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Public health surveillance allows for the identification and monitoring of trends in human health. Syndromic surveillance is a relatively recent addition to these activities, offering the potential to monitor trends on a (near) real-time basis and is often more timely than may be possible through other, traditional, surveillance routes. Emergency department (ED) syndromic surveillance systems have been developed and successfully operated worldwide. The Public Health England Emergency Department Syndromic Surveillance System (EDSSS) was developed in preparation for the London 2012 Olympic and Paralympic Games and remains as a public health legacy of the Games. This thesis aimed to describe and provide evidence of how emergency department syndromic surveillance (as performed by EDSSS) provides additional benefit to public health surveillance and added value to emergency care services in England. Additionally the potential for further development and future improvements to public health surveillance is described. The EDSSS is shown here to have been successfully used to describe the impact of the rotavirus vaccine, indicating that EDSSS has the potential to be used for future rapid, stand alone, investigation of impact of vaccines in England. In the first cross-national study of its kind, the EDSSS (alongside OSCOUR, its counterpart in France) was successfully used to describe the changes in human health indicators during periods of poor air quality. In addition to reporting on both infectious and non-infectious disease, emergency department syndromic surveillance also successfully described the impacts of human behaviour on ED attendances. During the EURO 2016 football tournament ED attendances were found to differ from the expected during match periods, not only in France the host country, but also in the UK home nations where fans followed team progress from home. The EDSSS is also the first example of a syndromic surveillance system having input into the development of a standardised national dataset, which has been mandated across EDs in England. Primarily aimed to improve patient care and the wider workings of EDs, this improved data collection has resulted in improvements in the EDSSS itself, which was subsequently expanded from a small sentinel to truly national surveillance system. The standardisation of ED data collection and reporting, alongside improved geographical coverage and near real-time surveillance reporting, enabled rapid feedback on the impact of the COVID-19 pandemic on ED attendances in England. EDSSS described general trends in ED attendances, encompassing both infectious and non-infectious indicators, prompting the refinement of public health messaging, encouraging continued use of emergency care as required by the general public. The evidence presented in this thesis has demonstrated where the ED syndromic surveillance has added value for public health surveillance in England, utilising the system flexibility and timeliness of reporting. Successful collaborative working has provided the potential for future cross-system learning for further system development, as well as the ability to work at local, national and potentially international scales.

With data indicating around 126,720 refugees and 45,244 pending asylum cases in the UK, inclusion of refugee and asylum-seeking children in UK schools is highly important. The Asylum and Immigration Act 1999 has meant refugees and asylum-seekers have been dispersed around the country into the care of local authorities, some with little prior experience supporting their inclusion into communities and schools. Seeking the perspective of educational professionals, a qualitative synthesis of four research articles was undertaken using a meta-study method. The review of the literature, presented in Chapter one, revealed three key themes related to inclusion: how inclusion is conceptualised, how others are valued, and how the needs of children are conceptualised. The review concludes with a reflective framework built on the premise that conceptualisation of inclusion influences the practice of inclusion. Arising from the systematic literature review, Chapter three presents the five stage process of an Appreciative Inquiry in which a group of eight professionals from a local authority and two primary schools in the North East of England considered: their previous and current successes in inclusive practice, and their dreams and wishes for the future. Analysed using abbreviated realist grounded theory, findings revealed several factors related to supporting the structural and relational inclusion of refugee and asylum-seeking children in schools: being human, proactive working together/sharing, professional qualities which empower and enable others, and access and opportunities. Chapter one and three are linked by a bridging document outlining the philosophical and methodological stance underpinning the thesis. The hoped contribution of the thesis is to add to the understanding of factors and conditions that support the inclusion of refugee and asylum-seeking children in UK schools, and to emphasise the implications for policy. Chapters one and three are written for considered for publication in The Journal of Refugee Studies.

This thesis considers the ways that different types of advice operate within an employee’s network, and the choices that employees make about who to approach for advice, and when to do so. In elucidating these behavioural triggers, this thesis highlights how over time, advice behaviours and the networks in which they are embedded become crafted, contributing to the design and the development of a job. The research uses a mixed methods approach in order to build an explanatory case study of the advice networks within a population of engineers employed by a multi-national manufacturing organization. The case study is built through a four-stage methodology (context building interviews, a network questionnaire, follow-up interviews, and a follow-up questionnaire), which utilises both qualitative and quantitative techniques. Some hypotheses are deductively tested, but equally, there is much of inductive interest in the quantitative measurement of the network, which is considered in its own right. Thematic analyses also yield valuable insights. These emergent findings are integrated in order to present this single, explanatory case study. The theoretical implications of this are considered. This includes the presentation of a model for conceptualising social job design, and within this, a model of the advice seeking process. Together, these insights are consolidated to suggest some directions for future research in this domain.