CoSurv – communicable disease reports
•
Spotter GP practices (e.g. RCGP)
•
Large scale GP databases (QResearch and GPRD)
•
Cancer registration
•
Congenital anomaly registers
•
Adverse drug reactions
•
Accident databases (ROSPA HASS/LASS)
•
Occupational health statistics
•
Hospital activity data (especially SUS, A&E data)
•
Mortality statistics
•
NHS Direct
•
Bespoke surveillance systems (e.g. BPSU, UK OSS)
•
Disease registers and device registers (heart valve registers, hip replacement
register, CJD etc. etc.)
“NHS South Central – Improving health and alleviating the causes of poor health
for the benefit of patients, the public and taxpayer alike in Oxfordshire,
Buckinghamshire, Berkshire, Hampshire and the Isle of Wight”
Down Syndrome Cases in England and Wales
Source = National Down Syndrome Cytogenetic Register
“NHS South Central – Improving health and alleviating the causes of poor health
for the benefit of patients, the public and taxpayer alike in Oxfordshire,
Buckinghamshire, Berkshire, Hampshire and the Isle of Wight”
Number of Tayside residents with known diabetes who were identified independently by
each data source used in electronic record linkage
Type of treatment
Source of data
Insulin
Oral
Diet
Encashed prescriptions
1868
2690
583
Hospital diabetes clinics
1715
2050
858
Young adult/paed. clinics
193
0
0
Mobile eye unit
1593
2578
1313
Biochemistry database
1077
1675
896
Hospital discharge diag.
1278
820
465
Total
2228
3419
1949
“NHS South Central – Improving health and alleviating the causes of poor health
for the benefit of patients, the public and taxpayer alike in Oxfordshire,
Buckinghamshire, Berkshire, Hampshire and the Isle of Wight”
• Adequate data collection systems in place
before the hypothesis is generated
• Systematic and sophisticated analysis
• Timely reporting to those who can act
• Clear responsibilities for each step
• Secure resources
“NHS South Central – Improving health and alleviating the causes of poor health
for the benefit of patients, the public and taxpayer alike in Oxfordshire,
Buckinghamshire, Berkshire, Hampshire and the Isle of Wight”
• Statutory requirements
– International Health Regulations
– Water Act 2003
– Others??
“NHS South Central – Improving health and alleviating the causes of poor health
for the benefit of patients, the public and taxpayer alike in Oxfordshire,
Buckinghamshire, Berkshire, Hampshire and the Isle of Wight”
•
•
•
•
•
Infectious diseases
Effects of environment
Occupational health risks
Chronic disease and trauma
International and tropical risks
“NHS South Central – Improving health and alleviating the causes of poor health
for the benefit of patients, the public and taxpayer alike in Oxfordshire,
Buckinghamshire, Berkshire, Hampshire and the Isle of Wight”
Information Centre, Disease Registers,
QResearch, Trusts and Labs etc.
Data collectors / collators
£
Surveillance experts
Sponsors / responsible authorities
HPA, PHOs, Registries,
academic groups, institutes
DH, MHRA, HPA, NICE,
R&D sponsors, PCTs, ONS,
ABPI, Regulators, Third
Sector, Media, Public, etc.
“NHS South Central – Improving health and alleviating the causes of poor health
for the benefit of patients, the public and taxpayer alike in Oxfordshire,
Buckinghamshire, Berkshire, Hampshire and the Isle of Wight”