Integrated surveillance networks: the development of a new paradigm for health protection surveillance in the UK

Abstract

The creation of the new Health Protection Agency in England and Wales has brought both the challenge and the opportunity for broadening current surveillance systems to incorporate the full range of agents likely to cause harm to human health. The new surveillance system must be capable of measuring, recording and reporting the effects of infectious disease, chemical, and radiological hazards on human health. The pathways resulting in adverse human health are complex and infection control efforts are often hampered as a result. We describe an approach to health protection surveillance that draws on models of hazard/exposure/ outcome and the use of Hazard Analysis Critical Control Points to identify points at which the application of surveillance and intervention would have the maximum impact on final health outcome. This approach facilitates the identification of key surveillance partnerships and proposes the integration of existing surveillance networks. Illustrations of the application of this approach to common problems of infection control are given in the regional surveillance of Legionnaires' disease and Campylobacter in north-west England. We propose that the principles of this approach should be adopted in England and Wales to ensure that the new health protection function achieves its goals.