The main findings from this study reveal that developing a European surveillance system for infectious diseases in HCWs using absence and symptom reports would need to overcome cultural and logistical barriers but would nonetheless probably be feasible if HCWs can be convinced that it has value. Differences in the perception of risk and need for monitoring will challenge any unified system. Economic and structural barriers for HCWs to manage their health, such as loss in income and staffing pressures will undermine the development of concepts for this type of surveillance, as it is based on encouragement and the responsibility of individual staff to report when unwell.