Integration of disease surveillance in the English context: a qualitative study

Abstract

ObjectivesThe world is experiencing increasing threats from infectious diseases and environmental hazards. Integration of disease surveillance systems has been put forth as one way to ensure more timely analysis of data and response. This study sought to explore the current context and state of integration of disease surveillance in England, including the barriers and facilitators to integration, as well as opportunities for improvement. Study designQualitative study with focus groups and key informant interviews. MethodsFocus group discussions (FGDs) and key informant interviews (KIIs) were conducted with key national, regional, and local stakeholders involved in surveillance activities in August and September 2022. These discussions and interviews were recorded, transcribed, and coded using a within-case content and thematic analysis. ResultsIn total, five FGDs and 10 KIIs were conducted with 27 participants. Participants had different views on what integration is, though mostly agreed that surveillance systems in England are not integrated. Lack of standardisation, governance and oversight, and structural and financial barriers were hindering the current system from being more integrated. The additional benefits of integration above and beyond the ‘status quo’ during response activities were questioned by some. ConclusionEngland does not have a single integrated disease surveillance system but has a range of disease-specific surveillance systems that have evolved largely independently to meet operational needs. Greater integration may be desired and to a certain extent is important, but it is essential that it is understood as a means to an end and the overall purpose of surveillance is kept in mind.