Effective surveillance is key to understanding and managing the impact of healthcare associated infections. In England, data is collected locally for specific organisms subject to mandatory surveillance, then submitted to a central database (HCAI-DCS). This takes considerable time from infection prevention and control staff. Whilst huge amounts of routine electronic data is collected on patients locally, automated processes for submitting, linking and using this data for surveillance, and associated epidemiology, are rare. However, implementing central surveillance systems raises several challenges which will be discussed.