1. The PHE Field Epidemiology Service Dr Paul Crook Consultant Epidemiologist Field Epidemiology Services, Victoria Serving Kent, Surrey & Sussex, London, Thames Valley and Wessex PHE Centres

2. Organisational structure -Part of Health Protection Directorate of PHE -Staff of 27 -Regional epidemiologists -Scientists -Information officers/ managers -Admin team -Trainees - Public health / European Epi (EPIET) / UK Field Epi (FETP) 2Field Epidemiology Services, Victoria

3. Overview of role Both ACUTE and STRATEGIC -Intelligence -Field investigations and response -Surveillance -Rapid research and development -Epidemiology training 3Field Epidemiology Services, Victoria

4. Acute work – field investigation 4Field Epidemiology Services, Victoria

5. 5 Acute work – field investigation

6. Intelligence Multiple sources of PHE data -Some collected locally -e.g. HPZone, laboratory data, London TB register, antenatal hepatitis B -Some collected centrally by National Centre for Infectious Disease Surveillance (NCIDS) -e.g. GUMCAD (STI data), unlinked anonymous surveys Use other sources of information e.g. ONS 6Field Epidemiology Services, Victoria

7. Laboratory surveillance Responsible for laboratory surveillance (Cosurv) and antimicrobial surveillance (Amsurv) 7Field Epidemiology Services, Victoria CoSurv Region DB LabBase 2 (National database) HPZone data files Patient Demographics LabBase data file PDS MDP DB CoSurv data file Mandatory data file Laboratory (Labmod) HPUs

8. What do we do with the information? -Identify and respond to outbreaks -Outputs / ad hoc data requests to inform -Assessment of need -Service design and improvement -Priorities and policy -Whole range of stakeholders -Commissioners / Clinicians / EHOs -PHE Centre / HPTs / Local authorities / CCGs / NHS England / third sector -Public - media 8Field Epidemiology Services, Victoria

9. Outbreak detection - exceedances 9Field Epidemiology Services, Victoria

10. Cryptosporidiosis cluster maps Research undertaken with TVHPU (In submission) Enhanced surveillance on all cases Modelling to identify clusters Modelling increased sensitivity

11. Incident communication 11Field Epidemiology Services, Victoria

12. Sexual health 12Field Epidemiology Services, Victoria

13. 13Field Epidemiology Services, Victoria Prevalence of diagnosed HIV in London residents (15-59 yrs) by MSOA, 2011

14. 14Field Epidemiology Services, Victoria

15. 15Field Epidemiology Services, Victoria

16. Research into gonorrhoea Access Under 20s and South Asian tend to seek care more locally whereas MSM tend seek care further away Long opening hours and weekend opening times of GUM clinics seem to attract people out of their area Risk factors Black Caribbean women have 5 times risk of gonorrhoea than White women: Black Caribbean men have 2.6 times risk. Even controlling for deprivation 16Field Epidemiology Services, Victoria Le Polain de Waroux O, Hughes G, Maguire H, Crook P. Factors associated with travel to non-local genitourinary medicine clinics for sexual health care: an analysis of patients diagnosed with gonorrhoea in London, 2009-10: Int J of STD and AIDS Jul 19 2013 Le Polain de Waroux O, Ross H, Hughes G, Crook PD. Spatial clustering of gonorrhoea in London and its association with socio-demographic risk factors: A Bayesian spatial modelling approach. Epidemiol Infect. 2013 Apr 8:1-10

17. TB 17Field Epidemiology Services, Victoria

18. BBV 18Field Epidemiology Services, Victoria

19. VPD -Outputs -Evaluation 19Field Epidemiology Services, Victoria

20. GI 20Field Epidemiology Services, Victoria

21. HCAI 21Field Epidemiology Services, Victoria

22. Future -Refining outputs (more consistent nationally) -More efficient / automated systems -Working closer with other PHE Directorates (Chief Knowledge Officer) -E.g. pulling together SH data 22Field Epidemiology Services, Victoria

23. How you can help us -Feedback! 23Field Epidemiology Services, Victoria