Corporate report

UKHSA Advisory Board: Chief Executive's Report

Updated 9 May 2024

Date: 8 May 2024

Sponsor: Jenny Harries

1. Purpose of the paper

The purpose of the paper is to provide a forward look of current organisational priorities and a brief overview of the recent operational and response status of the UK Health Security Agency (UKHSA) since the last Advisory Board.

2. Recommendations

The Advisory Board is asked to note the update.

3. Overview

I noted last month that financial year 2024 to 2025 will be the first year of UKHSA’s existence that, apart from the Covid Vaccine Unit, no clear distinction is made between COVID-19 and other preparedness and response provision, as (non-vaccine) COVID-19 work will no longer be separately funded in UKHSA’s budget. This transition has now been successfully implemented.

This has meant a significant focus and pressure on budgets across all areas of the organisation as we approached year end. We have now concluded our most recent round of business planning and have received a budget of £395million. It will continue to be an organisational priority in coming months to develop further operational delivery plans, to ensure we are using the budget effectively and efficiently in full alignment to key strategic goals.

This is occurring at a time of challenge and uncertainty, with the majority of seasonal infectious diseases (e.g., seasonal influenza, RSV, norovirus, group A strep) now starting to return towards the high end of pre-pandemic averages.

At the same time, we continue to see a resurgence in reported levels of many endemic diseases, such as measles, pertussis, and mycoplasma. The resurgence in cases coincides in many instances with a decline in vaccination uptake, particularly in vulnerable populations and groups. By example reports published in March show that pertussis case numbers across England continue to increase in the first three months of 2024 rising from 556 cases in January, 918 in February and 1319 cases in March. Vaccine uptake for Pertussis fell from 75% in December 2017 to 59% in December 2023.

As cases continue to grow it reinforces the criticality of the work undertaken by multiple teams in the agency to combat the spread of emerging infectious diseases and I expect this work will continue to be a priority over the coming year.

As part of this proactive health protection work, we have also been working closely with partners at the Animal and Plant Health Agency, Department for Food, Environment and Rural Affairs, the Food Standards Agency, the FluMap consortium and the Worldwide Influenza Centre at the Francis Crick Institute to monitor the risk posed to Public Health, prepare, and respond to the recent cases of H5N1 that were detected in US dairy cattle on 1 April 2024.

4. Key activities over the last 2 months

During a busy February and March, I contributed evidence to three separate public Committee hearings:

•        The Health and Science Select Committee which focused on the lessons learned from COVID-19;

•        The Science Innovation and Technology Committee which focused on emerging diseases and learnings from COVID and;

•        The Public Accounts Committee which focused on UKHSA’s accounts for the last financial year.

In my last update I provided details of the national childhood immunisation communications campaign that was rolled out in the first week of March. This vaccination campaign, built with significant input from the Department of Health and Social Care (DHSC) Marketing, Liverpool City Council, NHS England, NHS Northwest, and NHS Greater Manchester, was designed to cover all vaccine preventable childhood disease, including measles but was expanded to also provide targeted focus on increasing uptake of the maternal vaccination for Pertussis (whooping cough).

NHS England data shows that the campaign has been effective, with more than 360,000 MMR jabs were administered in the 12 weeks to 24 March 2024. The largest increases were seen in the North-west, London and the West Midlands.

Communications colleagues have also been working closely with NHSE colleagues who on 1 April announced the commencement of the spring Covid-19 vaccination campaign. Following Joint Committee on Vaccination and Immunisation recommendations, this year’s spring campaign focuses on protecting those in the UK population most vulnerable to serious negative outcomes from infection including residents in a care home for adults, those 75 years of age and over and those six months and over who have a weakened immune system.

I provided an update last month on work underway to close down legacy elements of the COVID testing infrastructure as part of the transition towards a new national pathogen agnostic approach to pandemic preparedness.

•        Testing Operations close down: As noted at the previous meeting, the Testing Operations team formally closed on 31st March 2024. This aligned with an ending of routine asymptomatic discharge testing of patients from NHS to Adult Social Care and hospice settings, which came into effect from 1st April 2024. I would like to formally thank all those who have worked in the Testing Operations team throughout the pandemic, and in particular those who have managed the closure over the past few months. Many of the teams involved will remain within UKHSA supporting wider pandemic response work.

•        Rosalind Franklin Laboratory: Following a decision reached on the 22nd March, the UKHSA executed an early agreement that enabled an exit from government liabilities under the Rosalind Franklin Laboratory (RFL) lease. A 3-month licence period was agreed with the landlord to enable us to remove UKHSA owned equipment that may be useful for wider pandemic preparedness purposes.

April also saw the launch of our organisational commercial strategy. Our strategy looks ahead to new opportunities, new challenges and the new capabilities and sets out how we will develop to meet the needs of a unique organisation charged with a hugely important mission. It sets out how our procurement, business development collaborations, operational and supply chain expertise, and strategic management of relationships with industry will help to deliver more equal health outcomes, contribute to growth in the UK’s world-leading life sciences and help tackle climate change.

I have also visited the republic of Korea to further develop the professional relationship that was cemented when we signed a memorandum of understanding with the Korean Disease and Control Agency in May 2022 and follows an earlier visit by UKHSA Chief Scientific Officer. I would like to take this opportunity to thank all who participated in the planning and organisation of this highly successful visit, which has established opportunities to further develop strategic partnerships between our two agencies. Further conversations between the two agencies have continued during May.

5. Strategic forward look

The Public Bodies Review is nearing finalisation with the evidence gathering period now complete, a final report is expected to be published in June. UKHSA teams are developing an internal comms plan and a separate implementation plan to make sure recommendations from the report are appropriately addressed.

Work also continues at pace on the COVID-19 public inquiry launched on 12 May 2021. Public hearings have now commenced on module 2c (examining core decision making in Northern Ireland during the pandemic). There are a further 4 active modules requiring contribution to rule 9 responses from various teams across the organisation, with several key deadlines in May to submit responses for module 4 and 5 respectively. Whilst this work remains critical it does increase pressure on teams who are contributing at an already extremely busy time, I wanted to recognise the significant work being undertaken by teams on this matter and to thank them for their efforts. 

I will be attending the Public Accounts Committee hearing again on 13 May, where the committee will focus on findings from the National Audit Office report into the management of the Science Hub Programme. I will be accompanied by colleagues from DHSC (Shona Dunn) and UKHSA (Scott McPherson).

In parallel, UKHSA also continues to develop its own organisational strategic and operational plans for pandemic preparedness whilst also supporting and assuring alignment with the overarching work on a pandemic preparedness strategic framework led by the Department of Health and Social Care. That framework, once compiled, will outline the government’s approach to preparedness and response in a number of differing threat and outbreak scenarios. The strategy is intended to be published in summer 2024.

As with all health protection work, this strategy will be underpinned by our key strategic relationships with international partners that are being driven by various teams across the agency.

To support this work, there are several planned engagements over the coming month including:

•        Supporting the upcoming visit of the Japanese Chief Medical Officer to the UK to conduct the signing ceremony of a Health Protection memorandum of understanding between UKHSA and senior health officials from the Japanese government. This comes at a time of significant public health reform within the Japanese system, including the merger of public health bodies to create a new ‘health security agency’ as well as the launch of new health security initiatives and investments in research and development. A renewed Memorandum of Cooperation between Japan’s Ministry of Health, Labour, and Welfare and UKHSA will offer a framework through which public health collaboration can continue.

•        Hosting the launch of the World Health Organization (WHO) Euro Pan-European Network for Disease Control (NDC). A network of health security networks, The Pan-European NDC’s mission is to bolster the preparedness of the WHO European Region, spanning 53 countries across Europe and Central Asia, by proactively identifying and mitigating potential risks before they escalate into regional or global threats.

•        Contributing to a WHO panel on Collaborative Surveillance in Geneva ahead of the World Health Assembly.

•        Participating in the UK Government led International Conference on antimicrobial resistance led by Dame Sally Davies and hosted by the Royal Society.

Jenny Harries Chief Executive March 2024