Corporate report

UKHSA Advisory Board: Minutes of 13 March 2024

Updated 9 May 2024

Date: 13 March 2024

Present at the meeting were:

• Ian Peters – Chair of UKHSA Advisory Board
• Simon Blagden – Associate non-executive member
• Dame Jennifer Dixon – Non-executive member
• Jon Friedland – Non-executive member
• Graham Hart - Non-executive member
• Susan Hopkins – Chief Medical Advisor
• Mark Lloyd – Non-executive member
• Sir Gordon Messenger – Non-executive member
• Scott McPherson – Director General, Strategy, Policy & Programmes
• Isabel Oliver – Director General, Science and Research
• Cindy Rampersaud – Non-executive member
• Andrew Sanderson – Chief Financial Officer
• Thom Waite – Deputy Chief Medical Officer (England)

Observers at the meeting were:

• Lee Bailey – Director of Communications
• Oliver Munn – Director General, Health Protection Operations
• Steven Riley – Director General, Data, Analytics and Surveillance
• Clara Swinson – Director General, Global Public Health (Senior Departmental Sponsor)
• Jac Gardner – Chief People Officer

In attendance at the meeting were:

• Sam Organ – Director Data Operations
• Deborah Williamson - Director Microbiology and Labs
• 5 attendees had their name and title redacted

Apologies were received from:

• Sir Frank Atherton – Chief Medical Officer (Wales)
• Marie Gabriel – Associate non-executive member
• Dame Jenny Harries – Chief Executive
• Sir Michael McBride – Chief Medical Officer Northern (Ireland)
• Raj Long – Associate non-executive member
• Sir Gregor Smith – Chief Medical Officer (Scotland)
• Sir Chris Whitty – Chief Medical Officer (England)

1. Announcements, apologies, and declarations of interest

24/027 The Chair welcomed participants to the meeting and noted apologies. There were no additional declarations of interest.

24/028 The Advisory Board expressed their thanks and appreciation to Ed Wynne-Evans, his team and the Governance team for hosting the meeting at Chilton and providing a tour programme for Board members.

24/029 The Chair noted that it had been a busy period for UKHSA since the January meeting including the progress of the Public Bodies Review and the Chief Executive’s appearance at the Public Accounts Committee and select committees.

2. Minutes of the previous meeting and matters arising

24/030 The Advisory Board agreed the minutes of the meeting held on 13 January 2024 (enclosure AB/24/011) as an accurate record.

24/031 The Advisory Board noted the list of actions from the previous meeting (enclosure AB/24/012).

3. Chief Executive’s Update

24/032 The Chief Executive had provided apologies as she was appearing in front of the Public Accounts Committee that afternoon. In her absence, the Director General, Strategy, Policy and Programmes presented the Chief Executive’s update (enclosure AB/24/013).

24/033 The main areas of activity included:

• the National Audit Office (NAO) report on the Harlow programme had been published at the end of February.  This had highlighted the areas of delay, specifically in respect to decision making. UKHSA had updated ministers on options for modernising UKHSA’s scientific estate;
• advice had been provided to ministers recommended the ending of asymptomatic discharge testing of patients from NHS to adult social care and hospice settings. This was an important moment showing the move to managing COVID-19 in line with other respiratory pathogens and UKHSA focusing on multi-pathogen preparedness;
• public inquiry work was expected to increase in the coming year with multiple module responses planned in parallel;
• UKHSA had worked with health system partners to launch a national immunisation catchup campaign for children and adults;
• the Executive Committee remained committed to systematically tracking and implementing recommendations arising from internal audits;
• Oliver Munn would be leaving UKHSA on 31 March as his fixed term appointment concluded. He was thanked for his contributions to UKHSA including the modernisation of Health Protection Operations.

24/034 There was interest in the strength of UKHSA’s relationships with Directors of Public Health (DsPH). UKHSA teams continued to work closely with DsPH in their region on a weekly basis and the wider organisation level on a monthly basis for formal issues. UKHSA had maintained strong links from predecessor organisations to enable planning and reactive responses with DsPH.

24/035 Discussion followed on the communication of UKHSA activity. There was positive engagement on proactive communication (e.g. MMR vaccination campaign), although informal stakeholder feedback encouraged stronger reporting on pandemic preparedness from UKHSA. It was recognised that more could be done on showcasing UKHSA’s efforts to prevent and stay ahead of emerging threats. Timing and choice of case studies was an important aspect in communications to balance the resources of campaigns with return on engagement.  A paper on Communications Strategy was due at the July Board.

24/036 Work was underway to analyse the impact of UKHSA’s activities from a health perspective and broader economic impact. The Chair, Director General, Strategy, Policy and Programmes, and the Director General, Data, Analytics and Surveillance would discuss the appropriate forum to update the Advisory Board on outputs of this work. (Action: Ian Peters / Scott McPherson / Steven Riley)

4. Financial Report

24/037 The Advisory Board noted the financial update to end of January 2024 (enclosure AB/24/014). Forecasts continued to be optimistic for the final quarter of FY2023/24 with delivery being closely monitored by the Executive Committee. The Covid Vaccine Unit budget could show a larger underspend due to the change in delivery timescales for the national vaccine drawdown plans being accounted for in the following financial year.

24/038 Planning continued for FY2024/25 with a near finalised core budget and continuing conversations on capital budget. Covid funding would cease this financial year with prioritisation choices required on enduring activities to be resourced through core funding.

24/039 Discussion followed on the continued complexity in accounts and loss of personnel from financial roles. This had been discussed in detail at the Audit and Risk Committee. UKHSA had progressed planning for the coming year’s audit with the Department of Health and Social Care and the National Audit Office to ensure appropriate resourcing. It was noted that a surge in resourcing was planned to align with required activity from the Finance Control and Improvement Plan and this would support driving sustainable change of UKHSA’s financial controls. 

5. Core preparedness for environmental hazards

24/040 The Director General, Science and Research introduced the update on activities to support preparedness for environmental hazards (enclosure AB/24/015). The Advisory Board noted the progress with the assessment on other environmental hazards and an increasing focus on health threats from climate change.

24/041 The Head of the Centre for Climate and Health Security was focused on strengthening leadership, coordination and impact in this area. Milestones from the centre included:

• the launch of Adverse Weather and Health Plan with significant engagement from NHS and local authorities. UKHSA issued warnings from data to health system partners; and
• the Health Effects of Climate Change (HECC) Report which synthesised the evidence base of climate impacts on health every 5 years. The report garnered positive attention with a particular interest in threat of vector borne disease.

24/042 UKHSA would focus on developing collaborations for effective interventions identified from the evidence base on health threats from climate change. Internal policy teams had provided valuable support to translate findings into recommendations.

24/043 It was intended to develop interim reviews between the 5-year HECC reports. This would include living documents on the research base and special reports in collaboration with partners. Health Protection Research Units were progressing evaluation work, especially from a behavioural science perspective. The Science and Research Committee would consider the reviews and evaluation work in more detail at a future meeting. (Action Jon Friedland / Isabel Oliver)

24/044 Discussion noted the following areas of risk in relation to health protection from climate change:

• the number of medical experts to support surge responses was limited. This was pertinent for medical entomologists and the increasing risk from vector borne diseases; and
• challenges continued in local authorities planning for increased risks of mosquitos establishing in regional climates. It was important to consider how environments would changes from other climate initiatives (e.g. establishing greener spaces). UKHSA was reviewing emerging technology for automatic monitoring and tracking to ease the resource burden for surveillance activity.

24/045 There was interest in the surge capacity to respond to different threats including those from vector borne disease. This was complicated by the small number of highly expert teams understanding medical entomology or other threats. Further discussion in this area should consider availability of equipment and skills in other UK organisations and access to out-of-country resources alongside personnel.

24/046 The Chair and Director General, Science and Research would discuss an appropriate time for deeper discussion with the Advisory Board on vector borne disease threats, picking up on the points as raised by the Advisory Board. (Action: Ian Peters / Isabel Oliver)

24/047 The challenges with surge capacity building from small, expert teams, were regarded as similar to those which the Board observed across the Chilton specialist areas.  A UKHSA wide review of this challenge and response capability would be brought to a future Board.

(Action: Jenny Harries)

6. Pathogen Genomics Strategy and Programme update

24/048 The Chief Medical Advisor introduced the paper on UKHSA’s Pathogen Genomics Strategy and cross-agency programme (enclosure AB/24/016). The COVID-19 pandemic had demonstrated the real-time impact to public health of pathogen genomics with UKHSA’s capacity and potential well established.

24/049 UKHSA identified the main areas of challenge to progress its pathogen genomics activities:

• demonstrating value for money. Formal evaluations would be built into programmes to show the impact of genomics activity;
• workforce transformation, which would include upskilling the overall workforce in using genomics data, and providing career pathways with opportunities to diversify skillsets;
• the ability to operate as part of the global genomics community which would maximise investment through sharing data at scale;
• laboratory transformation; and
• unconfirmed budget for 2024-2026.

24/050 It was recognised that the aims of the pathogen genomics strategy could not be achieved without processing of data. UKHSA’s focus was to centralise functions and drive efficiency of data capabilities.

24/051 The Advisory Board noted the published genomics strategy and the formation of the new genomics programme.

24/052 Discussion followed as below:

• the Pathogen Genomics Strategy detailed work in a specific area and linked with overarching strategies such and Science Strategy, Data Strategy and Global Health Strategy;
• there was value in clarifying pathways to collaborations through linking specific partners with specific pathogens. UKHSA remained confident in strong networks of the genomics programme;
• the cost-benefit analysis could be challenging where UKHSA did not control levers for delivery and there is not a single point cause and effect. There was positive progress in value from reactive genomics with the intention to expand systemic evaluation for longer term and proactive opportunities;
• UKHSA remained close to academia to scan the opportunities of leveraging artificial intelligence tools for analysing data; and
• Quality assurance was in place to mitigate bias including ISO accreditation to produce clinically reliable evaluation results.

24/053 Metagenomics is regarded as a breakthrough application especially in collaboration with the NHS.

24/054 It was suggested that the Equalities, Ethics and Communities Committee could discuss ethics in relation to the genomics programme and use of data. A discussion would be scheduled for a future meeting.

24/055 A further update on the programme would return to the Advisory Board before the end of the year, with a specific update on metagenomics and funding.

7. Advisory Board Committees

7.1 Audit and Risk Committee

24/056 The Advisory Board noted the minutes of the Audit and Risk Committee meeting on 18 January 2024 (enclosure AB/24/017). The March meeting discussed year-end finances and the planned audit approach for 2023/24. The financial control improvement plan was dovetailing into the year-end process and embedding improvements into daily activity.

7.2 People and Culture Committee

24/057 The Advisory Board noted the minutes of the People and Culture Committee meeting on 31 October 2023. The February meeting discussed bringing recruitment in house, the people functionality available from the Money and People Services (Oracle) system, for which urgent approval of the business case for investment is needed, and the developing leadership framework. The freedom to speak up discussion had reassured the Committee on serious approach to addressing bullying, harassment and discrimination.

7.3 Science and Research Committee

24/058 The Advisory Board noted the minutes of the Science and Research Committee meeting on 8 November 2023. The February meeting had discussed artificial intelligence, scientific workforce and pathogen prioritisation.

8. Questions from members of the public

24/059 No questions were received from members of the public. ##Forward Look

24/060 The Advisory Board noted the topics for future meetings (enclosure AB/24/020).

9. Associate non-executive member appointments

24/061 Simon Blagden departed the meeting room for discussion of associate non-executive member extensions (enclosure AB/24/021). Marie Gabriel and Raj Long were absent having provided apologies for the meeting.

24/062 The Advisory Board approved the extensions as below:

• Marie Gabriel for a two-year extension to 24 April 2026
• Raj Long for a two-year extension to 24 April 2026
• Simon Blagden for a one-year extension to 24 April 2025

10. Any other business and close

24/063 Thanks were noted to Oliver Munn for his valuable contributions to the UKHSA Advisory Board and agency modernisation and collaboration.

24/064 There being no other business, the meeting closed at 3:09pm.