Public Health England - Field Epidemiology Services - EPIET
Tel. + 44 20 7811 7251
Fax + 44 20 7811 7757
We cover London and the South East of England; a population of approximately 17 million; about 30% of the population of England. Our area includes the metropolis of London, one of the largest, most densely populated and ethnically diverse cities in Europe. The South East covers a wide geographical area (19 000km), and is the most populous region in the UK. London and South East England together include both urban and rural parts with extremes of deprivation and affluence, including a highly mobile, multi-ethnic population with many universities, prisons, care homes, hospitals, major UK airports, and commercial sea ports. The variety of the experience means that the team have numerous outbreaks and incidents to investigate and high rates of infectious diseases in some areas. Rates of tuberculosis, sexually transmitted, blood borne and imported infections (eg, malaria and enteric fever) are higher in London than elsewhere in the country.
FES SEaL's main areas of work include:
- Surveillance of all communicable diseases of public health significance:
Analysis of trends, risk assessment, epidemic response, and production of regular electronic and hardcopy reports. We manage a range of regional reporting systems for communicable disease, including laboratory reporting, clinical reporting including the London TB Register, and statutory notification systems.
- Practical and active support in investigation and control of incidents and outbreaks of communicable disease:
The Epidemiology Unit may be involved directly when an incident is particularly serious, large, crosses boundaries or is of national importance. The Unit also provides support to the seven PHE Centre Health Protection Units (HPT) one of which is co-located hospital colleagues and NHS authorities and local authorities in locally led incident investigations.
- Epidemiological applied research and audit:
The Unit has an active programme of applied research and audit into communicable disease problems in London and the South East, and we have also been involved in a number of research projects in association with academic departments and with colleagues at HPA Colindale in north London.
The Unit has four Consultant Epidemiologists, one scientific epidemiologist and two senior epidemiologists including one EPIET alumni. There are 27 team including senior and junior epidemiological scientists, and an information team, each with specific areas of responsibility. There are usually one or two UK public health specialist trainees (SpR/SpT/StR), and others working on secondment to the unit as well as a Fellow from the UK Field Epidemiology Training Programme. There are good working relationships with academia, local regional and national colleagues in PHE, other Field Epidemiology teams and NHS stakeholders.
Main areas of activity in recent years:
- The focus of our work is in areas of particular public health importance, including tuberculosis, healthcare associated infection, antimicrobial resistance, vaccine preventable diseases of childhood, HIV/STIs, and antenatal infection.
- TB surveillance and treatment outcome monitoring is conducted across all 30+ London TB clinics using the web-based London TB Register (LTBR).
- We continue to monitor and audit antenatal testing uptake and infection prevalence rates for hepatitis B, HIV, syphilis.
- Outbreaks of gastrointestinal and other infections continue to provide a major area of work, and we frequently support PHE centre and local authority colleagues, particularly with analytical epidemiology.
As the largest Field Epidemiology team in teh UK, located in a busy metropolitan location, with many public health problems, we are well placed to facilitate Fellows’ exposure to practical management of communicable disease incidents and outbreaks, and to surveillance and policy issues at regional and national level. We do this in liaison with colleagues in the centres, other FES teams and the National Infection Service in Colindale.
The Team regularly provides training placements of three to six months for trainees from the UK Public Health training programme, as well as ad hoc secondments to colleagues who wish to gain experience of regional public health work.
All fellows have opportunities to participate in all activities of the unit, and provide an invaluable contribution to the work of this busy team, while in the process gaining practical field experience. We have close working links with the centres, which enables trainees to be actively involved in investigation of outbreaks and incidents. We supported 54 incidents and outbreaks in 2016. So last year fellows and trainees have worked on major outbreaks such as a London wide measles outbreak, anE. coli O157 outbreak in a nursing home, a pseudomonas outbreak associated with piercing, a national norovirus outbreak associated with a chain of restaurants, a group A streptococcus Emm66 outbreak associated with drug use and many smaller outbreaks requiring analytical studies.
In the period June 2013- June 2016, we supervised projects with 12 public health trainees, four FETP, two EUPHEM, one EPIET, two MSc/BSc projects, one PHD and five work placement trainees. Thus trainees provide a major impetus to the applied research and audit activity of the Team, and research and surveillance projects are agreed, taking into consideration previous experience and interest. Recent trainees have been involved in :evaluation of a national MMR catch up campaign; the Bacillus Cereus outbreak in neonatal units; TB delays to tuberculosis diagnosis; Quantifying the proportion of tuberculosis due to relapse or reinfection, and risk factors for these in London event based-surveillance for the Olympics; time series analysis of attendances at sexual health clinics in the Olympics.
We have good links with several academic institutions, including the London School of Hygiene and Tropical Medicine (LSHTM), Imperial College, University College London, and the Sexual Health Health Protection Research Unit. Members of the Team have several specialist interests for example we include the Field Epidemiology Services lead for TB, sexual heath, influenza, legionella and invasive Group A streptococcus.
Within the Unit, and in conjunction with the other FES units, we organise shared teaching sessions/journal clubs. Fellows have numerous opportunities to teach: weekly team training sessions, monthly scientific presentations that we host for all South East and London HPTs, and also routinely hold outbreak investigation case studies and analytical teaching sessions. In addition we teach on academic courses.
One of the senior epidemiologists will be the overall supervisor for the period of the Fellow’s training. For specific projects and tasks, the appropriate specialist for the area of work will act as trainer; on occasion consultants from Colindale or academic departments contribute to specific training projects.
Number of EPIET/FETP fellows trained at institute: 10 (2004, 2006, 2007, 2009, 2010 (2 fellows), 2011 (one EPIET, one FETP), 2013 (FETP), 2015 (2 FETP)
EPIET Alumni working at institute: one