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Emergency Department Syndromic Surveillance System:
England
22 April 2020
In This Issue:
Key messages.
Diagnostic indicators at a glance.
Weekly report statistics.
Total attendances.
Respiratory.
Gastrointestinal.
Cardiac.
Notes and caveats.
Acknowledgements.
Data to: 19 April 2020Key messages
During week 16 the number of ED attendances for acute respiratory infections and pneumonia decreased (figures 5 & 8), although attendances remained highest in the 65+ years age group (figures 5a & 8a). Please note: respiratory attendances (including acute respiratory infections) have been retrospectively updated for mid-March to mid-April 2020 to account for new clinical coding in use in EDs (figures 1, 2 and 2a).
Diagnostic indicators at a glance: Further details on the syndromic indicators reported can be found on page 9.
EDSSS weekly report statistics
Only Type 1 EDs meeting the weekly reporting criteria are included (see page 6 for details).
*max EDs included across full time period reported in charts, individual days may include fewer EDs.
Indicator Current trend Level
Respiratory decreasing below
Acute Respiratory Infection decreasing similar
Bronchiolitis no trend below
Influenza-like Illness no trend similar
Pneumonia decreasing below
Asthma decreasing below
Gastrointestinal increasing below
Gastroenteritis no trend below
Cardiac increasing below
Myocardial Ischaemia increasing below
Number %
13/04/2020 7,014 5,355 76.3% 60
14/04/2020 7,611 5,708 75.0% 60
15/04/2020 7,412 5,722 77.2% 60
16/04/2020 7,526 5,766 76.6% 60
17/04/2020 7,551 5,723 75.8% 60
18/04/2020 7,315 5,448 74.5% 60
19/04/2020 7,309 5,468 74.8% 60
Total 51,738 39,190 75.7% (max)* 60
Diagnoses CodedDate
Total
Attendances
Type 1 EDs
Included
Year: 2020 Week: 16
0%
5%
10%
15%
20%
25%
30%
35%
40%
45%
50%
21/04/19 19/05/19 16/06/19 14/07/19 11/08/19 08/09/19 06/10/19 03/11/19 01/12/19 29/12/19 26/01/20 23/02/20 22/03/20 19/04/20
% a
tten
da
nce
s
<1yr 1-4yrs 5-14yrs 15-44yrs 45-64yrs >=65yrs
0
1,000
2,000
3,000
4,000
5,000
6,000
7,000
21/04/19 19/05/19 16/06/19 14/07/19 11/08/19 08/09/19 06/10/19 03/11/19 01/12/19 29/12/19 26/01/20 23/02/20 22/03/20 19/04/20
No
. a
tten
da
nce
s
<1yr 1-4yrs 5-14yrs 15-44yrs 45-64yrs >=65yrs
EDSSS
22 April 2020.
Page 2.
1: Total attendances.
Daily number of total attendances recorded, across the EDSSS network.
The entry of new ED(s) is marked by a vertical red line (see page 6 for inclusion criteria).
2: Daily attendances by age: Numbers.
Daily number of total attendances, by age group, recorded across the EDSSS network.
3: Daily attendances by age: Percentages
Daily percentage of total attendances by age group, recorded across the EDSSS network.
0
2,000
4,000
6,000
8,000
10,000
12,000
14,000
16,000
18,000
21/04/19 19/05/19 16/06/19 14/07/19 11/08/19 08/09/19 06/10/19 03/11/19 01/12/19 29/12/19 26/01/20 23/02/20 22/03/20 19/04/20
No
. at
ten
dac
ne
s
Weekend Bank holiday Entry of new ED(s) Total Attended 7 day moving average
Year: 2020 Week: 16
0
50
100
150
200
250
300
350
400
450
21/04/19 19/05/19 16/06/19 14/07/19 11/08/19 08/09/19 06/10/19 03/11/19 01/12/19 29/12/19 26/01/20 23/02/20 22/03/20 19/04/20
Nu
mb
er o
f a
tten
da
nce
s
<1yr 1-4yrs 5-14yrs 15-44yrs 45-64yrs >=65yrs
0
200
400
600
800
1,000
1,200
1,400
1,600
1,800
21/04/19 19/05/19 16/06/19 14/07/19 11/08/19 08/09/19 06/10/19 03/11/19 01/12/19 29/12/19 26/01/20 23/02/20 22/03/20 19/04/20
Nu
mb
er
of
atte
nd
acn
es
Weekend Bank holiday ACUTERESPIRATORYINFECTION 7 day moving average baseline
0
500
1,000
1,500
2,000
2,500
21/04/19 19/05/19 16/06/19 14/07/19 11/08/19 08/09/19 06/10/19 03/11/19 01/12/19 29/12/19 26/01/20 23/02/20 22/03/20 19/04/20
Nu
mb
er
of
atte
nd
ance
s
Weekend Bank holiday RESPIRATORY 7 day moving average baseline
Page 3.
EDSSS
22 April 2020.
4: Respiratory.
Daily number of attendances recorded as respiratory attendances across the EDSSS network.
5: Acute Respiratory Infection.
Daily percentage of all attendances recorded as acute respiratory infection attendances across the EDSSS network.
5a: Acute Respiratory Infection by age group.
7 day moving average of ARI attendances within each age group.
Year: 2020 Week: 16
0
10
20
30
40
50
60
70
80
90
100
21/04/19 19/05/19 16/06/19 14/07/19 11/08/19 08/09/19 06/10/19 03/11/19 01/12/19 29/12/19 26/01/20 23/02/20 22/03/20 19/04/20
Nu
mb
er
of
atte
nd
ance
s
Weekend Bank holiday INFLUENZALIKEILLNESS 7 day moving average baseline
0
20
40
60
80
100
120
140
160
21/04/19 19/05/19 16/06/19 14/07/19 11/08/19 08/09/19 06/10/19 03/11/19 01/12/19 29/12/19 26/01/20 23/02/20 22/03/20 19/04/20
Nu
mb
er o
f a
tten
da
nce
s
<1yr 1-4yrs 5-14yrs 15-44yrs 45-64yrs >=65yrs
0
50
100
150
200
250
21/04/19 19/05/19 16/06/19 14/07/19 11/08/19 08/09/19 06/10/19 03/11/19 01/12/19 29/12/19 26/01/20 23/02/20 22/03/20 19/04/20
Nu
mb
er
of
atte
nd
acn
es
Weekend Bank holiday BRONCHIOLITIS 7 day moving average baseline
EDSSS
22 April 2020.
Page 4.
6: Bronchiolitis/ bronchitis.
Daily number of attendances recorded as bronchiolitis/ acute bronchitis attendances across the EDSSS network.
6a: Bronchiolitis/ bronchitis by age group
7 day moving average of bronchiolitis/ bronchitis attendances within each age group.
7: Influenza-like Illness.
Daily number of attendances recorded as influenza-like illness attendances across the EDSSS network.
Year: 2020 Week: 16
0
10
20
30
40
50
60
70
80
90
100
21/04/19 19/05/19 16/06/19 14/07/19 11/08/19 08/09/19 06/10/19 03/11/19 01/12/19 29/12/19 26/01/20 23/02/20 22/03/20 19/04/20
Nu
mb
er o
f a
tten
da
nce
s
<1yr 1-4yrs 5-14yrs 15-44yrs 45-64yrs >=65yrs
0
20
40
60
80
100
120
140
160
180
21/04/19 19/05/19 16/06/19 14/07/19 11/08/19 08/09/19 06/10/19 03/11/19 01/12/19 29/12/19 26/01/20 23/02/20 22/03/20 19/04/20
Nu
mb
er
of
atte
nd
acn
es
Weekend Bank holiday PNEUMONIA 7 day moving average baseline
0
5
10
15
20
25
30
35
21/04/19 19/05/19 16/06/19 14/07/19 11/08/19 08/09/19 06/10/19 03/11/19 01/12/19 29/12/19 26/01/20 23/02/20 22/03/20 19/04/20
Nu
mb
er o
f a
tten
da
nce
s
<1yr 1-4yrs 5-14yrs 15-44yrs 45-64yrs >=65yrs
7a: Influenza-like illness by age group
7 day moving average of ILI attendances within each age group.
EDSSS
22 April 2020.
Page 5.
8: Pneumonia.
Daily number of attendances recorded as pneumonia attendances across the EDSSS network.
8a: Pneumonia by age group.
7 day moving average of pneumonia attendances within each age group.
Year: 2020 Week: 16
0
10
20
30
40
50
60
70
21/04/19 19/05/19 16/06/19 14/07/19 11/08/19 08/09/19 06/10/19 03/11/19 01/12/19 29/12/19 26/01/20 23/02/20 22/03/20 19/04/20
Nu
mb
er o
f a
tten
da
nce
s
<1yr 1-4yrs 5-14yrs 15-44yrs 45-64yrs >=65yrs
0
20
40
60
80
100
120
140
160
21/04/19 19/05/19 16/06/19 14/07/19 11/08/19 08/09/19 06/10/19 03/11/19 01/12/19 29/12/19 26/01/20 23/02/20 22/03/20 19/04/20
Nu
mb
er
of
atte
nd
ance
s
Weekend Bank holiday ASTHMA 7 day moving average baseline
EDSSS
22 April 2020.
Page 6.
9: Asthma.
Daily number of attendances recorded as asthma/wheeze/ difficulty breathing attendances across the EDSSS network.
9a: Asthma by age group.
7 day moving average of asthma attendances within each age group.
Intentionally left blank
Year: 2020 Week: 16
0
10
20
30
40
50
60
21/04/19 19/05/19 16/06/19 14/07/19 11/08/19 08/09/19 06/10/19 03/11/19 01/12/19 29/12/19 26/01/20 23/02/20 22/03/20 19/04/20
Nu
mb
er o
f a
tten
da
nce
s
<1yr 1-4yrs 5-14yrs 15-44yrs 45-64yrs >=65yrs
0
50
100
150
200
250
21/04/19 19/05/19 16/06/19 14/07/19 11/08/19 08/09/19 06/10/19 03/11/19 01/12/19 29/12/19 26/01/20 23/02/20 22/03/20 19/04/20
Nu
mb
er
of
atte
nd
ance
s
Weekend Bank holiday GASTROENTERITIS 7 day moving average baseline
0
100
200
300
400
500
600
700
800
21/04/19 19/05/19 16/06/19 14/07/19 11/08/19 08/09/19 06/10/19 03/11/19 01/12/19 29/12/19 26/01/20 23/02/20 22/03/20 19/04/20
Nu
mb
er
of
atte
nd
ance
s
Weekend Bank holiday GASTROINTESTINAL 7 day moving average baseline
EDSSS
22 April 2020.
Page 7.
10: Gastrointestinal.
Daily number of attendances recorded as gastrointestinal attendances across the EDSSS network.
11: Gastroenteritis
Daily number of attendances recorded as gastroenteritis attendances across the EDSSS network.
11a: Gastroenteritis by age group.
7 day moving average of gastroenteritis attendances within each age group.
Year: 2020 Week: 16
0
50
100
150
200
250
300
21/04/19 19/05/19 16/06/19 14/07/19 11/08/19 08/09/19 06/10/19 03/11/19 01/12/19 29/12/19 26/01/20 23/02/20 22/03/20 19/04/20
Nu
mb
er
of
atte
nd
acn
es
Weekend Bank holiday MYOCARDIALISCHAEMIA 7 day moving average baseline
0
100
200
300
400
500
600
21/04/19 19/05/19 16/06/19 14/07/19 11/08/19 08/09/19 06/10/19 03/11/19 01/12/19 29/12/19 26/01/20 23/02/20 22/03/20 19/04/20
Nu
mb
er
of
atte
nd
acn
es
Weekend Bank holiday CARDIAC 7 day moving average baseline
EDSSS
22 April 2020.
Page 8.
12: Cardiac.
Daily number of attendances recorded as cardiac attendances across the EDSSS network.
13: Myocardial Ischaemia.
Daily number of attendances recorded as myocardial ischaemia attendances across the EDSSS network.
Year: 2020 Week: 16
EDSSS
22 April 2020.
Page 9.
Notes and caveats: ► National EDSSS began operating in April 2018
► Following the introduction of the Emergency Care Data Set (ECDS) the national reporting of secondary care activity data through the commissioning data sets mechanism from EDs to NHS Digital became a daily feed:
https://www.england.nhs.uk/ourwork/tsd/ec-data-set/
► EDSSS receives an automated daily transfer of anonymised ED data from NHS Digital
► The number of EDs reporting through ECDS continues to increase
► Not all EDs currently provide data through ECDS on a daily basis
► EDs are eligible for inclusion in this report only where the EDSSS reporting criteria have been met during the surveillance week reported:
Data relates to attendances at a type 1 ED Data for 7 of the 7 most recent days was received by PHE Data for those days was received within 2 calendar days of the patient arrival
► Where an ED meets these criteria, all data received from that ED previous to the current surveillance week is included.
► EDs eligible for inclusion is likely to change each week, which will in turn affect the historical data inclusion
► Individual EDs will not be identified in syndromic surveillance reporting in these bulletins
► All EDs report diagnoses to EDSSS using SnomedCT codes. Where Snomed codes are not used the ED is excluded from indicator analysis
► The syndromic indicators presented in this bulletin are based on the SnomedCT diagnosis codes reported by EDs:
Respiratory: All respiratory diseases and conditions (infectious and non infectious).
Acute Respiratory Infections (ARI): All acute infectious respiratory diseases.
Asthma: As indicated by title.
Bronchiolitis/ bronchitis: As indicated by title (excluding ‘chronic’).
Influenza-like Illness (ILI): As indicated by title.
Pneumonia: As indicated by title.
Gastrointestinal: All gastrointestinal diseases and conditions (infectious and non infectious).
Gastroenteritis: All infectious gastrointestinal diseases.
Cardiac: All cardiac conditions.
Myocardial Ischaemia: All ischaemic heart disease.
► Baselines represent seasonally expected levels of activity and are constructed from historical data since July 2010. They take into account the change from sentinel EDSSS to National EDSSS and current coverage. Gastroenteritis, diarrhoea and vomiting baselines also account for changes since the introduction of rotavirus vaccine in July 2013. Baselines are refreshed using the latest data on a regular basis.
► Sentinel EDSSS 2010 to March 2018, collected data through a bespoke, voluntary network of EDs across England and Northern Ireland
► Sentinel EDSSS reports be found in bulletins up to and including week 13 2018: https://www.gov.uk/government/collections/syndromic-surveillance-systems-and-analyses
Acknowledgements: We are grateful to the clinicians in each ED and other staff within each Trust for their continued involvement in the EDSSS.
We thank the Royal College of Emergency Medicine, NHS Digital and NHS England for their support in the development of national EDSSS, using anonymised data collection from ECDS.
Emergency Department Syndromic Surveillance System Bulletin.
Produced by: PHE Real-time Syndromic Surveillance Team 1
st Floor, 5 St Philips Place, Birmingham, B3 2PW
Tel: 0344 225 3560 > Option 4 > Option 2 Email: [email protected]
Web: https://www.gov.uk/government/collections/syndromic-surveillance-systems-and-analyses
Year: 2020 Week: 16